Alberta Cancer Foundation

Ask the Expert: Cancer and relationships

How long was my colon tumour there before I developed symptoms?

It’s very hard to answer with confidence. Colon cancers typically start as benign polyps, small lumps of non-cancerous tissue extruding into your intestine. Over time the polyps become cancerous. “In many cases, although not all, the process for a benign polyp to become an invasive cancer can take a year, or even much longer,” says Dr. Jay Easaw, medical oncologist at the Tom Baker Cancer Centre. “Some patients develop symptoms from their cancer immediately. These can include pain, weight loss, nausea and blood in the stool, to name a few. Other patients may initially have no symptoms. In such situations, patients may develop symptoms only after the cancer has become quite large or has spread to other parts of the body.”

Easaw says that, rather than wondering about how long the tumour was there, now that you’ve been treated for colon cancer it’s more important to adhere to your followup appointments. In recent years, many colon cancer patients in Alberta were recommended for blood tests every three months, a CT scan at one and three years, and lifelong colonoscopies. But a study to see how people were adhering to these recommendations found only 7.2 per cent of patients were getting the suggested tests. Pharmaceutical leader Sanofi Canada partnered with the Alberta Cancer Foundation for a colorectal cancer surveillance research program, with grants to support the research over the next three years. The goal of the program is to reach 90 per cent adherence to followup guidelines with an aim to capture recurrences when a cure is still possible.

I feel like my friends don’t know how to deal with my cancer. How can I make it easier for them?

A cancer diagnosis can change your relationships, says Dr. Guy Pelletier, clinical psychologist at the Tom Baker Cancer Centre. “When you are diagnosed with this type of disease, you realize who can help you and who might not be able to.” It’s disappointing, but some people aren’t able to cope with a sick person. It may require you to distance yourself from them for a while.

For those who want to help, but have trouble knowing where to start, you can instigate a conversation with, “Gee, it’s great when you come by. I know it’s difficult sometimes, I really appreciate the support.” They’re worried about you and sometimes if you acknowledge that fact, it may be an ice-breaker that revamps the relationship.

Pelletier says it’s best to lower your expectations of loved ones because they’re likely overwhelmed by the high expectations they’ve placed on themselves. Some friends or family members think they should be making grand gestures and huge offering of help. “They feel they should be doing something for their sick friend,” Pelletier says, “They ask, ‘What am I doing? I should be able to do something! Can I clean your house? Can I take you to Mexico?’ ”

Take the pressure off your friends by telling them you don’t need a grand gesture, that a visit, just to chat, is enough. Pelletier says it’s more about being there for the patient that matters.
“If you have something concrete a person can help with (for example, shovel the sidewalks or mow the lawn), by all means, make the suggestion and see how your friend or family member responds,” he says. “But if you don’t really have anything that you want them to do, say, ‘I’d enjoy it if you came by and we had a cup of tea. It’s great to see people when you can’t get out of the house much.’ ”

There are various professionally-led cancer support groups to join, too. Cancer centres across the province have psychosocial resources available to support you and help you understand the changing nature of your friendships.

Ask our experts questions about general health, cancer prevention and treatment. Please submit them via email to letters@myleapmagazine.ca. Remember, this advice is never a substitute for talking directly to your family doctor.