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Adjusting after cancer treatment

While there’s plenty of information and support available to you during your treatment for cancer, what happens afterwards?

A cancer survivor is somebody who lives with or beyond their cancer. But the impact of having cancer doesn’t necessarily finish when your treatment ends. Below is some information that will help answer some of your questions and show that you can live a healthy, happy life after cancer treatment.

Details

  • After your treatment After your treatment

    Once your treatment is over, you may feel a range of emotions. Everyone’s experience is different – you may feel happy, relieved, fearful and anxious all at the same time. Some people start to feel low and may develop depression.

    Getting back to normal for you may take some time, and you might find that your values and priorities have changed. You may change your diet, the things you do or the people you see. Or you may find that things may go back to exactly how they were before your treatment. There’s no right or wrong way.

    The most important thing is to give yourself plenty of time to adjust to the changes and find out what works for you. And there’s plenty of support that can help − find out what’s available in your local area.

  • Follow-up appointments Follow-up appointments

    After your treatment has finished, it’s likely that you’ll still have regular check-ups with your doctor. You may be seen every few months and eventually only once a year. Your appointments may continue for several years. Your follow-up care can depend on many things, such as your age, the type of tumour you had and whether you have any other health conditions.

    It’s normal to feel anxious about these appointments, so finding ways to manage your anxiety can be helpful. The following tips may help.

    • Write down any questions you want to ask your doctor before your appointment. See our questions to ask your doctor for more information.
    • Take a pad and pen so you can write down any answers to help you remember them.
    • Take a friend or relative with you. They can help you understand what has been said and support you. 
    • Talk openly and honestly with your doctor about any symptoms, worries or problems you’re having.

    If you have any worries or concerns in between your scheduled appointments, contact your doctor or nurse.

  • Long-term effects of your treatment Long-term effects of your treatment

    Some people may have short-term problems after their treatment, which get better quite soon after their treatment finishes. For others, it can take much longer. Some long-term effects may even be permanent.

    Everyone’s different, so you may have long-term effects that are different to someone who has had the same type of cancer and treatment as you.

  • Bupa cancer promise

    We understand the impact that cancer can have on you and your family. That’s why our health insurance comes with Bupa cancer cover as standard. Find out more today.

  • Your appearance Your appearance

    Some treatments for cancer may involve surgery that can affect how you feel. For example, you may have had a breast removal (mastectomy). Or, you may have had a colostomy (where part of your large bowel is removed or bypassed) and be left managing a colostomy bag.

    You may feel uncomfortable about how this makes you look and feel afterwards. Talk to your family and friends about how you’re feeling. It may also help to join a support group to talk to people who have been through similar experiences to you, or speak to a psychologist or counsellor.

  • Fatigue Fatigue

    Fatigue is extreme tiredness and is common for people who have had cancer or treatment for cancer. It’s very different from normal tiredness because it doesn’t always go away with rest and sleep. Fatigue can be frustrating and can impact your daily life.

    Everyday activities, such as having a shower, doing the shopping, cooking a meal or eating can be extremely exhausting. It’s normal for some people to feel tired for several months after treatment for cancer. But the good news is, there are plenty of things you can do that may help.

    • Plan your day so you’re most active when you feel most energetic.
    • Take regular naps and rest breaks throughout the day.
    • Ask for help if you feel you need it. For example, ask somebody to help with your shopping or housework.
    • Get regular exercise. This can help reduce your feelings of fatigue. However, it’s important to balance exercise with rest. 
    • Eat a healthy, balanced diet. See our healthy diet during and after cancer for more information.
    • Use less energy for tasks at home. For example, sit on a stool whilst you’re doing the washing up.

    For further advice about ways of managing your fatigue, speak to your doctor or nurse.

  • Pain Pain

    Pain after cancer treatment can last for many months. However, some people may have no pain at all. Chemotherapyradiotherapy and surgery can damage your nerves and cause pain and numbness in certain parts of your body, such as your hands, feet or pelvic area.

    If you have any kind of pain, tell your doctor or nurse.

    Your doctor may suggest taking over-the-counter painkillers, such as aspirin or paracetamol. Over-the-counter medicines can be bought from a pharmacy without a prescription.

  • Fertility Fertility

    Cancer and its treatment can sometimes affect your ability to have children. Your doctor will discuss this with you before your treatment, so you can plan for the future. If you’d like more information, or have any questions, speak to your doctor. He or she will be happy to discuss your options with you.

