Survivorship

Julia Canas

Julia Canas knows a thing or two about getting past cancer. She’d been a breast cancer survivor for 17 years when it recurred.

In the nearly two decades since she first experienced cancer at 36, Julia found it shaped her life positively. It propelled her to get a master’s degree in health education so she could advocate for others facing cancer. It motivated her to become a triathlete. It made carpe diem a lifestyle.

“I’m not sure I would have had the guts to do these things if it had not been for cancer,” she said. “I realized you need to seize opportunities and not say, ‘I want to do this’ but ‘I will.’”
 
Breast cancer runs in Julia’s family: her mother, grandmother, two great-aunts and a cousin all had it, which prompted Julia to be vigilant about screening. Both cancers were found early. With the latest bout, her surgeon recommended a bilateral mastectomy to eliminate the possibility of another recurrence.

Julia said she was unprepared for the slow and painful physical—and emotional—recovery from the surgery.

“My mastectomy has been different kind of challenge. I knew I wasn’t going to die from this cancer, which was my biggest fear the first time around,” the 53-year-old said. “But the physical challenges after mastectomy were greater. Even though I had worked with a lot of cancer patients, I was shocked by the way it impacted me.

“Frankly, there’s still a lack of communication between patients and surgeons and a lot of opportunity for greater discussion around dealing with the cancer experience. It was just treated like a procedure, something we needed to get done. I was never invited to a conversation about how I was feeling about it—nothing was said about loss, grief, self-image,” Julia said. “I’m a ‘pull yourself up by your bootstraps’ kind of person, but man, I was not prepared for it.”

Pain, a rubber band-like tightness across her chest, and limited use of her arm on the radiated side of her body prompted Julia to seek physical therapy at Seattle Cancer Care Alliance, where she began working as a patient and family centered care program coordinator in September 2010.

The work role gave Julia reason to utilize the Survivorship Program’s services.

“I felt the best thing I could do was to talk to everyone to find good resources for patients. Of course, the Survivorship Program is just unique, one of a kind. I took the opportunity to be seen as a patient and as an employee—it was a win-win.

“I was already seeing a physical therapist, so the Survivorship Clinic referred me to a nutritionist. No one had ever talked to me about nutrition in my cancer experience. Even though I’m well read in nutrition and cancer prevention, I learned so much,” she said.

Julia also found an outlet for discussing her feelings. “The Survivorship Program and physical therapy helped me heal emotionally. In the entire 17 years following my first diagnosis and in the past year, no other health care provider asked me about my emotional concerns.”

The Survivorship Program created a care plan for her, another first.

“I think for every survivor, one of the greatest fears is cutting yourself off from your health care provider when your treatment is over,” Julia said. “What do I do now? Through the Survivorship Clinic, you’re given the resources, the tools, the data to back up those things, that give you the confidence to move past cancer and a way to do it.”

Julia continues to do physical therapy, run and swim, and has set her sights on participating in another triathlon this year, a goal she first achieved after her initial cancer treatment.

“I was never an athlete—I was always the last person selected on any team. But something about my cancer diagnosis really caused me to become more proactive about my fitness and nutrition,” she said. “There are so many things in the cancer experience you can’t control. Exercise and nutrition were both things I knew if I made a commitment I could control. And if I had a recurrence, I wanted to know that I had done all I could. That mattered a lot to me.”

Cancer’s return didn’t lessen Julia’s belief in the importance of good self-care. “I truly believe there are no guarantees in life. I accepted that long ago,” she said. “But I’m vigilant about taking care of myself, and I know my ability to heal and return to work quickly was the result of me being in good health beforehand.”

With her body slowly healing, Julia is determined to spread the word about the Survivorship Program: “We need survivorship clinics everywhere. If I can be a conduit for getting the word out about this great program, you’d better believe I’m going to do it. Survivors deserve it. It’s about quality of life.”

Fred Hutchinson Cancer Research Center is a world leader in research to prevent, detect and treat cancer and other life-threatening diseases.