It takes time after treatment ends to recover physically, emotionally and financially. How much time, and what happens in the meantime, is as individual and unique as each of us are. (It may help to know that most women report high levels of functioning and quality of life one year after breast surgery, regardless of whether they received a mastectomy or a lumpectomy.)

Emotionally:

• In the short term, there may be depression instead of the high you may expect at the end of treatment. Emotions which have been held in check since diagnosis have an opportunity to surface. The constant reassuring words from the cancer center staff will mostly be gone. You are suddenly left on your own to deal with uncertainty and fear, ongoing physical and emotional issues, and may even be continuing anti-cancer therapy.
• Emotional swings can continue for years. The severity of emotional swings generally lessens over time, but can surface at unexpected times.
• There is generally the fear of your breast cancer returning, or another cancer appearing. The fear can pop up unexpectedly, or be triggered by symptoms such as a flu.
• You also likely feel out of step with the healthy world.

Physically: There may be physical disfigurement to live with, at least on a short term basis if you are undergoing reconstruction. Fatigue and/or chemo brain may continue for a while. Some effects may not show up until years after the end of treatment. If they do, speak with your doctor.

Medically:  

• Do not be surprised if symptoms continue.
• Get a breast cancer follow-up plan from your cancer doctor.
• Give yourself a monthly breast exam.
• Show up for doctors appointments.
• Prepare for follow up visits with your doctors.
• Consider gene testing.
• Help prevent lymphedema.
• If you are overweight, lose the extra weight.
• Comply with drug regimens. Save money when purchasing drugs. Store and dispose of drugs safely.
• There is no guarantee that your breast cancer will not return or that another cancer will not appear or that something else will not happen. You can help prevent another cancer occurrence, maximize your body's fighting ability, and help feel in control on a daily basis by adopting a cancer prevention lifestyle.
• Consider taking supplements.
• Take care of your mouth. Oral infections can spread quickly through the body, lowering your immune system's ability to fight disease.

Financially: It is time to focus on paying off your medical bills and other debts and to get your finances in order to withstand the possibility of a recurrence or other expense. The same kind of planning will also help you meet your retirement and other goals.

On a day to day basis: 

• Reclaim your life.
• Let family and friends know when you need assistance. You do not need to be superwoman.
• Keep your children informed. Continually monitor their reactions.

Planning Ahead:

• If you haven't before, get your legal affairs in order. Be sure you have Advance Directives which keep you in control of your medical care even when you cannot communicate. And, of course, everyone should have a valid, unchallengeable, will. Consider creating an Ethical Will.
• If you have children and haven't made plans to protect them if something happens, now is a good time to do it. 
• Thinking about, and talking about, funeral plans will save unnecessary stress and a good deal of money.

Our discussion is divided into eight categories which we cover in alphabetical order: Day To Day Living, Emotional Well Being, Finances, Government Benefits, Insurance, Medical Care, Planning Ahead, and Work Issues. We recommend that you skim the content to get an overview, then return to each subject as it works for you. Each subject starts with a summary. Links take you to the depth you want at any given moment, down to form letters and what to say or not say to an insurance company.

NOTE:

• You can personalize the steps to your medical, insurance, economic, work, and social situation by getting a Survivorship A to Z Personalized Survival Guide. If you do not feel able to take these steps yourself at the moment, ask a trusted friend or family member to help.
• If your cancer recurs, see: Recurrence
• If you believe you are within six months of the end of your life, see: End of Life.

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