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Information about all aspects of finances affected by a serious health condition. Includes income sources such as work, investments, and private and government disability programs, and expenses such as medical bills, and how to deal with financial problems.
Information about all aspects of health care from choosing a doctor and treatment, staying safe in a hospital, to end of life care. Includes how to obtain, choose and maximize health insurance policies.
Answers to your practical questions such as how to travel safely despite your health condition, how to avoid getting infected by a pet, and what to say or not say to an insurance company.



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 offsite link. 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 offsite link 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).

At work:

  • 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

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.

It is a myth to think that you can put cancer behind you with no emotional aftermath. The severity of emotional swings generally lessens over time, but can surface at unexpected times.

It is common to feel anxiety about whether your condition will come back (known as "fear of recurrence"). This is particularly to be expected when a medical checkup is scheduled or you get any physical symptoms such as a cold. (Survivorship A to Z provides information about how to get through the often anxiety provoking period of waiting for test results).

Watch for signs of depression. Depression is not unusual. Depression is usually treatable.

Use whatever other coping mechanisms you used to get you through treatment. Additional coping mechanisms are described in the documents listed in "To Learn More."

If you are still feeling the effects of your cancer or treatment, let the people around you know that the transition after treatment takes time. Dr. Julia Rowland, a noted psycho-oncologist, suggests that the time to a return of a feeling of normalcy is generally about the same as the time between the first diagnosis and end of treatment. If that period was 18 months, expect at least 18 months to recover.

Get your emotions out. Share them with family members and/or friends. Many people find that writing their thoughts help. The writing doesn't have to be a bound journal, and you don't have to share it with anyone to get a benefit.

Talk with another person who is going through the same thing you are or who has been there. Look for someone who had the same cancer and experience. If you were treated for cancer 10 years ago, the experience was likely different than the experience of a person who was treated 5 years ago and from a person treated today.

You can find other long term survivors through a variety of sources including:

  • Your local or national disease specific nonprofit organization, such as The American Cancer Society: offsite link or 800.ACS.2345
  • Cancer Support Community (formerly Gildas Club Worldwide and The Wellness Community). See: offsite link to find a community near you or for online support groups.
  • The ACOR long term survivors list connects people with similar cancers online. See: offsite link. Click on "Mailing Lists." Then, under "Survivorship," click on "Long Term Survivors."
  • Your cancer center or possibly staff in your cancer doctor's office.

Also consider joining a support group. Many cancer centers have support groups for people who have completed treatment. In addition to emotional support, groups are a great source of practical tips and information. The length of time to stay in a group depends on the individual. You'll know when it's time to stop. When you feel that way, give the group a few more sessions to be sure.

If you haven't already, turning to religion or spirituality can help.

If your emotions make living difficult or interfere with your daily routine, let your doctor know. Perhaps he or she can prescribe a medication that will help. Professional therapeutic help is also available.

Don't be surprised if you look at life in new ways. For instance, many people look for meaning in the experience or for a purpose in life.

Last, but not least, consider getting a pet. Studies show that pets ease emotions, enhance quality of life and can even extend it. If you live in an apartment with a "no pet" policy, you may be entitled to an exception if your doctor prescribes a pet for your health thanks to the Americans With Disabilities Act.

NOTE: Adult cancer survivors are at increased risk of psychological distress. Remind your primary care doctor of that fact and ask that he or she screen for psychological distress.

Relationships with your spouse or partner, family and friends change over time. Ask for help when you need it.

Your relationship with your spouse or partner, family and friends will likely evolve over time as your and their needs shift. Family members or friends who took over chores for you may want life to go back to what it was before your treatment and still expect you to do what you used to The longer You may feel that you aren't getting the support you need which might make you angry or frustrated. It may be hard for you and the people around you to express feelings or know how to talk about what you've been through - and are still going through.

The longer since the end of treatment, the more likely family and friends assume you are okay. Let them know when you are not, or when you need assistance.