    Infertility means that you’re unable to conceive a child despite having regular, unprotected sex. This is sometimes temporary but it can also be permanent. Being told you’re infertile can be overwhelming, so it may be helpful to talk to someone about how you’re feeling.

    Male infertility

    Some cancers can affect your sperm, for example, testicular cancer can lower your sperm count. Certain cancer treatments, such as radiotherapy, can affect your ability to get an erection (erectile dysfunction). Hormone therapies used to treat prostate cancer can have an effect on your production of sperm, whilst chemotherapy drugs can damage your sperm.

    There are different ways to improve male infertility problems, including medicines and therapies. You may have been advised to store some sperm before your treatment. This can be used for in vitro fertilisation (IVF) when you want to start a family. You might find it helpful to talk to your cancer nurse if you’re having problems.

    Female infertility

    Some chemotherapy medicines won’t affect your fertility but others may temporarily or permanently stop your ovaries producing eggs. Having radiotherapy in your pelvic region can also damage your uterus (womb). Some forms of surgery involving your reproductive system can damage your ovaries or cause scarring to your fallopian tubes. All of these factors can affect your fertility and may mean that you may not be able to become pregnant after your cancer treatment. In some cases, you may also have symptoms of the menopause, such as your periods stopping, hot flushes, dry skin and vaginal dryness.

    Your GP may prescribe hormone replacement therapy (HRT) if your cancer has caused early menopause to help prevent your bones from thinning (osteoporosis). However, HRT is not recommended if you have had breast cancer because it may increase the risk of your cancer returning.

    Surrogacy (where another woman carries a baby for you) or adoption may be alternatives for you to consider. Or you could explore the possibility of using donated eggs, sperm or embryos. Having problems with your fertility can be an anxious and stressful time. Speak to your doctor or nurse, who can put you in contact with support groups or a counsellor. Your partner, family and friends may also be able to offer support.

  • Sex and relationships Sex and relationships

    Many people experience changes in their sex life during and after cancer treatment. These changes are usually temporary but for some people they can be permanent, which means having to change the way you approach your sexual relationships. Sexual problems can be caused by:

    • how you see yourself (body image) 
    • changes in how your body looks and functions
    • pain that you may be feeling
    • fatigue
    • emotions you may be having, such as anger, sadness and fear
    • how your partner responds to you

    It’s important to let your partner know how you’re feeling so they don’t feel like they are being rejected. There are other things you can try if you’re having problems with your sex life. For example, being intimate in other ways such as hugging, kissing, and massaging. You could also try experimenting with other ways to help increase your sex drive. You may find it useful to speak to a sex and relationship therapist for more help and support.

  • Fear of your cancer returning Fear of your cancer returning

    One of the hardest parts of life after cancer treatment is dealing with the fear of your cancer returning. This fear is perfectly normal. It can be difficult to predict if your cancer will return − this can depend on things such as the type of tumour you had. It’s important to attend all your follow-up appointments so you can talk to your doctor if you have any concerns.

    You may find that over time, your fear of cancer coming back reduces and you may start to think about it less and less. Your doctor can tell you which symptoms to be aware of.

    Thinking about your cancer coming back can make it hard for you to carry on with your daily life. Concentrating on what is important to you each day can be a form of distraction from these thoughts. Joining a support group or speaking to a counsellor may also help.

  • Work Work

    You may want to go back to work as soon as possible for financial reasons or to regain a sense of normality. For some people though, it can take several months to adjust to everything that has happened and get used to the physical and emotional changes.

    If you feel you’re unable to cope with the full demands of your job, you could consider reducing your hours, changing the times you work, or the type of work you do. Or your employer may be able to allow you a phased return to work, where you gradually increase your hours. Talk to your manager or the human resources department to find out what options are available for you. For more information, see coping with cancer and work.

  • Developing a wellness plan Developing a wellness plan

    After your cancer treatment, you may decide that you want to live a healthier lifestyle. Your doctor can help you to develop a plan for living healthier. He or she may suggest some of the following.

