Finishing treatment can be both stressful and exciting. While you will be relieved to be done, it is hard not to worry about cancer coming back. (When cancer returns, it is called recurrence.) This is a very common concern among those who have had cancer.

It may take a while before your recovery begins to feel real and your fears are somewhat relieved. You can learn more about what to look for and how to learn to live with the possibility of cancer coming back in the American Cancer Society document, Living with Uncertainty: The Fear of Cancer Recurrence, available at 1-800-ACS-2345.

Follow-up care

After your treatment is over, it is very important to keep all follow-up appointments. During these visits, your doctors will ask about symptoms, do physical exams, and may order blood tests, scans, or x-rays. Follow-up is needed to check for cancer recurrence or spread, as well as possible side effects of certain treatments. This is the time for you to ask your health care team any questions you might have and to discuss any of your concerns.

Many cancer treatments can have side effects. Some may last for a few weeks to several months, but others can be permanent. Don't hesitate to tell your cancer care team about any symptoms or side effects that bother you so they can help you manage them.

Most doctors recommend follow-up exams every few months for the first 2 years after treatment, then every 4 to 6 months for the next few years, and less often after this. If you had radiation treatment to the neck, your doctor will likely want to get blood tests to check your thyroid function.

You may be told to see your dentist after treatment to check on the health of your teeth. Your doctor will also want to keep a close eye on your hearing, speech, and swallowing, which can be affected by treatment.

If cancer does come back at some point, further treatment will depend on where cancer is, what treatments you've had before, and your health. For more information on dealing with a recurrence, please see the American Cancer Society document, When Your Cancer Comes Back: Cancer Recurrence.

It is also important to keep medical insurance. If your cancer comes back, you don't want to have to worry about paying for treatment.

Your appearance and other changes

Surgery or other treatments can affect nerves and other structures in the face and neck. This can change how you look and may have an impact on other things such as speech and swallowing.

These issues can often be addressed after treatment has ended. There are many ways to correct these problems. Some involve surgery and others do not. For instance, if you are having problems with speech or swallowing, your doctor may refer you to a physical or speech therapist.

Talk with your doctor or nurse about any problems you are having. There are also groups that can support you and help teach you how to manage any lingering problems you may have. Some of these groups are listed in the "Additional resources" section of this document.

Seeing a new doctor

At some point after your cancer treatment, you may find yourself seeing a new doctor. It is important that you be able to give your new doctor the exact details of your diagnosis and treatment. Make sure you have the following information handy:

• a copy of your pathology report from any biopsy or surgery
• if you had surgery, a copy of your operative report
• if you were hospitalized, a copy of the discharge summary that every doctor must prepare when patients are sent home from the hospital
• if you had radiation, a final summary of the type and dose of radiation and when and where it was given
• if you had chemo, a list of your drugs, drug doses, and when you took them

After you show this to your new doctor, get your copies back and keep them in a safe place. You will likely need them again and again.

Lifestyle changes to think about during and after treatment

Having cancer and dealing with treatment can take up a lot of your time and be emotionally draining, but it can also be a time to look at your life in new ways. Maybe you are thinking about how to improve your health over the long term.

Make healthier choices

Think about your life before you learned you had cancer. Were there things you did that might have made you less healthy? Maybe you drank too much alcohol, or ate more than you needed, or smoked, or didn't exercise very often.

Now is not the time to feel guilty or blame yourself. However, you can start making changes today that can have positive effects for the rest of your life. Not only will you feel better but you will also be healthier.

You can start by working on those things that you feel most concerned about. Get help with those that are harder for you. For instance, if you are thinking about quitting smoking and need help, call the American Cancer Society at 1-800-ACS-2345.

Diet and nutrition

Eating right can be hard for anyone, but it can get even tougher during and after cancer treatment. If you are still in treatment and are having eating problems related to your treatment, please ask for a copy of our Nutrition for the Person with Cancer publication.

One of the best things you can do after treatment is to put healthy eating habits into place. You will be surprised at the long-term benefits of some simple changes, like increasing the variety of healthy foods you eat. Try to eat 5 or more servings of vegetables and fruits each day. Choose whole grain foods instead of white flour and sugars. Try to limit meats that are high in fat. Cut back on processed meats like hot dogs, bologna, and bacon. If you drink alcohol, limit yourself to 1 or 2 drinks a day at the most. And don't forget to get some type of regular exercise. The combination of a good diet and regular exercise will help you maintain a healthy weight and give you more energy.

Rest, fatigue, work, and exercise

Tiredness (fatigue) is a very common symptom in people being treated for cancer. This is often not an ordinary type of tiredness but a "bone-weary" exhaustion that doesn't get better with rest. For some, this fatigue lasts a long time after treatment, and can interfere with being active. However, exercise can actually help you reduce fatigue.

If you are ill and need to be on bed rest during treatment, it is normal to expect to lose some of your fitness, endurance, and muscle strength. Physical therapy can help you maintain strength and range of motion in your muscles. This can help you fight fatigue and the sense of depression that sometimes comes with feeling so tired.

Any program of physical activity should fit your own situation. Talk with your health care team before starting, and get their advice about your exercise plans. Then, try to get an exercise buddy so that you're not doing it alone.

If you are very tired, though, you will need to balance activity with rest. It is okay to rest when you need to. (For more information about fatigue, please see Fatigue in People with Cancer.)

Exercise can improve your physical and emotional health.

• It improves your cardiovascular (heart and circulation) fitness.
• It strengthens your muscles.
• It reduces fatigue.
• It lowers anxiety and depression.
• It makes you feel generally happier.
• It helps you feel better about yourself.

And long term, we know that exercise plays a role in preventing some cancers. The American Cancer Society recommends that adults take part in at least 1 physical activity for 30 minutes or more on 5 or more days of the week. Children and teens should try to get at least an hour of high-energy physical activity each day for at least 5 days a week.

How about your emotional health?

Once your treatment ends, you may find yourself overwhelmed by emotions. This happens to a lot of people. You may find that you think about the effect of your cancer on your family, friends, and career. You may also begin to re-evaluate your relationship with your spouse or partner. Unexpected issues may also cause concern -- for instance, as you become healthier and have fewer doctor visits, you will see your health care team less often. That can cause anxiety for some people.

This is an ideal time to look for emotional and social support. You need people you can turn to for strength and comfort. Support can come in many forms: family, friends, cancer support groups, church or spiritual groups, online support communities, or individual counselors.

The cancer journey can feel very lonely, but you don't need to take it all by yourself. Your friends and family may feel shut out if you decide not include them. Let them in and anyone else who you feel may help. If you aren't sure who can help, call your American Cancer Society at 1-800-ACS-2345 and we can put you in touch with a group or resource.

You can't change the fact that you have had cancer. What you can change is how you live the rest of your life -- making healthy choices and feeling as well as possible, physically and emotionally.

Last Medical Review: 02/26/2009
Last Revised: 02/26/2009