Family and friendship concerns will likely lessen as the years go by. Here are some ideas that have helped others deal with family concerns:

  • Let others know what you are able to do and what not to expect you to do. For example, don't feel you must keep the house or yard in perfect order because you always did in the past.
  • Ask for help when you need it, including asking for help from your underage children. (It will help make them feel as if they are assisting your recovery).
  • Accept help. When friends or family offer to help, say yes. Let them know things that they could do to make your life easier. In this way, you will get the support you need, and your loved ones will feel helpful.
  • Help the children in your family understand what you have been treated for and that it may take a while for you to have the energy you used to have.
  • Talk about your needs. Ask each family member to talk about their needs and concerns. Consider scheduling a weekly or monthly meeting. Don't let cancer be the 800 pound gorilla in the room that everyone knows is there, but no one talks about.
  • Keep in touch with friends. It will help relieve their anxiety about you.

If you are part of a couple, expect changes in your relationship and needs as time passes. A resource to consider, including exercises, is the American Cancer Society's book: Couples Confronting Cancer ($18.95 including shipping).

If you need help dealing with family or friends, professional help is available. Particularly look for an expert on family roles and concerns after treatment.

Reclaim every aspect of your life if you haven't already.

Treatment can play havoc with your self image long after it ended. This includes how you see yourself in your relationship, as a sexual partner, physically, and in the work place.

Reclaim yourself by taking the following steps:

  • Return to those parts of your old routine that still make sense to you. Start slowly and build up as you go.
  • Reassert control over as much of your life as you can.
  • Celebrate being here today and the things you can do. Let go of yesterday and what you were able to do.
  • Travel if you want. (Survivorship A to Z provides information for traveling as an educated consumer who has had cancer).
  • At work, take back activities you may have handed off to other people. Work on the parts of your to do list that you let slide. Keep your limitations in mind. There is a reason people still use the old adage "Rome wasn't built in a day."
  • Get back into your social world. Don't let the long term emotional or physical effects of your cancer hold you back. Social support is important to quality of life and longevity.
  • Do what you can to make yourself look better and to feel better physically. We are back to the basics: eat right, exercise, take care of your oral health, get the rest you need, do what you can to keep a positive mental attitude. (If you need help with make-up, contact the American Cancer Society's Look Good Feel Good program at 800.ACS.2345).
  • Renew romantic relationships. The incidence of separation and divorce is no higher for people with cancer than the general population. Still, the two of you have been through a stressful ordeal. Find time for just the two of you on a weekly basis. Maybe even try "dating" each other for awhile.
  • Regain physical intimacy.
    • Physical intimacy is important for human well being.
    • If you don't want to have sex for reasons other than your cancer, that's your choice. However, if you are refraining because of your cancer, or what the treatment did to your face or body, it is time to reexamine the issue.
    • If you are having any difficulty at all, speak with your cancer doctor or primary care physician. For example, women may have pain during intercourse or difficulty lubricating. Don't wait for your doctor to bring it up.
  • If you are single, starting dating again. There is no right or wrong about when to tell someone your cancer history.

If you have been disfigured, you have a new physical identity that may take some adjusting to. Keep in mind that only your physical appearance has changed - not you. The key to coping with the change is to how you see yourself. People in a similar situation suggest that you think of your disfigurement as an emblem of your strength and fortitude.

Take care with underage children

Children do not have any idea what to expect. Like the adults in your life, they likely expect that everything will return to the way it was. 

If physical or emotional symptoms continue, tell them about your ongoing needs in an age appropriate manner. 

Watch for reactions - including those that seem overboard for the immediate cause. It may be a substitute for fear that you may die. 

If you err on either side, do it on the side of caring too much. Under age children do not need to know about your continuing concerns about the future, or what could happen. 

Adolescent children may appear to be indifferent. Self absorption during adolescent years is a normal development. Each child will deal with fears about your health in his or her own way. 

If your experience with breast cancer comes up, let your children know: 

  • You were scared too. Remind them you are fine now. You see the doctors to keep it that way. 
  • That you will always be honest with them. 

Tips for coping are the same as during treatment. For example: 
  • Spend one-on-one time with each child. 
  • Encourage each child to talk about how they felt during treatment and how they feel now. 
  • Ask teachers to watch for behavioral problems. 

Prepare to answer the question: "Are you cured mommy?" Be honest. For example, you can say something like: "I am okay now. I'm hopeful that I will stay that way."  
Children who were Preschool or were Adopted

Children who were of preschool age when you went through treatment may not remember, and adopted children will not know about, your breast cancer and treatments. 

Never mentioning it adds stress to your life and adds unnecessary negativity to the episode. The children will know one day. It is better for you to be open about it. 

Children take their emotional cues from the adults in their lives. If you are okay and talk calmly about it, they are likely to be okay as well. 

