Cancer Survivorship After Treatment

The day cancer treatment ends, a new chapter in life begins. While some survivors leave cancer behind and move forward with few problems, others might experience physical or emotional effects. Some of these effects may start during cancer treatment and continue long-term. Some aftereffects or late effects of treatment can appear months or even years later.

Cancer survivorship includes the physical, emotional, and day-to-day issues of the cancer journey. Survivorship begins at the time of diagnosis and continues during and after treatment. When treatment is completed, survivorship needs include follow-up health care and getting help with any emotional and physical late effects of cancer or treatment. A Survivorship Care Plan helps to ensure the best possible follow-up care and quality of life. This includes working with your doctor to plan and get recommendations for future cancer screening, prevention and healthy living choices.

Read LIVESTRONG.COM Cancer Advisor Andy Miller, MHSE, CHES' guide on what to do after cancer treatment.

Physical Effects
Not all survivors experience long-term or late physical effects of cancer treatment. Your doctors cannot always predict if, or when, late effects will occur. In the past, treatments for many types of cancer were more severe than today.

If you experience physical effects, they may be different than those of other survivors you know. Much depends on the type of cancer and the treatment received. Some physical effects, such as anemia or fatigue, might improve or go away with time. Other physical effects may be permanent, such as certain types of nerve damage.

Ask your doctor if there are late effects that could occur with your type of cancer or treatment. This information will help you, and those close to you, to know what to watch for. In most cases, the earlier late effects are identified, the easier they are to treat.

Emotional Effects
Survivors often experience a mix of emotional reactions after cancer treatment is completed. Some emotions feel positive, such as a sense of gratitude and renewed wonder about life. You may feel good about personal strengths that were discovered during treatment. There may be deepened relationships with loved ones and friends. Sometimes there is a renewed commitment to get the most out of life and a desire to meet new goals.

Survivorship can also include confusing feelings that do not feel positive. Some survivors describe the period after cancer treatment as one of the most emotional times of their lives. You may find more time to think about things that you did not have time to consider during treatment. It can be a surprise to discover uncomfortable thoughts and unanswered questions.

Survivorship issues may include worry about the unknowns of the future. Some survivors have mixed feelings when they are no longer actively receiving cancer treatment. You could feel a loss of connection from the healthcare team members who guided and supported you through your cancer diagnosis and treatment.

Sometimes, loved ones, friends and healthcare team members are ready to celebrate the victory of beating cancer before you feel ready to do so. It might be hard for others to understand the emotional stress that completing cancer treatment can bring. This can feel like pressure to get on with your life, and it can be difficult to deal with these types of feelings if those close to you think you should be celebrating. Talking with others about how you are feeling can help them better understand your experience.

Acknowledging your concerns about the cancer experience can be a first step in finding ways to manage survivorship issues. You may find that it is helpful to discuss these issues with other survivors. The emotional impact of cancer and treatment is likely to lessen as other life events begin to take up more of your time after treatment. However, it is possible that certain dates or events cause you to again think more about the cancer experience. Talk with your doctor if strong emotions continue to affect your life, such as anxiety or depression. You can ask for a referral to a licensed counselor or oncology social worker to get help finding ways to treat and deal with your concerns.
More on Cancer and Emotional Support

Other Survivorship Issues
Survivorship issues sometimes affect other areas of life after cancer treatment. Support services can help you deal with physical, emotional and day-to-day issues, such as:

Difficulty on the job or in school
Changes in relationships with loved ones, friends or coworkers
Loss of self-esteem
Concerns about body image changes
Problems getting health or life insurance coverage
Stressors related to financial issues

You may experience changes in personal beliefs, priorities or values during the cancer journey. Sometimes survivors feel angry or question spiritual beliefs because of the experience of living with cancer and uncertainty. Consider talking with loved ones, friends, other cancer survivors or a member of your faith-based group to find ways to manage changes. Keep in mind that you can also ask your doctor for a referral to a healthcare professional, support group or nonprofit cancer organization for help. You do not have to deal with survivorship issues without support from others.

Survivorship Care Plan
After cancer treatment is done, work with your doctor to develop a Survivorship Care Plan. This is a plan for wellness that can help ensure that you continue to receive the best health care possible. It includes important information about your medical experiences to be shared with your current and future health care team members. Be sure to keep a copy of your plan, and to also give a copy to each of your doctors.

Your Survivorship Care Plan should include the following information about you:
Medical history with dates, past health problems, diagnoses, treatments and results
Cancer treatment summary with dates, information about cancer treatments, aftereffects and results
Health care follow-up plan with recommendations and schedule for future exams, screenings and tests

Talk with your doctor about things you can do to maximize your health, such as:
Avoiding tobacco products and excessive alcohol use
Being physically active and reducing stress
Eating the right foods
Maintaining a healthy weight
Protecting skin and eyes from exposure to ultraviolet radiation, such as from the sun and sunlamps
Avoiding known risk factors, such as asbestos and certain chemicals
Getting regular medical and dental care

As you move forward with life after treatment, keep your healthcare team informed about concerns, such as pain or symptoms of a new or recurring cancer. Ask your doctor to help you or refer you for assistance with physical, emotional and day-to-day challenges. Many nonprofit cancer organizations, government agencies and health care providers offer excellent resources and services to help with survivorship needs.

Additional Sources of Information:
Cancer.Net: www.cancer.net
Centers for Disease Control and Prevention (CDC): www.cdc.gov/cancer
Lance Armstrong Foundation (LAF): www.livestrong.org
National Cancer Institute (NCI): www.cancer.gov
The Wellness Community: www.thewellnesscommunity.org


For more information about survivorship issues, visit the Lance Armstrong Foundation.