Scottsdale, Arizona - I was talking with a young cancer survivor recently about transitioning back to a new routine as her treatment was ending.

She brought up something that isn't always easy to do — speaking honestly with your friends. She told me she'd been a marathon runner and her friends had invited her to participate in one within the next two months.

She wondered how to react when her friends said she looked great, but she still felt tired and exhausted. There was no way she could run a marathon that soon.

I realized what a difficult situation this is for survivors. People may have unrealistic hopes for you, which is a setup for failure.

My suggestion was to be open and honest. I reassured her it's OK to admit you're still healing and your energy level isn't what it what it was before.

We talked about other ways in which she could be involved with the marathon, by going along and cheering on her friends. This would let her connect with them and the marathon experience.

Friends and family need to remember that life doesn't always return to normal after treatment. Open and honest communication isn't as easy as it sounds. Finding the right words may seem a bit awkward at first. Here are a few ideas that might help:

• Communicate your current status honestly — like this example. "I'm just finished with treatment and so happy to be back at home again. But, I still need time to heal and get my energy back, so I might not be able to do everything I'd like to do."
• Tell people what you need — for example, you might connect with a friend or family member who's offered to help by asking them to pick up groceries, make dinner together or run an errand.
• Reach out to family and friends — touch base with those you've missed while undergoing treatment. Suggest an outing that works for your schedule and energy level. It's so important to give and receive the positive energy that social outings provide. This creates a new sense of normalcy that takes you away from the stress of being a patient.

Once you're comfortable with the idea that it's OK to be open and honest, it will become easier.