Make what you do to stay healthy part of your everyday life. Be matter of fact about your cancer history and how it has prompted you to do what you can to stay healthy. 


  • As you will see in the Planning Ahead section, have arrangements in place to take care of your children in case you become sick and unable to take of them or if you die. 
  • Consider writing an Ethical Will that passes on your life lessons and family history to your children. 
  • Some women create scrap books or a journal that capture moments in time with their children. It is always a nice memory to have around even if you live a very long life.

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.

Treatment for some cancers is followed by a regimen of chemopreventive substances that can help prevent or delay a recurrence of your cancer or development of another cancer. For example, Tamoxifen may be prescribed for up to 5 years after the end of breast cancer treatment.

You may also be prescribed other medications to take on an ongoing basis.

It is important to follow the doctor's orders both as to how to take the drugs and for how long. This is known as "adherence" or "compliance." Over the long haul, some people associate continuing to take medications with their disease. They stop taking their meds to put the entire episode behind them. It is better to think of each pill you take as part of your commitment to do what you can to maximize your health.

Even if you have health insurance, you can save money by purchasing drugs wisely. If a health insurer declines to pay for use of a drug because it is "off label" (a use other than the use approved by the FDA), appeal with your doctor's help. Survivorship A to Z provides a guide to appealing. Be persistent.

Help is available if you cannot afford prescribed drugs.

For information about how to buy, take, store, dispose of drugs, as well as tips for complying with a drug regimen, click here.

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.

It is possible that the physical and mental effects of chemotherapy or radiation will continue for quite a while. For example, fatigue may persist.. Depression may be ongoing or recurrent. The severity, and how long they continue, varies from person to person.

You may even experience post traumatic stress.

If you had chemotherapy, it is not unusual for a reaction known as "chemo brain" to continue or even to show up after treatment ends.

If you experience fatigue, work with your doctor to try to determine the cause. For example, fatigue could be a symptom of:

  • Depression: A psychologist can help improve functioning, especially one knowledgeable about the impact of cancer on someone's life. Psychotropic medication may also help.
  • Hypothyroidism: Thyroid tests usually done routinely may not be specific enough for people with cancer treatment in their medical history. If thyroid problems are suspected, a specialist known as an endocrinologist will be able to accurately diagnose and treat them.
  • Anemia: A simple blood test can determine iron deficiency anemia. Some people may need iron supplementation. A change in eating habits may help.
  • Heart problems.

Other symptoms may show up in time. For example, peripheral neuropathy (a tingling or pain in your hands or feet).

Watch for increases in risky behavior. This kind of behavior has been reported in cancer survivors. It can lead to subsequent illness or injury.

Continue the techniques that worked to combat side effects during treatment. If they' stop being effective, consider using other methods. They are described in the documents noted in "To Learn More" - including techniques for coping with chemo brain.

If any lingering effects interfere with your life or seem severe, contact your cancer doctor or other health care provider.

NOTE: Use oral hygiene. Get a dental check up at least once a year in case any treatment after effects appear. Chemotherapy may lead to problems with your teeth. So can radiation involving the oral cavity or salivary glands.

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.

According to the American Cancer Society: "It is not possible to guarantee that a person who has completed cancer treatment will never have their cancer come back. Even though your doctor may say, "Your cancer is gone," or "I think I removed all the cancer," or "I see no evidence of any cancer," the fact remains that there is always a chance that some cancer cells are left in your body and survived, even though they cannot be seen or found with any test used today. Over time, these cells can begin to grow and cause your cancer to recur.... Cancer is not predictable. In some cases it will never come back, but in some cases it will. No doctor can guarantee cancer will stay gone forever."

A cancer prevention program helps to reduce the chances of your cancer returning and to maximize the body's defenses in case it does. It also helps you feel in control. Not incidentally, a cancer prevention program also helps protect against heart disease, stroke, diabetes and other illnesses.

