Yes, definitely, as long as you feel up to it, of course; i.e., if neither the tumor nor the side-effects of the therapy stop you from doing so. Fortunately, this favorable situation is common. Cancer does not prevent from having a normal life.
Then again, patients who are on adjuvant therapy have no visible disease, which means that any problems they may have can only be caused by the therapy itself. In a good 30-50% of patients, these therapies are well tolerated; in these circumstances, it is strongly advisable to continue as normal a life as possible.
Even patients in an advanced stage with metastases (stage 4) may be in excellent physical condition and can continue to carry out their normal everyday activities, including sport.
Indeed, having a couple of metastatic nodules of 1-2 cm in an internal organ will not generally cause symptoms; and the frequency of severe side-effects of treatment is usually fairly modest (5-20%).
However, it must be remembered that the psychological component plays a very important role. A patient may well feel very tired or unable to function properly both physically and mentally, regardless of the disease or the side-effects of treatment. In such cases, the general rule is that the patient should do as much or as little as she feels like doing.
A very delicate aspect concerns future plans regarding work when the patient has advanced disease and a limited life expectancy (6-12 months). In such cases we should be very careful not to discourage the patient from making plans, for at least three good reasons.
- Firstly, estimates of life expectancy are taken from the average values recorded in clinical studies; these values may not apply to that particular patient, who may still be alive and well after 2 or 3 years (CAN WE PREDICT HOW MUCH TIME IS LEFT?)
- Secondly, as we have already said, it is very difficult for doctors to predict how much time the patient has got left if the prognosis is not very short (from a few days to a few weeks) (ANTI-CANCER THERAPIES NO LONGER WORK)
- Finally, being able to plan for the future – even if it is not a distant future – may be of precious value to the patient. It is therefore always advisable to support patients in their future work plans.