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The following information has been provided with the kind permission of the National Cancer Institute.
What is Normal After Cancer Treatment?
Congratulations on Finishing Your Cancer Treatment! Ending cancer treatment can be both exciting and challenging. Most people are
relieved to be finished with the demands of treatment, but many also feel
sadness and worry. Many are concerned about whether the cancer will come back
and what they should do after treatment.
When treatment ends, people often expect life to return to the way it was
before they were diagnosed with cancer. This rarely happens. You may have
permanent scars on your body, or you may not be able to do some things you once
did easily. Others may think of you–or you may view yourself–as being somehow
different.
After you’ve finished your cancer treatment
This information designed mainly for cancer survivors who
have recently completed their cancer treatment, but you may find the information
helpful even if you were treated a long time ago. The purpose of this
information is to give cancer survivors and their loved ones a better idea of what to expect
during the first few months after treatment ends. It covers what may happen
with:
- Your medical care
- Your body
- Your mind and your feelings
- Your social
relationships - Practical matters such as job and insurance issues
As you’ll see,
this information talks about many concerns of those who have been through cancer
treatment and offers suggestions that have helped others move forward. As you
read, you may find yourself saying, “That’s just how I feel.”
Although this information describes issues that are important to many survivors,
each person has a unique response to having cancer. While some of the issues
covered may reflect your experience well, other issues may not
concern you. Focus on finding what works for you. The information is not intended to be all-inclusive. Resources are provided
at the end of the article if you need
more information on a given topic or one that is not included. We encourage you
to be active in getting the information and support you need.
It is natural for anyone who has finished cancer treatment to be concerned
about what the future holds. Many people worry about the way they look and feel
and about whether the cancer will come back. Others wonder what they can do to
keep cancer from coming back. Understanding what to expect after cancer
treatment can help survivors and their families plan for follow-up care, make
lifestyle changes, stay hopeful, and make important decisions.
All cancer survivors should have follow-up care. But you may have a lot of
questions about getting the care you need now, such as:
- Whether to tell the doctor about symptoms that worry you
- Which doctors to see
after treatment - How often to see the doctor
- What specific tests you need
- What
you can do to relieve pain and other problems after treatment - How long it will
take for you to recover from treatment and feel more like yourself
Dealing with
these issues can be a challenge. Yet many say that getting involved in decisions
about their future medical care and lifestyle was a good way for them to regain
some of the control they felt they lost during cancer treatment. Research has
shown that people who feel more in control feel and function better than those
who do not. Being an active partner with your doctor and getting help from other
members of your health care team is the first step.
This next section offers some guidance on working with the people who provide care
after treatment. It describes the kinds of help you may need and provides tips
for getting what you want out of your medical visits. Reading this section can
also help you create a plan of action for your recovery and future health.
QUESTION
Cancer is the result of the uncontrolled growth of abnormal cells anywhere in the body.
See Answer
What is Follow-Up Care?
The main purpose of follow-up care is to check if your cancer has returned
(recurrence) or if it has spread to another part of your body (metastasis).
Follow-up care can also help in:
- Finding other types of cancer
- Spotting side effects from treatment now or
that can develop years after treatment
Follow-up care means seeing a doctor to
get regular medical checkups. At these visits, your doctor will:
- Review your medical history
- Examine your body
Your doctor may run follow-up
tests:
- Imaging procedures (ways of producing pictures of areas inside the body)
- Endoscopy (the use of a thin, lighted tube to examine organs inside the body)
- Blood tests
Follow-up care can also include home care, occupational or
vocational therapy, pain management, physical therapy, and support groups.
Which Doctor Should I See and How Often?
You will need to decide which doctor will provide your cancer follow-up care
and which one(s) will provide other medical care. For follow-up cancer care,
this may be the same doctor who provided your cancer treatment. For other
medical care, you can continue to see your family doctor or medical specialist
as needed.
Depending on where you live, it may make more sense to get cancer follow-up
care from your family doctor than to travel long distances to see an oncologist.
No matter whom you choose as a doctor, try to find doctors you feel comfortable
with.
At your first follow-up visit, ask your doctor to recommend a follow-up
schedule. In general, people who have been treated for cancer return to the
doctor every 3 to 4 months during the first 2 to 3 years after treatment, and
once or twice a year after that for follow-up appointments. Some medical
organizations also have follow-up guidelines for certain cancers and update this
information as researchers develop new approaches to follow-up care.
Follow-up care will be different for each person who has been treated for
cancer, depending on the type of cancer and treatment he or she had and the
person’s general health. Researchers are still learning about the best
approaches to follow-up care. This is why it is important that your doctor help
determine what follow-up care plan is right for you. Lastly, it is important to
note that some insurance plans pay for follow-up care only with certain doctors
and for a set number of visits. In planning your follow-up care schedule, you
may want to check your health insurance plan to see what restrictions, if any,
apply to your follow-up care after cancer treatment.
Keep in Mind
Some people may suspect that their cancer has returned, or they notice other
changes in their bodies. It is important for you to be aware of any changes in
your health and report any problems to your doctor. Your doctor can find out
whether these problems are related to the cancer, the treatment you had, or
another health problem. Even if you learn that your cancer has returned, there
is no reason to lose hope. Many people live good lives for many years with
cancer that has returned.