A cancer prevention program should consider y our physical, emotional, social and spiritual needs and include the following:

  • Healthy eating guidelines. Your doctor can help you create a healthy diet which can also help prevent cancer. He or she can also inform you about any food or diet restrictions due to your cancer or treatment. A few sources for cancer prevention recipes are:

  • Supplements which provide the nutrients your diet doesn't provide. Before taking supplements, check with your cancer doctor to be sure they don't adversely interact with the residue of your cancer treatment. Also check to see that the supplements do not negatively interact with any medications you are taking. Since supplements are not regulated, your doctor may have a brand to recommend, or look for brands that have helped other people you know (rather than what you find online).
  • Exercise. A recent study found that interviewees who exercised more and had better dietary habits experienced better vitality and physical functioning. On the other hand, individuals who were obese had worse physical quality of life.
  • Reducing the stress in your life to the extent you can. There are stress reduction techniques for the stress that you cannot eliminate.
  • Sharing your emotions.
  • Engaging in a supportive social life.
  • Hope.

Many long term survivors find strength and purpose in spirituality and/or religion.

Drop unhealthful activities such as smoking or chewing tobacco. Do what you can to avoid second hand smoke. Limit your direct exposure to the sun.

If you drink alcohol, do it in moderation.

Avoid unnecessary infection. A few techniques have been shown to greatly reduce the risk of infection. For instance:

  • Keep your hands away from your face - particularly around your mouth, nose and eyes.
  • Wash your hands regularly. When you wash your hands, use soap and warm water for at least 20 seconds ( the amount of time it takes to sing Happy Birthday).
  • Wash your hands before leaving the gym and after being in other highly trafficked areas.
  • Eat a healthy diet - such as the cancer prevention diet described elsewhere in this document.

NOTE: Don't try to change everything overnight, or expect that you could. Change takes time - especially when habits build up over a lifetime. Start slowly, perhaps in one area at a time. Do small steps you can accomplish. Then build on them, one at a time.

Show up for follow-up physical exams and tests.

End of treatment is generally followed by a series of regular follow-up visits to your doctor. A typical schedule includes physical examinations and blood tests approximately like the following:

  • Every three or four months for the first one to three years
  • Examinations every six months until the end of five years
  • Then an exam once a year.

There will also likely be periodic imaging exams.

As with all doctor appointments, it is advisable to prepare for your appointments. For instance:

  • Keep track of your symptoms, if any. (We provide a Symptoms Chart to make it easier).
  • Keep track of questions as they arise so you don't forget them. (You can do that on our Prioritizer. Then, before you go to the appointment, you can reorder your questions to your priority with the click of a button.)

If you haven't already, learn how to maximize your time with your doctor. Survivorship A to Z provides guidelines as well as videos to help you learn how to communicate better.

It is also advisable to keep your own copy of your medical records for future reference.

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.

For some people, late effects begin showing up within a few years after treatment while others do not see late effects for many years. Since two-thirds of all survivors will experience some late effects, follow-up provided by a knowledgeable provider or team of providers is key to good outcomes.

You can get an idea of the late term effects that may follow your treatment by looking at the list put together for late effects of childhood cancer. While not all information pertains to adult survivors, individuals of all ages may be at risk for late effects.

Primary care providers are not trained in caring for long-term survivors.

Your cancer doctor may provide follow up care. If not, look for a nearby Survivor clinic at an NCI certified cancer center. You can locate one at:

Your insurance is likely to cover these services.

When a specialist in long-term effects is not an option, your oncologist should provide a disease specific Follow Up Plan. If you don't have one, ask for it.

A disease specific medical Follow Up Plan provides a "watch for" list for you and your primary care doctor. It should include the following:

  • A description of your disease.
  • The name and duration of each treatment you received.
  • Steps to take to promote a full recovery.
  • What symptoms to look for that may indicate a recurrence.
  • What other conditions may show up in the future because of your particular disease and/or treatment.

Give a copy of the medical follow up Plan to your primary care doctor and to every other doctor you see.

If you cannot get such a plan, at least ask for a copy of your medical records that relate to your diagnosis and treatment. The records will be needed to create a plan.

If your primary care physician is not familiar with the long term effects of your cancer, or refuses to look at your follow up plan, look for another doctor. In addition to whatever other qualities you want in a primary doctor, it is preferable to look for one who is experienced with the long term effects of your cancer and treatment.

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.

Health Insurance

In spite of your health history, there are a variety of ways to get health insurance. The easiest is through a group plan offered by an employer or membership organization. The larger the employer, the more likely to have an employee health plan. (Employers are not required to offer their employees health insurance coverage).

Each employer and/or each plan may have different rules regarding eligibility of dependents for coverage. Most include children and the spouse of the employee; some may include domestic partners as well.

