The first six months after the end of treatment for colorectal cancer are likely to be emotionally difficult. In addition to the sense of joy and elation, there is also likely to be heightened anxiety and a sense of loss - possibly even depression. Your medical team has been a source of security - plus you've been taking action. Now you’re seemingly on your own.  Questions surface such as "What's next?", "How can I stay healthy?", “What if it comes back?”

To help cope, consider the following time tested ideas, each of which are discussed in other sections of this article:

• Give yourself a break. You deserve it.
• Talk – with your spouse or significant other, family, friends, possibly even co-workers. 
• Find and talk with a colorectal cancer buddy. 
• Consider joining a support group or a self help group. 
• Consider getting a pet.
• Decide how to define your self going forward.
• Do something life affirming.
• Keep humor in your life.
• Use whatever worked for you in the past. to get you through difficult times.

If emotions interfere with life, speak with your doctor or reach out to a mental health professional with experience in helping people cope with a life changing health condition. (See “To Learn More”). If the holidays are approaching and you are having a difficult time emotionally related to colorectal cancer, learn how to cope by clicking here.

Challenges don't end just because a treatment does. Although the acute phase has ended, a new set of challenges appears as you move from treatment to recovery mode.

• It is not unusual to feel abandoned and to grieve the withdrawal of the safety net which was provided by constant contact with the treatment team and with your caregivers who have returned to their lives. In fact, you may even be impatient with family and friends who expect you to be back to normal the moment treatment ends (or at least somewhat soon after the end of treatment).
• It is common to feel anxiety about whether your colorectal cancer will come back. This is known as "fear of recurrence." It is also known as the "Damocles Syndrome" because of a feeling that there is a sword hung by a thin string over your head just like Damocles. This is particularly to be expected when a medical checkup is scheduled or you get physical symptoms such as a cold.
• Tears may flow at unexpected times for no apparent reason. Sadness and depression are not unusual. Neither is anger about having cancer.
• People who have survived treatment with relatively few side effects have also reported feeling guilt - especially people who were close to other people who had a difficult time with the same treatment or who died.
• Some people start doubting whether they took the right treatment or whether it was worth it. Refocusing on the present and doing what you can to make the future better is an antidote to this kind of thinking.
• It is not unusual to feel out of place or alone in a world of healthy people, particularly if you have an ostomy. It is likely that colorectal cancer caused you to look at death, perhaps for the first time. The experience likely changed your perspective and what is important to you.
  • People can be off putting in what they say about your cancer experience.
  • Everyday topics may bore you. What other people see as problems may be trivial to you.
  • It is likely that colorectal cancer caused you to look at death, perhaps for the first time. The experience likely changed your perspective and what is important to you.
• People don't give you room to recover. Family and friends expect you to be joyful and happy about finishing treatment. They expect you to be back to the same person you were before your diagnosis.
• The prospect of each doctor’s appointment and test can bring up major anxiety.
• It is easy to feel overwhelmed by the return of all the life, relationship and financial problems that were put on hold because of your focus on your illness.
• Some people even experience Post-Traumatic Stress Disorder (PTSD).

Just as it takes time to heal physically after treatment, it may take even longer to heal emotionally. The esteemed psycho-oncologist Dr. Julia Rowland suggests that, as a general rule of thumb, it will take at least as long to heal emotionally as the period of time from when you were first diagnosed until the end of treatment. It may even take longer.

Will you ever feel "normal" again? Yes. In fact, many people report that their lives feel even more full after living through cancer treatment because of a new value on each moment.

For information about the emotions and feelings that may surface, and what to do about each of them, see the documents in “To Learn More.”

The best way to get through this period is to express your feelings. There are a variety of ways to do that.

Family and Friends

Talk with family, friends, with sympathetic co-workers. (Keep in mind that, unlike employers, co-workers are not legally required to keep your personal information confidential. For more information, see our document about disclosing your condition to co-workers and your legal rights under the Americans With Disabilities Act.)

Colorectal Cancer Buddy

Consider talking with another person who is going through the same thing you are or who has been there. We call such a person a Cancer Buddy.

You can find a cancer buddy through your cancer doctor, cancer support center or such disease specific nonprofit organizations as Colon Cancer Alliance, Tel.: 877.422.2030

Support Groups and Self Help Groups

Consider talking with other people in a similar situation in a support group or a self help group. In addition to the support, you are likely to learn practical information.

The group can meet in person, on the telephone or even on line. Support groups have been proven to be good for emotional health, and possibly even physical health.

You can find colorectal cancer support groups through the following non-profit groups which are listed in alphabetical order:

•  American Cancer Society
• Cancer Care
• Cancer Support Community  (formerly The Wellness Community and Gilda's Club Worldwide)
• Colon Cancer Alliance www.ccalliance.org , Tel.: 877. 422.4030

For self help groups see: Self Help Groups.

If you are a young man or woman, other sources include:

• I'm Too Young For This! Cancer Foundation, see: www.I2Y.org
• Planet Cancer, see: www.PlanetCancer.org
• Ulman Cancer Fund For Young Adults, www.Ulman.org

Writing And Creative Activities

Many people find comfort in being creative or by writing their thoughts or creating art.

