Your Health After Cancer Treatment
Your health after treatment may be different than it was before you started treatment, and you may find yourself having to manage problems you never had previously.
Some of the more immediate health issues people begin to encounter after cancer treatment ends are:
- Sleep Changes
- Cognitive Problems: Chemo-Brain
- Lymphedema: Pain and swelling in the arms, legs or trunk
- Nerve Damage (Neuropathy)
Some of these health issues may be short-term. Others may be health concerns you need to manage for the remainder of your life.
Maintain a Healthy Lifestyle
As you move beyond cancer, it is important to continue to maintain a healthy lifestyle. What does this mean?
- Don’t smoke. If you smoke, talk to your doctor about quitting.
- Get proper nutrition. A healthy diet will help you keep off pounds. This is important because studies have shown that gaining weight after completing cancer treatments may increase your risk of a cancer recurrence.
- Exercise. Keep moving. Walk. Do yoga. Swim. Garden. Being active will help you keep the weight off and may help prevent a cancer recurrence.
- Pay attention to your emotional health. Life after cancer treatment isn’t always easy. You may experience a rollercoaster of emotions after treatment ends, including fear of recurrence. You may be sad or angry about the way cancer has affected your life. If you need to, talk to a counselor or psychologist or join a support group. Within the cancer community, there are others who will understand your experience and what you are feeling.
Managing Fatigue and Sleep Changes
Cancer-Related Fatigue (CRF) is one of the most common health problems people face after their cancer treatment ends.
CRF is a level of tiredness deeper than simple lack of sleep. “Bone weary” is how some people describe it. Often fatigue will dissipate over time. You may find that you regain energy gradually as your level of exercise increases and your diet becomes more nutritious.
In some cases, the fatigue may be because your cancer treatments have led you to become anemic. (This means you lave low levels of oxygen-carrying components in your blood.) A simple blood test can show whether you have anemia and the cause of it (such as iron deficiency). Simple changes in what you eat can help relieve this condition. It’s also possible your doctor will prescribe medication or iron supplements.
Tips for fighting fatigue include:
- Careful planning to take advantage of your best times of day
- Consistency in times for waking and sleeping
- Cutting back on, but not cutting out, favorite pastimes
- Finding chances to rest
- Creatively changing normal activities
- Accepting fewer responsibilities or volunteer activities to enable more “free time” for rest
- Asking for help and allowing others to help you
If fatigue is a problem in your life, your doctor should know. Keep track of how often you experience fatigue. This will prepare you to answer any questions your doctor may ask during your next follow-up visit. Remember: If your doctor or nurse doesn’t ask about fatigue or other symptoms, it is up to you to mention it.
Many people who have completed treatment find they have trouble getting the right amount of sleep. At one end of the spectrum is hypersomnia, which causes people to sleep 10 hours or more at time. At the other end is insomnia, the inability to get enough sleep to let you feel rested. Hypersomnia, insomnia and increased nightmares can aggravate other side effects and lessen your ability to deal with everyday activities.
Tips for Managing Hypersomnia
- Try to get exercise every day, during the morning or early afternoon
- Develop a routine to sleep and wake at the same time every day. When it is time to get up, get out of bed
- Engage in activities that you enjoy and that call for your full attention
- Avoid foods that make you sleepy during the day
Tips for Managing Insomnia
- Work with your doctor to address underlying sources of insomnia, such as pain, anxiety, or stimulating medication
- Sleep and wake at the same time each day
- Avoid caffeine, alcohol, and tobacco, especially at night
- If you are hungry at bedtime, eat a light snack
- If you are able, exercise regularly
- Sleep in a quiet, dark room that is not too hot or cold
- Start a bedtime ritual, such as reading or taking a bath, to signal it is time for sleep
- Medications are sometimes used to treat insomnia in the short-term and only when other treatments are ineffective
Tips for Dealing with Nightmares
- Talk about the nightmares—reach out to a trusted family member or friend
- Write in a diary or draw pictures to express the content or themes of the nightmares
- Imagine alternative endings or storylines to the nightmares
- During the daytime, talk with someone close about your fears and feelings
Long-Term Health Concerns
Fear of Recurrence
One of the most common feelings people who have been treated for cancer share is their fear that their cancer will return. This fear can interfere with every aspect of life—eating, sleeping, working, and playing. It can be triggered by reminders such as follow-up visits, birthdays, someone else’s diagnosis, and an ache in your body or a bump on your skin. All of this can affect your quality of life.
Tips for Coping with the Fear of Recurrence
- Learn the signs of recurrence for your type of cancer—be informed
- Keep up with any medical tests or appointments your doctor recommends
- Talk about it—express your feelings
- You do not have to be upbeat all the time, but look for the positive
- Be Patient Active—take control of what you can, make a plan, know what you cannot control
Learn about recurrence and make a plan for the future. Your doctor and other members of your health care team are a good starting place for information. When you have questions, write them down and bring them to your office visits.
If fear of recurrence is affecting your ability to enjoy life, you may want to consider seeing a mental health professional who can help you find ways to manage your fear.
Depending on the treatments you received, you may also be at risk for “late effects.” These are side effects that occur years after treatments end. Late effects vary from person to person. Treating these side effects has become a larger component of cancer care because more people are living longer after treatment ends.
Late Effects of Cancer Treatment
Health care providers following cancer survivors should be aware of the late effects they may be at risk for because of how old they were when they were diagnosed with cancer, the type of cancer they had, and the type of treatments they received. Although some problems may be unavoidable, others can be prevented or minimized with routine health monitoring. Some cancer treatments may increase your risk of a second cancer.
Long-term health risks related to treatment are based on individual risks, such as:
- Your type and stage of cancer
- The treatment you received
- The effectiveness of the treatment
- Your overall health after treatment
Just because you are at risk for late effects does not mean you will experience them. Even so, it is important for you and your doctor to pay attention to changes and monitor your health with the right tests. Late-effects vary for each cancer survivor, so we strongly encourage you to talk about your risks with the cancer specialists on your health care team. Your follow-up visits provide opportunities for you to raise questions or concerns. Ask what your specific risks are, how your doctor will monitor them, and what you can do to minimize future problems.
Some potential health problems that could arise over time include:
- Hearing loss
- Heart symptoms
- Hormonal problems
- Chronic fatigue
- Weight gain
- Bone loss
- Thyroid, kidney, or breathing problems
Different treatments are linked to different risks for late effects. Doctors should look for possible changes in your:
- Joints and bones
- Mouth and teeth
- Endocrine system
- Reproductive system