If you and/or your spouse leave a job through which you have your group health insurance, you may be eligible to continue the coverage at your own expense under the provisions of the law known as COBRA.

Other insurance

Insurance protects against losses that the average person cannot bear alone. It is important for everyone to have basic insurance. The need is even greater after a diagnosis because it is likely harder for you to recoup in the event of a large loss.

Explore purchasing Disability Income insurance in case you become disabled and Long Term Care Insurance in case you need long term care. The longer you are in remission, the more likely you will be able to find coverage, even if there will be an increased premium. You may be able to obtain this coverage from an employer. (As noted in the work section of this document,  you health history does not prevent you from changing jobs or even careers.)

Do your best to carry basic insurance such as Homeowners Insurance (either the variety for an owner or for a renter). If you own a vehicle, carry at least Automobile Insurance in the amount required by your state. The longer the period after your episode of cancer, the more likely you will also be able to get Disability Income Insurance and/or Long Term Care Insurance.

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.

With respect to debt, a few pointers may help:

  • Every debt that isn't secured by an asset (such as a mortgage) is negotiable. If for no other reason, every person and company you owe money knows that collection is not free. At the least, they would be likely to settle for payment of an amount that is less than the whole but more than they would receive if they were forced to use a collection agency or go to court. Creditors also know that there will be a lengthy time delay before they see any money -- possibly a long delay.
  • If your debts are more than you can afford:
    • Survivorship A to Z provides detailed information about how to deal with a financial crunch. For instance, start with getting a fix on your financial situation. A budget will help you get an idea of where you money really goes, and where you can make changes. Perhaps you can get money from an asset without selling it. We call the subject "New Uses Of Assets." Consider borrowing money from family and friends in a manner that doesn't affect your relationship. See "To Learn More."
    • There are counseling services that will negotiate for you with your creditors at no cost to you (they are paid by the creditors). Be cautious when choosing such a service. There are ads on television and radio for companies that for nonprofit services that end up charging you a fee.
    • Consider bankruptcy. It is not an option that counseling services generally talk about. However, the right for a person to start over financially is so ingrained in our system that it was built into our constitution.

Now is the time to start working on your financial situation in case it does. For instance:

  • If you do not have health insurance, now is the time to start working on getting it. If you work, and your employer doesn't offer a health insurance benefit, consider changing to an employer that does. A new employer cannot ask about your health condition before offering you a job.
  • Increase your credit. Start accepting the credit card offers you get in the mail. That doesn't mean to use the cards to run up debt. It does mean using each card enough to keep it open in case you need credit in the future. If you don't have credit, start getting it. Our documents in "To Learn More" tell you how.
  • Do what you can to improve your credit score. Credit scores are important for a batch of reasons, including how much you will be charged to borrow money.
  • Create an Emergency+Fund so you have cash on hand for emergencies and other expenses that may require cash.
  • Revisit your investment strategy to take into account the possibility of a recurrence and of a shorter than normal life expectancy. That is not to say that cancer as such shortens your expectancy. Just that if it does, take that into account. Our documents on the subject show you how.
  • See what you can do to improve your income. Perhaps there is a better paying job with your employer for which you can qualify. Or, as mentioned above, consider changing jobs.
  • A little financial planning will help maximize your financial situation. It doesn't have to take a lot of time. Planning should take into account ongoing medical costs and changes in your income and non-medical expenses due to your cancer. Planning should also include the possibility of a recurrence. If this becomes burdensome, ask a family member or friend to help. Professional help is also available.
  • Consider increasing the amount of life insurance you have. Among other ways to get life insurance, you may be able to get it at work once a year no matter what your health history If you become sick, life insurance can be used as an asset from which you can get cash.
  • Find out if you can obtain Disability Income Insurance. If you cannot obtain it on your own, you may be able to get it from a new employer. Large employers such as the government often offer such insurance as an employee benefit.
  • When you have extra money, put as much money as you can spare into your retirement accounts. Saving tax dollars is the same as earning extra money. You can usually withdraw money or borrow it if necessary. If you become disabled, withdrawals are usually without penalty. Plus, money in a retirement account is protected from creditors. If you have a choice of accounts:
    • First priority is to fund accounts in which your employer matches your contribution. The value of your contribution is increased as soon as you put it into the account.
    • Then consider:
      • Which accounts are easier to withdraw money from or borrow against in case of unexpected expense. Pay particular attention to when you can do these things as well as the costs you’ll pay, such as penalties.
      • Which accounts are earning you the most money.
    • If you need help with this decision, speak with a financial planner, your accountant or attorney.
  • A diagnosis heightens the importance of minimizing taxes. A diagnosis is not an excuse to skip filing. Plan to minimize chances of an audit. If audited, your diagnosis may help.
  • If you still have money left, open new retirement accounts to the maximum permitted by the tax laws.  