    • Giving up smoking, if you are a smoker. Smoking increases the chances of you getting certain cancers. See ways to stop smoking for more information.
    • Reducing the amount of alcohol you drink. Drinking more alcohol than the recommended guidelines can increase the chance of you getting certain cancers. See our sensible drinking topic for more information.
    • Eat a healthy, balanced diet. See our information on healthy diet during and after cancer to give you ideas of what types of food you should be eating. A dietitian can also give you practical advice and support on eating well and staying hydrated.
    • Exercise. Staying active can provide mental and physical benefits. For more information about how much exercise you should be doing and how to start, see exercise – getting started.
  • Resources Resources

    Further information

    Sources

    • Life after cancer treatment. Canadian Cancer Society. www.cancer.ca, published May 2013
    • Adjusting to life after cancer. Macmillan. www.macmillan.org.uk, published April 2012
    • Your feelings after cancer treatment. Macmillan. www.macmillan.org.uk, published 1 January 2012
    • About to have a colostomy? Colostomy Association. www.colostomyassociation.org.uk, accessed 24 September 2014
    • Cured of cancer – but at what cost? Long-term consequences of cancer and its treatment. Macmillan. www.macmillan.org.uk, published July 2013
    • Sex, fertility and cancer drugs. Cancer Research UK. www.cancerresearchuk.org, published 6 August 2014
    • Fertility and women with cancer. Fertility and men with cancer. American Cancer Society. www.cancer.org, accessed 24 September 2014 
    • Infertility. NICE Clinical Knowledge Summaries. cks.nice.org.uk, published April 2013
    • Menopause. NICE Clinical Knowledge Summaries. cks.nice.org.uk, published June 2013
    • Care after cancer treatment. Macmillan. www.macmillan.org.uk, published 1 April 2012 
    • Planning your life around fatigue. Macmillan. www.macmillan.org.uk, published 1 July 2013
    • Facing forward – life after cancer treatment. National Cancer Institute. www.cancer.gov, published 16 May 2014
    • Healthy sexuality. Macmillan. www.macmillan.org.uk, published 1 October 2011
    • Other options if cancer has affected your fertility. Macmillan.www.macmillan.org.uk, published 1 December 2013
    • Going back to work after cancer treatment. Macmillan. www.macmillan.org.uk, published 1 October 2013
    • Upper gastrointestinal (GI) cancer. Map of Medicine. www.mapofmedicine.com. International View. London: Map of Medicine; 2014 (Issue 1)
    • Ovarian cancer. Map of Medicine. www.mapofmedicine.com. International View. London: Map of Medicine; 2014 (Issue 2)
    • Colorectal cancer. BMJ Best practice. www.bestpractice.bmj.com, published 19 December 2013
    • Prostate cancer. Map of Medicine. International View. London: Map of Medicine; 2014 (Issue 4)
    • Prostate cancer. BMJ Best Practice. www.bestpractice.bmj.com, published 10 November 2014
    • Prostate cancer. Medscape. www.emedicine.medscape.com, 2 December 2012
    • Breast cancer. Map of Medicine. www.mapofmedicine.com. International View. London: Map of Medicine; 2014 (Issue 4)
    • Start active, stay active. A report on physical activity for health from the four home countries’ Chief Medical Officers. Department of Health, 2011. www.gov.uk
    • Oncology and palliative care. Oxford handbook of clinical medicine (online). Oxford Medicine Online. www.oxfordmedicine.com, published August 2010 (online version)
    • Paracetamol. British National Formulary. National Institute for Health and Care Excellence. www.evidence.nhs.uk, published January 2015
    • The effects of cancer treatment on reproductive functions. Guidance. The Royal College of Physicians. www.rcplondon.ac.uk, published 2007
    • Testicular cancer. BMJ Best practice. www.bestpractice.bmj.com, published 24 September 2014
    • Women’s fertility and chemotherapy. Cancer Research UK. www.cancerresearchuk.org, published 17 April 2013
    • Sex and cancer for women. Cancer Research UK. www.cancerresearchuk.org, published 24 October 2013
    • Preventing cancer: promoting a healthy diet and physical activity in childhood. The World Health Organization. www.who.int, accessed 28 Jan 2015
    • Surrogacy. The Human Fertilisation and Embryology Authority. www.hfea.gov.uk, published 5 August 2014 
    • Reproductive endocrinology. Oxford handbook of endocrinology and diabetes (online). Oxford Medicine Online. www.oxfordmedicine.com, published March 2014
    • Skin cancers. Oxford handbook of oncology (online). Oxford Medicine Online. www.oxfordmedicine.com, published June 2011
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