Lung Cancer

Survivorship

During the transition from active treatment to post-treatment care, you may find the first few months are a time of change — physically, mentally and emotionally. You may resume your home activities and possibly go back to work. However, you could find difficulties in returning to the way life used to be. Adapting to these changes will make it easier to move forward.

You have relied upon your oncology team for your health care needs while receiving treatment. After treatment ends, you will likely return to your primary care physician for your care. This may bring up fear, anxiety or uncertainty. You may experience “care withdrawal,” which is missing the close interactions you had with your treatment team. Rely on the support system you created to get you to this point. Your family, friends and caregivers will be instrumental in helping you cope with the transition into survivorship.

Before you return to your primary care physician, it is helpful for your oncologist to set up a long-term follow-up care plan. Also known as a survivorship care plan, it will include schedules for physical exams and medical tests to monitor you for recurrence and secondary cancers. You should also ask your oncologist for an “end-of-treatment summary,” which offers the following details that will be useful to your primary care physician.

  • Type and stage of cancer
  • Type of treatment you received, such as surgery, radiation therapy or drug therapy, including the amount of radiation given and drug names, if applicable
  • Lymph node removal, if applicable
  • Any hospital stays
  • Side effects experienced during treatment
  • Late effects to watch for in the future
  • Other services you received, such as physical therapy, fertility preservation, exercise, integrative medicine, advice from a dietitian and counseling
  • Recommendations for upcoming cancer screenings, such as frequency and type of CT, colonoscopy, mammogram, PSA and skin screening
  • Any other health needs or concerns

This information will guide your primary care physician in continuing your care after treatment. When you think about it, this care plan is really your survivorship life plan.

Late Effects and Maintenance Therapy

Late effects may occur months or years after diagnosis or even after treatment has ended. Your survivorship plan should include information about your risk for developing various late effects based on your specific diagnosis and treatment plan. Be sure to ask your doctor about the signs and symptoms to watch for so you can begin to manage them before they become serious. Like almost all side effects, most late effects can be treated more easily the earlier they’re detected. That’s why it’s so important to stay in contact with your doctor to communicate any new health concerns.

Depending on your unique diagnosis, your doctor may prescribe maintenance therapy, which is treatment given to keep cancer from coming back or to slow the growth of advanced cancer to prolong a person’s life. Maintenance therapy includes using chemotherapy, immunotherapy or targeted therapy, and you may receive this treatment for a long time.

Going Back to Work or School

Once you are past treatment or are on maintenance therapy, returning to work may be an option. For some people, going back to work is a welcome return to normalcy. For others, it’s a source of great anxiety yet a financial necessity. Before you jump right back into work, it’s important to re-evaluate your career goals. Do you still want the same things as before your diagnosis, or have your priorities shifted?

It’s also important to re-examine your career abilities. Talk to your doctor about how your follow-up treatment schedule and long-term side effects might affect your ability to perform the same job you had before cancer. You may decide that you want to first try part-time work to ease back into the routine. Or you may need to change course and pursue a career that is less physically demanding.

Also keep in mind that you may be dealing with difficult side effects that might require temporary adjustments at work, such as a flexible schedule, reduced hours, a redesigned workstation, the ability to work from home and/or altered responsibilities. Although your employer is required under the Americans with Disabilities Act to provide reasonable accommodations, it’s important to be fair and upfront about your requests.

If you are returning to school, you might worry about getting an infection, “catching something” from classmates or not having enough energy. You may fear not being able to keep up with schoolwork or that your friends and classmates have moved on and won’t welcome you back. These concerns are all common. Back-to-school jitters make the decision of returning to school difficult, but the benefits of attending school usually outweigh the risks.

Your transition may need to happen slowly, as it can be physically and emotionally tiring. Being prepared may help ease anxiety and any feelings of being overwhelmed. Contact the school administrators and teachers to prepare for your return and address any accommodations that may be necessary, such as extra time between classes, as well as learning or classroom challenges.

 

Additional Resources

 

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