Writing doesn't have to be in a bound journal. It can be on pieces of paper you keep in a file, or on your computer.

You don't have to share your writing or other means of expression with anyone to get a benefit.

Religion And Spirituality

Colorectal cancer brings an awareness of mortality for most people. Suddenly life seems as short as it is - no matter how long it is.

If you haven't done so already, turning to religion or spirituality can help. Most clergy people will speak with you even if you do not belong to their congregation or religion.

This may be a time to renew your connection with a religion or spiritual practice. If you are not sure how to proceed, shop around. Talk with friends. Read. Speak with clergy in different houses of worship. Speak with clergy in different religions if you are open to a change.

NOTE: Especially during the first year after treatment, it is not unusual for anxiety and fear of recurrence to surface before doctor appointments and while waiting for test results. This type of anxiety may continue for a very long time. There are techniques available to help you through these periods.

For more information about this subject and the other subjects in this section, see "To Learn More."

Use whatever strategy has helped you get through treatment and otherwise get through life.

A few examples of what has worked for other people may help trigger thoughts about what has worked for you in the past:

• Kristy irons naked.
• Jamie cleans when she starts to feel overwhelmed by emotion.
• Terri created a corner of her home that felt sacred. Such a apace may only have a candle or some fresh flowers. She spent about 10 minutes a day being there - taking deep breaths, giving herself pep talks, and saying prayers.

Talk with a professional mental health therapist who has experience working with people after cancer treatment if any of the following happen: 

• You feel like you're getting stuck emotionally.
• You have trouble sleeping.
• You are frequently teary or upset for no reason.
• Your weight continues to fluctuate.
• You lost interest in your usual activities and friends.
• You fixate on your cancer experience.
• You think you need it.

Check your insurance to see if mental health is covered. If it is, what are the limitations and restrictions?

NOTE: Especially during the first year after treatment, it is not unusual for anxiety and fear of recurrence to surface before doctor appointments and while waiting for test results. This type of anxiety may continue for a very long time. There are techniques available to help you through these periods.

For more information about this subject and the other subjects in this section, see "To Learn More."

Your body and emotions have been through a difficult time. Do not expect to be up to speed physically or mentally right away.

Pamper yourself. For example, consider a massage, hot tub, fresh flowers, or a night out.

Try to get some relaxation and rest. What is relaxing and restful is different for each person. For some people, it can be walking on a beach or in the woods. For some people, it is cleaning out the drawers. You know what has been relaxing and restful for you in the past. Build it in to your life.

If you have a spouse or significant other, consider taking a trip, or perhaps two trips. The first trip would just be to unwind after the treatment and to take time reconnecting with each other. The second trip can be a bonus for getting through treatment.

NOTE: If you decide to travel, the documents in "To Learn More" provide information about how to choose a destination and make appropriate preparations to help keep you healthy and provide information about what to do in case there is a medical emergency.

Studies indicate that pets are good for your emotional health. As noted in our medical care section, pets may possibly even be good for your  physical health.

The pet doesn't have to be a dog or cat. Look for a pet that fits your lifestyle and budget. The document in "To Learn More" not only tells you how not to get sick from your pet, it also includes such practical information as how to travel with a pet and whether to get pet insurance.

People who have lived through colorectal cancer suggest doing something life affirming such as planting a tree, or perennials in the spring, or bulbs in the fall.

Start a project that will take a long time to complete.

Some men and women even go back to school. (You cannot be discriminated against because of your health history. To learn more, see: Americans With Disabilities Act). CancerForCollege.org provides college scholarships to current and former cancer patients.

Most people report being anxious in the days and hours before medical appointments and exams, especially those that are made as a result of a call about symptoms.

If you call with a question about a symptom, and the office takes the symptom seriously, keep in mind that the office is just playing it safe.

To help cope, consider techniques noted in the documents in "To Learn More" about coping with stress and anxiety.

It may help if you take a friend with you to appointments.  (A friend also helps raise questions during appointments and recall what is said afterward). At the least, let friends know you are anxious before appointments and would appreciate their checking in on you.

NOTE: Prior to medical appointments, you can help make effective use the time if you:

• Keep track of your symptoms. See Survivorship A to Z's Symptoms Diary to help. (With the click of a button, an easy-to-read graph is created that you can take with you to the doctor.)
• If tests are likely to be ordered during the appointment, find out if you can schedule them ahead of time. This way you can discuss the results when you are with the doctor instead of over the telephone. This technique also avoids an additional stressful waiting period.

For more information, see the documents in “To Learn More.”

It becomes important how you define yourself. The word "survivor" means different things to different people. The word(s) you use help you process what has been happening and where you are. The word(s) also help define you in the world. Keep in mind that you are a person who had colorectal cancer. Colorectal cancer was and is not your life. It is not your life today. You are not your disease.

If you need help, consider speaking with a professional therapist, or a clergy person.

See the articles in "To Learn More" for information about:

• The concept that you are not your disease 
• How to choose a mental health professional.

Do not be surprised if you feel overwhelmed. This period can be particularly emotional – filled with obsessive worry, sleeplessness, and lack of concentration.