Survivorship

Life After Cancer

Once you move into survivorship, it’s important to continue to be proactive about your health, including making and keeping regular follow-up appointments. These appointments also give you the opportunity to keep the lines of communication with your doctor open as you transition back into former activities and explore new ones.

Regular monitoring will help your doctor detect warning signs of a recurrence or a second cancer so early treatment is possible (see Potential Second Cancers Among Adult Survivors). All of the detailed information you share with your doctor can be vital to monitoring you for other cancers and to manage any long-term side effects. Be sure to tell your doctor how you’re feeling physically, mentally and emotionally, and include the following.

  • New or ongoing pain that isn’t adequately relieved
  • New or ongoing physical symptoms, including bladder/bowel control; deep fatigue or insomnia; sexual dysfunction or lack of desire; mobility issues; signs of infection; tingling or numbness; fluid buildup; or changes in appetite, sense of taste, vision or hearing
  • Cognitive (thinking-related) symptoms, such as difficulties with memory, concentration, processing information, word-finding or completing tasks
  • Emotional issues: depression, anxiety, fear, anger, grief, hopelessness, emotional numbness, feeling overwhelmed or other concerns
  • New medications, over-the-counter remedies, vitamins, supplements or herbs
  • Visits to the emergency room, urgent care or other doctors, even if not cancer-related

Making Smart Lifestyle Decisions

Eating right and exercising continue to offer multiple health benefits and help you build a solid foundation for going forward with life. It may be helpful to consider nutrition and exercise as treatments your body needs to continue to be well. Remember, you’re in control of the choices you make about nutrition and exercise, and smart choices will help you live the healthiest life possible.

Healthy eating after treatment may help reduce the risk of cancer recurrence or secondary cancers. It also assists you with improving other health conditions you may have, such as obesity, heart disease and diabetes, which have been linked to cancer. Maintaining a healthy weight is important for survivors, especially if treatment caused you to lose or gain weight. Whether you are trying to lose, gain or maintain, make sure to eat the essential nutrients, including carbohydrates, fats and protein.

You might consider nutritional counseling with a qualified professional, such as a registered dietitian. Together, you can create a nutrition plan and discuss any nutrition concerns you have. If there isn’t a dietitian on your medical team, ask your doctor or nurse navigator for a referral.

Another healthy lifestyle choice for survivors is being physically active. After treatment ends, consult your doctor, who may suggest specific exercises, intensity levels and duration of activities, all based on your unique circumstances. Even a 10-minute daily walk can energize you and offer multiple health benefits, such as reducing anxiety, depression and fatigue. Physical activity is also a great way to reduce stress, which is important to your overall health. And, it's a natural way to boost your mood, offering drug-free relief for many of the emotional side effects of cancer and its treatment.

Returning to Work or School

If you had to quit working or cut back your hours while you were in treatment, you may consider going back to work. Keep in mind that you may be dealing with long-term effects that might require temporary adjustments, such as a flexible schedule, reduced hours, a redesigned work station, the ability to work from home and/or altered responsibilities. Work with your supervisor to evaluate your workload or reassign duties as needed.

You may choose to find a new employer or a different line of work than you did before treatment began. You may feel self-conscious about why you’re making a change but what you share is up to you. The Americans with Disabilities Act (ADA) prohibits current and future employers from asking about your medical history.

If you are going back to school, consider visiting the school or campus before returning. Maintain open communication and request additional resources from the school, such as emotional and social support, to help transition between treatment and school. Be sure to address learning or classroom difficulties early.

Giving Back

Consider volunteering to talk with other survivors in person, on the phone or online. Your experiences can be of great value to someone else and may offer them a sense of hope.

Many volunteer opportunities exist for survivors. Ask family members, friends and others in your community network whether they know of an individual or organization that could benefit from your help. Or you may also want to call local hospitals, cancer centers or advocacy groups and ask how you can get involved. Some survivors find an organization related to their cancer to participate in fundraising events.

Sometimes giving back can be as simple as sharing your personal experience with cancer. A survivor once said, “As survivors, none of us fight alone.” Many patients depend on the survivor community to educate, support and engage them before, during and after treatment. Reach out to your advocacy group of choice to find out if you can share your story with others. If you’re interested in sharing with other readers of Patient Resource guides, email us at editor@patientresource.com.

Re-evaluating Finances and Retirement

Cancer-related costs can add up quickly. The financial coordinators at your hospital can work with you to address your financial concerns and determine if you qualify for government assistance. Social workers, advocates, financial counselors and patient navigators at your medical facility can also refer you to organizations and charities that may be able to help.

Before you were diagnosed with cancer, you may have had plans for retirement or a strategy for it. However, treatment expenses and time off work may have caused you to dip into or deplete your retirement funds. You may decide to go back to work either full time or part time to rebuild your savings.

If you plan to continue working, consider some changes when it is time to select your health insurance coverage for the next calendar year. You will likely have more doctor’s visits and more tests (and possibly more prescriptions) than you did before your diagnosis of cancer. Read the fine print and determine if you want to choose a different coverage plan that may be a higher premium each month but covers more services and has a lower co-payment and deductible.

Reframing Your Life

Having cancer often changes your perspective on life. The priorities you had before your cancer diagnosis may have changed during or after treatment ended. Your life goals may have changed or need to be redefined. You may reconsider the work you do and what you want out of life. There may be things you’ve always wanted to try or places to see.

Some strategies you can use to reassess your life include journaling, speaking with a counselor or spiritual leader, or asking your health care team about specialized support groups or services for cancer survivors.

Reclaiming Your Sexual Health

You may face post-treatment sexual difficulties, such as a decreased sex drive, the inability to achieve or maintain arousal, pain during intercourse or the delay or absence of orgasm. Many factors can cause these difficulties. Your doctor may look for physical factors that contribute to these issues, including high blood pressure or diabetes. Sometimes controlling these can correct the problem.

Cancer treatment may also be the cause. The most common physical sexual problem among male cancer survivors is erectile dysfunction (ED), which is the inability to get and/or maintain an erection. Treatment for ED often combines medication with physical and psychological elements.

The most common sexual problems that affect female survivors include vaginal dryness and discomfort, as well as pain during intercourse. Correcting these problems can help boost sex drive, arousal and ability to reach orgasm. Remedies include vaginal dilators, low-dose vaginal estrogen, lubricants, moisturizers and pelvic floor physical therapy.

Don’t be embarrassed to bring up changes in your sexual health with your doctor so that your concerns can be addressed. Also, share your concerns with your partner and allow your partner to do the same. You could talk about ways to be intimate other than with intercourse. Do your best to set aside one-on-one time with your partner to rediscover and strengthen the intimacy in your relationship. Depending on your situation, consider a discussion with a professional counselor or therapist.

 

Key Takeaways

  • Keep the lines of communication open with your doctor after treatment ends. Address any new symptoms right away.
  • Keep follow-up appointments so your doctor can monitor you because sometimes you may not actually feel symptoms.
  • Eat right and exercise for optimal health. Consider nutritional counseling with a registered dietitian.
  • If returning to a job or school, address any adjustments that may be needed. When returning to work or starting a new job, read the fine print of your health insurance policy to select the plan that’s best for your needs.
  • Take time to evaluate your priorities after cancer because they may have changed.
  • Ask for a referral to a financial counselor to determine if you are eligible for assistance.
  • Consider sharing your experience with other survivors. It can be healing for them as well as you.
  • Don’t be afraid to bring up sexuality issues with your doctor. Treatments and therapies are available to help with this important part of your life.

 

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