- Do not be surprised at the emotions that may continue to surface. Share them. Contact another survivor with a similar experience. Consider a support group.
- Relationships with your spouse or partner, family and friends change over time. Ask for help when you need it.
- Reclaim every aspect of your life if you haven't already.
- Take care with underage children
- Comply with your drug regimen if you are given one. Learn how to save money when purchasing drugs, and how to store and dispose of them safely.
- Physical and mental effects may linger. New ones may show up. Avoid an impulse to engage in risky behavior. Report new symptoms or changes in existing symptoms to your doctor.
- There is no guarantee that your cancer won't come back. Help lower your risk of recurrence or developing a second cancer: Adopt a cancer prevention lifestyle.
- Show up for follow-up physical exams and tests.
- Get a disease specific medical Follow Up Plan. Go over it with your primary care physician. Tell every doctor or other medical person about your cancer history including diagnosis, treatments and dates.
- If you do not have health insurance, do whatever you can to get it. If you do have it, do whatever is necessary to keep it. Also learn how to maximize use of your policy. Keep other basic insurance as well.
- Do basic financial planning. It will help you, first, pay off debt. (Free negotiating help is available). Then set aside money for health and other emergencies, then money to go after your dream. If debt is overwhelming, consider bankruptcy.
- At work, negotiate if you need a change to allow you to do your work. Learn how to maximize time off and prepare for a recurrence or disability "just in case." Keep track of the facts in case of a discrimination claim.
- If you want to change jobs, or even careers, you can
- If you are unable to work or may be unable to work in the foreseeable future, there are guidelines to make life easier.
- If you want to have children, consider the options that are still open.
- If you don't have a pet, consider getting one.
Post Treatment 6 months +
FOR ADDITIONAL INFORMATION ABOUT THE FOLLOWING SUBJECTS, SEE THE OTHER SECTIONS OF THIS ARTICLE
Whether it has been six months, ten years, twenty years or more, you will always be a person who is a cancer survivor.
In addition to the memory of a difficult time, you may continue to live with long term effects of your cancer or treatment, such as fatigue, depression, fear of recurrence, or physical disfigurement. Some effects may not show up until years after the end of treatment. There are steps to take to help reduce the impact of long term effects.
You can help prevent another cancer occurrence, maximize your body's fighting ability, and feel in control, by doing the following:
- If you are supposed to continue to take medications, stick with the instructions faithfully for as long as you are supposed to. (This is referred to as "adherence.") It may help to think of every pill you take as a daily renewal of your commitment to do what you can to be healthy.
- Adopt a cancer prevention lifestyle. This includes eating healthy, taking supplements if necessary, exercise, avoiding stress to the extent you can, and getting rest. If you smoke, quit. Stay away from second hand smoke. While lifestyle in and of itself cannot prevent a health episode, it can help you feel in control every day. It can also help prevent other diseases such as a heart attack or diabetes. Think of the lifestyle as much a part of your everyday life as you do brushing your teeth. It is just something you do. (It gets easier with time. In fact, people who develop this lifestyle report feeling poorly when they go off diet or have to skip exercise for a while).
- If you don't have one already, get a copy of a cancer Follow Up plan from your cancer doctor. Give a copy to your primary care doctor so both of you will know what to look for as a warning sign of a possible recurrence or the appearance of a possible long term effect from the cancer and/or treatment. If your primary doctor isn't familiar with long term effects of cancer, look for a survivor clinic at an NCI certified cancer center or on the list of the Cancer Survivor's Project . If you don't qualify for a particular center, perhaps they have a recommendation for you.
- Keep each follow up appointment suggested by your cancer doctor. Health insurance covers follow up care..
- For the rest of your life, tell every doctor or other medical person you see about your cancer diagnosis and treatments (including dates).
- Keep in mind that you do not have to live in pain.
- Do what you can to make your home environment a healing environment.
- If you don't have one, consider getting a pet. Studies show that pets improve quality of life and even help to extend it. The pet doesn't have to be a dog or a cat. If you do have a pet, learn how to avoid becoming infected.
