Hester Hill Schnipper Photo Courtesy of Beth Israel Deaconess Medical Center

IT CAN BE FRIGHTENING to think about the future. People diagnosed with cancer may wonder whether they even have a future—and if so, how long it might last. Many with cancer say they are unwilling to buy a new coat or think about a summer vacation. Some have superstitions about inviting bad karma. More rationally, they are concerned about spending money they might need elsewhere. These anxieties strike people with a likely curable cancer as well as those living with advanced disease.

There is a great deal of discussion about the value of living in the moment, appreciating each day as it comes and trying not to worry about next month or next year. But it is important to believe in the future and to allow yourself to plan ahead in positive ways. Here are some suggestions:

1) Unless and until you have been told time is limited, try to live as though all is well. If trouble is looming, you will have to deal with it when the time comes. There is no benefit either today or for the future in allowing those fears to contaminate the present moment.

2) Break the future into smaller chunks. If you have scans every three months, plan your time in 90-day blocks.

3) Shop as usual. If you always buy a new bathing suit in April, continue to do so.

4) Even if you are being treated and are never sure how you will feel, continue to accept appealing invitations. Your friends will understand if you have to cancel.

5) If you are worried about a side effect or a symptom affecting your plans, figure out how to manage it. For example, if you know you need extra time in the bathroom in the morning, just schedule your activities a little later. Don’t cancel them.

6) Continue your normal social traditions. If you host Thanksgiving dinner every year, consider asking others to bring part of the meal or ask if someone else can take primary responsibility for the event. The important thing is to plan Thanksgiving and adapt it as necessary, but expect to be present and hungry.

7) Go ahead and think about your next vacation. Planning and anticipation are always part of the pleasure. Even for people without health concerns, it may be smart to buy trip insurance. If you are worried about having an emergency away from home, think about purchasing medical evacuation insurance. Of course, it is important to speak with your doctor about restrictions on your travel; usually there are few.

8) Identify important events in your future such as a birthday, a graduation or a wedding. Include all the details in your dream for the day: the location, the weather, what you will be wearing. Afterward, keep a photograph of the event on your desk or dresser. Whenever you worry about the next occasion, look at the photo and remind yourself that you were worried about that one too, and you were there.

9) Never let your calendar be empty. If necessary, plan in pencil, but keep planning.

Hester Hill Schnipper, a licensed independent clinical social worker, is a breast cancer survivor who served as the manager of oncology social work at Beth Israel Deaconess Medical Center in Boston.