Do You Have Trouble Talking to Your Doctor
It is not always easy to talk with your doctor. Sometimes, he or she uses
terms you do not know. When this happens, it is important to stop and ask the
doctor to explain what the words mean. You may be afraid of how you will sound
to the doctor, but having questions is perfectly normal.
Talking with your doctor is important. Both of you need information to manage
your care. Telling the doctor about your health and asking questions helps both
of you do your “jobs” well. Here are some points to cover.
At your first follow-up visit, ask your doctor/health care team about:
- The tests and follow-up care you need, and how often you will need them.
- The
kinds of physical problems you may have from your cancer treatment and what you
can do to prevent, reduce, or solve them. T - he potential long-term effects of
treatment and the warning signs that you might have them. - The warning signs that
cancer may be coming back and what to do if you see them. - Fears you may have
about follow-up care.
Keep in Mind
Many survivors want to learn about symptoms that may indicate their cancer
has come back, or recurred.
There are many types of symptoms that may show if cancer has returned, and it
depends on each person, the kind of cancer she/he was treated for, and the kind
of treatment he/she had.
It is for this reason that you should talk to your doctor about the signs or
symptoms that you should watch for and what you should do about them.
At each visit, tell your doctor/health care team about:
- Symptoms that you think may be a sign of cancer’s return.
- Any pain that
troubles you. - Any physical problems that get in the way of your daily life or that
bother you, such as fatigue, trouble sleeping, loss of sex drive, or weight gain
or loss. - Other health problems you have,
such as heart disease, diabetes, or arthritis. - Any medicines, vitamins, or herbs
you are taking and any other treatments you are using. - Any emotional problems you may have, and any
anxiety or depression you have had in the past. - Any changes in your family medical history.
- Things you
want to know more about (such as new research or side effects).
Your health care
team should be able to help you or refer you to someone who can help with any
side effects or problems you may have. You have a right to get the help you
need.
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Complementary and Alternative Medicine
Complementary and alternative medicine includes many different healing
approaches that people use to prevent illness, reduce stress, prevent or reduce
side effects and symptoms, or control or cure disease. An approach is generally
called complementary when it is used in addition to treatments prescribed by a
doctor. An approach is often called alternative when it is used instead of
treatments prescribed by a doctor. Research has shown that more than half of all
people with cancer use one or more of these approaches.
Some common approaches include: visualization or relaxation; acupressure and
massage; homeopathy; vitamins or herbal products; special diets; psychotherapy;
spiritual practices; and acupuncture.
Even though you have finished your cancer treatment, if you are thinking
about using these methods, discuss this decision with your doctor or nurse. Some
complementary and alternative therapies may interfere or be harmful when used
with treatments normally prescribed by a doctor.
How do I develop a wellness plan
After cancer treatment, many survivors want to find ways to reduce the chances
of their cancer coming back. Some worry that the way they eat, the stress in
their lives, or their exposure to chemicals may put them at risk. Cancer
survivors also find that this is a time when they take a good look at how they
take care of themselves and their health. This is an important start to living a
healthy life after cancer.
When you meet with your doctor about follow-up care, you should ask about
developing a wellness plan that includes ways you can take care of your
physical, emotional, social, and spiritual needs. You may not be used to talking
with your doctor as a partner in planning for your health, so it may be hard for
you at first, but it is very important that you do it. The more you do it, the
easier it will become.
Research is just beginning to show what people can do to lower their risk of
getting certain cancers. But we don’t yet know why cancer comes back in some
people and not others.
Making changes in the way you eat, exercise, and live your life may not
prevent your cancer from coming back. However, making these changes can help you
feel better and may also lower your chances of developing other health problems.
Changes you may want to think about:
- Quitting smoking. Research shows that smoking can increase the chances of
developing cancer at the same site or another site. For more, please read
the Smoking and Quitting
Smoking article. - Cutting down on how much alcohol you drink. Research shows that drinking
alcohol can increase your chances of developing certain cancers. - Eating well and exercising.
Eating Well After Cancer Treatment
- Eat a variety of healthful foods, with an emphasis on foods from plant
sources.
- Eat five or more servings of vegetables and fruits each day.
- Choose whole grains–rather than processed (refined) grains and
sugars.- Limit eating red meats, especially high fat or processed meats.
- Choose foods that help you maintain a healthy weight.
- Adopt a physically active lifestyle.
- Maintain a healthy weight throughout the rest of your life.
- Limit drinking alcohol, if you drink at all.
Source: American Cancer Society Recommendations for Nutrition
and Physical Activity for Cancer Prevention, 2002
Exercise After Cancer Treatment
Few studies have been done to find out whether physical activity affects
survival after cancer treatment. More research is needed to answer this
question, but studies have shown that moderate exercise (walking, biking,
swimming) for about 30 minutes every–or almost every–day can:
- Reduce anxiety and depression
- Improve mood
- Boost self-esteem
- Reduce symptoms of fatigue, nausea, pain, and diarrhea
During recovery, it is important to start an exercise program slowly and
increase activity over time, working with your doctor or a specialist (such as a
physical therapist) if needed. If you need to stay in bed during your recovery,
even small activities–like moving your arms or legs around–can help you stay
flexible, relieve muscle tension, and help you feel better. Some survivors may
need to take special care in exercising. Talk with your doctor before you begin
any exercise program.
For additional information, please visit the Cancer
Center.