a person with cancer are protected by the Health Insurance Portability and Accountability Act (HIPAA). This law addresses pre-existing conditions, forbids discrimination against employees based on health status, and guarantees availability and renewability of health insurance coverage to certain individuals.
Follow Up CareCancer casts a long shadow. Anyone diagnosed with cancer lives with the possibility of recurrence. Although many women survive breast cancer and live out a normal lifespan, others do not. That is why each new pain or other symptom brings forth the fear of recurrence or metastasis until the symptom disappears or is found to be something other than cancer. Learning to live with uncertainty is part of recovery from cancer, and it is different for each individual. Healthcare providers can help reduce the fearand anxiety associated with cancer survivorship by providing practical information to patients. Self-efficacy is the confidence to produce desired effects by one’s own actions. In one study on breast cancer survivors, self-efficacy is defined as one’s confidence in the ability to manage symptoms and emotions related to having breast cancer, including the ability to ask for help, knowing how and when to report symptoms, and doing what is important after breast cancer treatments are completed. Overall, the study found women ages 45 or younger had greater fear of recurrence than older survivors, especially if their self-efficacy was low. By providing education, encouragement, and referrals to both support groups and reputable websites, nurses can help increase self-efficacy, which may help decrease fear and anxiety associated with recurrence risk (Ziner et al., 2012). Patients should be encouraged to focus on wellness—taking good care of body, mind, and spirit—by eating a healthy diet, getting enough sleep and exercise, paying attention to symptoms, and getting regular checkups. Wellness also includes grieving one’s losses, whether the loss of a breast, loss of a relationship, or loss of the sense of control. It means seeking supportwhen one needs it. Many women continue with a support group after treatment has ended. Others seek individual counseling and psychological support. Many women find further healing by helping others who are just starting on their cancer journey. The best outcome in the “new normal” for patients is a lifestyle that has changed to a healthier one and an attitude that has changed to one of ongoing appreciation where each day is viewed as a gift. Symptoms That Require Attention: When walking the tightrope between fear of recurrence and getting on with life, each new ache or pain can trigger anxiety. This is normal, but it can also be immobilizing. The American Society for Clinical Oncology (ASCO) recommends that patients see their doctor immediately if any of the following symptoms occur and/or persist: Chronic bone pain or tenderness (persistent), Skin rashes, redness, or swelling (persistent), New lumps in the breasts or chest, Changes in the breasts, Chest pain and any shortness of breath (persistent).