1. Harpham, Wendy S. MD, FACP

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This handout introduces the updated term new normal for now and discusses the ideas behind it. Feel free to share it with patients dealing with a new diagnosis, side effects or aftereffects, or metastatic disease. You'll be sending a message that creating a new normal for now can help them regain a sense of control and nourish hope of a better tomorrow (see Oncology Times 2019;41(19):12).

Wendy S. Harpham, MD... - Click to enlarge in new windowWendy S. Harpham, MD, FACP. WENDY S. HARPHAM, MD, FACP, is an internist, cancer survivor, and author. Her books include

The Healing Power of a New Normal for Now

Dear Patient,


During and after cancer treatment, life may feel "not normal." This handout explains how creating a new normal for now may help you deal with unwanted changes in healthy and hopeful ways.


Why might life feel not normal now?

Life feels normal when, for the most part, (1) your experiences match your expectations and (2) your routines help you get through the day. After cancer, differences between the way your life used to be and the way it is now can cause life to feel not normal.


Why is it important for life to feel normal?

You need a sense of normalcy to help manage the demands of life. If what happens usually matches your expectations, you can better prepare for tomorrow and minimize unpleasant surprises-both of which help decrease anxiety. If your routines fit your current circumstances, your days go more smoothly. That increases your confidence and saves energy, both physical and emotional.


What is the new normal for now?

The idea of a new normal for now refers to ALL the changes taken together, including...


* Physical changes (e.g., pain; fatigue; loss of a body function; insomnia; menopause)


* Emotional changes (e.g., fear of recurrence; altered self-image; sadness; sense of urgency)


* New routines for managing life as it is now (e.g., checkups; medications; therapy sessions; naps)


* Life lessons learned through illness (e.g., changed priorities; increased empathy)


* Changed relationships; new relationships (e.g., damaged or enriched friendships; new survivor buddies)



After cancer, it's challenging to deal with the unwanted changes thrust on you. The empowering and hopeful part of your new normal for now is that it is much broader than only those unwanted changes. It also includes your responses to them. We're talking about the new rules, routines, and skills you develop to make life better. In addition, your new normal includes good things that came out of your unwanted illness, such as increased gratitude for today and healing relationships that developed because of your illness.


Many people talk about a new normal after cancer. We encourage you to use the complete phrase, new normal for now. This emphasizes that we are talking about the next few weeks or months, and not necessarily forever after. Keep in mind that what's normal keeps changing throughout life for everyone, with or without cancer.


How might the idea of creating a new normal for now help?

While facing unwanted changes, it helps many patients to...


* Manage expectations for now.


* Feel motivated to find the best ways, for now, to deal with those unwanted changes.


* Find hope for a better tomorrow.



While creating a new normal for now, you are in the driver's seat. For starters, you can choose to follow new routines that decrease your stress and increase the chance for the best outcome. For example, if you are dealing with fatigue, you can rearrange your schedule to work around energy limits. You can pace yourself better and pursue helpful sleep and exercise measures. Over time, you'll benefit from both feeling better and minimizing fatigue-related mistakes, which cuts down your stress. In your new normal for now, you'll likely feel more in control and more hopeful of a better tomorrow.


In addition to making new routines, you can learn new techniques for dealing with challenges. You can find new, healing hopes that help you through the uncertainty.


What if you want to go back to your old normal?

That's perfectly understandable. For many patients, though, it's impossible. And acting as if nothing has changed can be dangerous.


Letting go of your old normal frees you to create your new normal for now. Still, letting go can be difficult, requiring courage, strength, support, and possibly professional guidance. It's normal to grieve the loss of things you liked about your old normal. It may help to remember that grief is healing and temporary, even if the loss is permanent. Meanwhile, take comfort in knowing that letting go of your old normal empowers you to make your life the best it can be.


How do you create your best new normal for now?

An essential step is to obtain sound knowledge. You need facts and insights about your challenges to determine your best responses. Even if you know everything there is to know, you can expect to go through trial-and-error while creating a new normal for now that works best for you. Please take advantage of reliable online resources, support groups, counselors, and other professionals such as physical and occupational therapists.


Why do some people dislike "the new normal"?

Sadly, some people mistakenly think the new normal means "living with unpleasant changes from now on." That hopeless-sounding definition is misleading because it...


* Misses the fact that we're talking about "for now" (for the next weeks or, maybe, months), which nourishes hope of a better tomorrow.


* Doesn't include all the things under your control in your new normal for now.


* Neglects the silver linings you might be enjoying today.



What now?

A patient captured it well, saying, "Cancer splashed ugly streaks across the canvas of my life. It's up to me to fill in the rest." Ask yourself, "What do I want my life to look like?" To create your best new normal for now ...


* Keep us informed of changes and stresses in your life, including minor discomforts.


* Ask for referrals to resources that provide information and support.


* Find people who can support your grief as you let go of your old normal.



We support your efforts to create your best new normal for now, with hope of making life the best it can be today, tomorrow, and every day.