As to your emotional and social needs:
- Share your emotions. Don't keep them bottled up.
- Make contact with another person who has gone through a similar cancer experience about the same time you did. (The experience of a person from a different period is likely different than yours).
- Don't allow any lingering physical or emotional effects from your cancer or treatment to keep you from a social life, travel, or physical intimacy with your spouse or partner.
- No matter long ago you completed treatment, don't be surprised if you get anxious in the days before a cancer follow up appointment or test and have difficulty sleeping the night before.
If you completed treatment less than five years ago:
- Family roles likely shifted during treatment with other family members taking on more of the chores and responsibility. It can take time to adjust to returning to the norm of the previous family dynamic or to work through a new one.
- Don't be surprised if every cough, flu-like symptom, or pain that is similar to the pain you felt before treatment, triggers the thought that your cancer may have returned. Such triggers will likely have less and less effect over time.
If you completed treatment more than five years ago:
- If fear of recurrence comes back, keep in mind that if your cancer does recur, the medical treatments and handling of side effects have evolved since you had your treatment. You survived it once. You can do it again. (Also keep in mind that fear is only a thought. Thoughts can be changed).
- Don't be surprised if other emotions unexpectedly surface periodically.
- If you get stuck in a down period, or become overwhelmed by other emotions, talk with your doctor or a therapist.
- Watch your underage children for lingering after effects.
- If there is a Cancer Support Community in your area check it out. (The Community is a result of a merger of Gildas Club Worldwide and The Wellness Community). The Cancer Support Community provides education, support and a community of cancer survivors with a like experience.
Get your insurance and financial situation in shape so you are prepared in case you have another bout with cancer or another health condition.
- Financial planning does not require any particular knowledge base. Help is available if needed.
- If you don't have health insurance, do everything you can to get it. If you have health insurance, do what you can to keep it. Learn how to maximize your health insurance.
- If you are in a financial crunch:
- First pay attention to unpaid bills. There are guidelines for figuring out the order in which to pay creditors described in the document in "To Learn More.". You can negotiate most bills.
- Then create a plan to pay debt off as soon as you can while keeping a healthy lifestyle.
- Once you are out of debt, set up an Emergency+Fund to tide you over any rough times.
- If you are over your head in debt, consider bankruptcy. Bankruptcy is such a basic right that the founding fathers built it into the constitution.
- Get back to working on your goals. Use your cancer experience to help focus on what would make your life fulfilling to you. Then do what you can to go for it. This may mean figuring out how to increase your income, or decrease your expenses, or both. Note that you can change jobs or even careers despite your history of breast cancer. New employers and schools cannot ask about your health history. If you move from job to job you are protected from a new waiting period before your breast cancer is covered.
- Reexamine your investment strategy to fit your current situation.
- Self employed and business owners are advised to think about planning for business continuation in the event cancer recurs (as well as natural disasters).
- If your cancer experience triggered a reassessment of what you want to do for work, your cancer history as such does not prevent you from changing jobs or even careers.
- Negotiate for accommodations if you need them to help you do your work.
- Keep track of job evaluations and good comments about your work in case you ever have a claim of discrimination due to your cancer history.
- Prepare "just in case" by taking such steps as increasing the amount of available credit and of life insurance.
If you haven't already:
- Put your legal affairs in order. Everyone should have a Will and should consider having a Living Will and other Advance Care Directives.
- Thoughts can change over time. Confirm with your family about what kind of medical care you would want or not want if you become unable to speak for yourself, and what kind of funeral you would want. If you do not want to focus on specifics, at least talk about your general attitude. Ask them to do the same so the discussion is about proper planning rather than about cancer.
- 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 don't feel able to take these steps yourself, ask a trusted friend or family member to help.
- If your cancer left you disabled and unable to work, read: On Disability
- If your cancer recurs, see: Recurrence
- If you believe you are within six months of the end of your life, see: End of Life