Survivorship A to Z information on finances and financial planning which is noted in "To Learn More" is tailored for people with cancer and other life changing diagnoses.

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.

At work

As a person with a cancer history, you are likely protected against discrimination in the work place under the Americans With Disabilities Act and similar laws. You are also entitled to an accommodation if necessary to help you do your job.

Negotiate for an accommodation for emotional or physical needs if necessary to help you do your work. Survivorship A to Z provides tips for the negotiation.

Keep track of job evaluations and good comments about your work as well as possibly discriminatory statements or activities in case you ever have a claim of discrimination due to your cancer history.

Learn how to maximize time off combining the employer's benefits such as sick leave and your rights under the Family and Medical Leave Act.

Prepare "just in case" by taking such steps as increasing credit and life insurance.

If you had chemotherapy, you may still experience a fogginess and forgetfulness due to what is commonly referred to as "chemo brain." Chemo brain may even start after treatment is complete. The odds are that chemo brain will lessen over time and then disappear. (There are techniques to help deal with chemo brain. They are described in the document in "To Learn More.")

Consider doing something to acknowledge the extra work co-workers do to help you. Even just saying "thank you" will be appreciated.

Start doing what you can at work to make your situation better in case of future need. For instance, if you have a choice of health insurance policies, choose one from the point of view of a person with cancer (Survivorship A to Z shows you how in jour Cancer Health Plan Evaluator). Increase the amount of your life insurance.

If you are just returning to work

  • Coworkers will be concerned about you. Until you return to work, keep them informed about your treatment and progress. Talk to them on the phone, send a text or email, or appoint a trusted friend or family member to do this for you. When you are able, stop in the office. Your return to work or other activities will be easier for you and others if you stay in touch.
  • Before you return to work:
    • If there's a question whether you are physically and mentally able to work, consider volunteering. Disability income won't be affected even if you volunteer from 9 - 5.
    • If you have been out of work awhile, think about what skills may need to be updated. For instance, learning the latest computer program, or the newest version of a program you already know how to use.
    • Think about who you want to tell about your health condition and/or treatment, and how much you want to tell. Be prepared for a variety of responses.
  • Let people know how you want to be treated. For instance, you may still not be able to work a full schedule, or you may need help accomplishing certain tasks, or you may need an accommodation such as being stationed close to a bathroom for a while. People may need to be reminded that cancer is not catching, or that you are not dying.

Keep track of facts needed for a discrimination claim "just in case." Start keeping a diary of conversations or actions that could be discriminatory. Include in the diary good things that happen, such as a good work report, or when someone compliments you for a job well done.

If you run into problems at work: While you may be legally protected against discrimination, a lawsuit is a last resort. Let your employer know you are aware of your rights and negotiate whatever accommodation you need. Survivorship A to Z provides tips on how to determine what accommodation is reasonable and how to negotiate for it.

If your life objectives have changed: It is not unusual for people with a cancer history to reevaluate what is important, including wanting a different kind of satisfaction at work. An underpinning common to long term survivors is the attitude of living each day until you can't. Applied to the work situation, this means: do what you can to find the work that is most satisfying to you and that fits into your work/personal time balance - while doing whatever is necessary to keep or obtain good health insurance coverage.

If you decide to change jobs or careers: Your health history is no longer a block preventing you from changing jobs or from getting health insurance from a new employer. A new employer is allowed to include a waiting period of up to 12 months before its health insurance covers pre-existing health conditions (your cancer) -- but it must offset against that period the amount of time you had your existing coverage as long as you aren't without insurance for more than 2 months.

A prospective employer cannot ask about your health condition. If you will need an accommodation for a while to help you do your job because of continuing effects of your cancer or treatment, it is advisable to tell a new employer about the situation immediately or soon after accepting the job rather than waiting.

Before moving to a new employer, check the employer's benefits. In addition to health insurance, particularly look for disability income insurance and life insurance. Even if you don't need life insurance for a beneficiary, it can become an asset that you can sell if you become sick.

Retraining is available, possibly free.

Disclosure: There is no legal obligation to disclose your health condition and/or treatments to your employer or co-workers unless you could be harmful to co-workers. However, you will need to disclose your health condition if you need an accommodation to help you do your work.

If you are self employed or a small business owner:

  • If you haven't done so, start planning for continuation of your business in the event your cancer returns or in the event of a natural disaster.
  • Decide who you want to tell about your experience, and how much you want to tell. You'll want to balance between your business interests and the stress of keeping a secret.
  • Do planning in case you become unable to run your business temporarily or permanently. While you're at it, consider disaster planning.
  • Consider writing a Business Ethical Will which passes on your business philosophy and guidance for continuing the business.

NOTE: Practical information about all these subjects is in the documents listed in "To Learn More."

If you want to change jobs, or even careers, you can

Your diagnosis and treatment may have caused a rethink of what is important to you, including your job and career.

Thanks to a combination of laws, you can make a change despite your health history. 

Thanks to the Americans With Disabilities Act and similar laws, a new employer cannot ask about your health history. Neither can an educational institution.

Thanks to HIPAA, you cannot be subjected to a new waiting period for breast cancer coverage if there is a gap of no more than 62 days between coverages.

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 may need to stop work:

  • Learn about the disability income sources to which you may be entitled. Check benefits at work. Look at the requirements for obtaining Social Security Disability Insurance (SSDI). You paid premiums from withholding. See if you qualify for Supplemental Security Income (SSI).
  • If you are going to apply for SSDI or SSI: Only one third of applicants for SSDI are awarded an income. Survivorship A to Z provides easy-to-use information for applying as an educated consumer that makes it more likely to get a "yes" when applying for SSDI and/or SSI.
  • If you already have an income from either SSDI or SSI: Survivorship A to Z provides information about keeping your income, including what to do if an investigator shows up. We also provide tips to make the transition easier and explain your ongoing rights, such as keeping Medicare.
  • If you have health insurance through work and will continue coverage through a COBRA type law, start thinking about how to pay for the premium.

Home health care is available for many situations that used to require hospitalization. Home health care is generally covered by health insurance.

Get your legal affairs in order. (We call the subject "Planning Ahead"). Please do not assume from this that we are suggesting you are going to die sometime soon. Your prognosis depends on many factors, including the type of cancer, your physical condition and your access to the best cancer care. However, it is better to be safe than sorry. And what we are suggesting is what we suggest to everyone. Life is fragile.

If you want to have children, consider the options that are still open.

There are options available for both men and women.

Common to both men and women is the ability to adopt. Thanks to federal law, you cannot be discriminated against because of your cancer history when seeking to adopt.

  • Do not assume that you cannot have children if chemotherapy causes you to stop menstruating You may still be able to get pregnant. Use condoms. If you get pregnant, and cancer returns, you will face questions about the impact of cancer treatments on the fetus and about possibly terminating the pregnancy or risking your life. 
  • Pregnancy does not generally cause cancer.However, hormones that accompany pregnancy may hasten a recurrence. Ask your cancer doctor how much time has to pass before it is okay for you to get pregnant. If you are infertile, you may still be able to carry another person's baby.You can find additional information from Young Survival Coalition ( offsite link) and Fertile Hope ( offsite link). 

Federal law (the Americans With Disabilities Act) prohibits discrimination against people with a disability. The law covers adoption agencies. 

Your cancer may or may not be considered to be a disability for purposes of the ADA. Whether it is covered or not, expect that an adoption agency will want clarification on your health status and the possibility of a recurrence. At least a letter from your cancer doctor will likely be required. Do not be surprised if the agency requests that you want for a few years after end of treatment before adopting. 


If you don't have a pet, consider getting one.

Studies show that pets help emotional stability and longevity. The pet doesn't have to be a dog or a cat. 

If you get a pet:

  • Learn how to live with it safely both for you and your pet.
  • Make arrangements to have it cared for in case you can't either temporarily or permanently. 
  • Plan what happens in case you die.

If you live in an apartment where the landlord prohibits pets, you may be entitled to an exception if your doctor recommends one. The longer you are post treatment, the harder it is to justify a pet on this basis, but it's worth the try.

To Learn More

More Information

Pets 101

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Americans With Disabilities Act (ADA)