Post Treatment: Breast Cancer: 6 Months Plus

No matter how long it is has been since diagnosis and/or the end of tretment, you will always be a breast cancer survivor and all areas of your life are likely to continue to be affected.

Our discussion is divided into categories which we recommend that you at least skim to get an overview. You can return to each subject if and as it works for you. 

Medical Care

• Do not be surprised if some symptoms such as fatigue, depression or fear of recurrence continue. Some effects may even show up years after the end of treatment. 
  • The presence of symptoms does not mean they won't go away eventually. 
  • There are steps to take to help reduce the impact of long term effects.
  • With respect to various treatments:
    • If you had surgery: 
      • You may continue to have some discomfort.
      • If you had a mastectomy or a lumpectomy as well as axillary (underarm) dissection, you are at risk for lymphedema. Lymphedema is uncomfortable and can also be unsightly. Even though new techniques make it less likely to appear than previously, it is advisable to do what you can to prevent lymphedema.  Once you experience lymphedema, it is likely to recur. There is no cure for lymphedema. See: Lymphedema And Breast Cancer In Women
    • If you had radiation:
      • Your breast and surrounding area are likely to continue to be sensitive for a good while. If the color and texture of your breasts are changed, your doctor can let you know if they will revert to closer to what they were before the treatment.
      • You may experience "radiation recall" with the treated breast becoming sore and/or skin changes due to targeted therapy.
      • If radiation therapy included the underarm, you are at risk for lymphedema. Do what you can to prevent lymphedema.
    • If you had chemotherapy:
      • The fuzziness known as "chemo brain" may continue from before or show up. It will likely go away over time, although for some people it is permanent. Chemo Brain 101 describes steps to take to help cope with this symptom.
      • Fatigue may continue for at least as long as the time between diagnosis and end of treatment. (For information about living with fatigue,click here.)
  • If new symptoms appear. let your cancer doctor know "just in case."
• Women who have had breast cancer are at increased risk for developing a second breast cancer.
  • Give yourself a monthly breast exam. Most recurrences are identified by women doing their own breast exam. 
    • If you have a question how to give yourself an exam, see the American Cancer Society web site . Look for: "How To Perform A Breast Exam" 
    • If anything suspicious appears during an exam or any of the noted symptoms appear, call your cancer doctor right away. There are lots of false alarms, but there is no reason not to call. (NOTE: Don't be surprised if the office takes your call seriously. That is their job. It is not necessarily indicative of the seriousness of the situation.)
  • Get a breast cancer follow-up plan if you don't have one already.
    • Keep all appointments noted in the plan. There is a reason for each one. "Feeling great without symptoms" is not a reason to skip a follow-up appointment. Neither is a symptom you fear may be a recurrence.
    • Share your plan with all of your doctors.
    • Report  all changes noted in the follow-up plan as well as unexpected changes in your health to both your oncologist and your primary care physician. 
  • Adopt a cancer prevention diet and lifestyle For instance:
    • If you smoke quit. It helps reduce the odds that cancer will reappear. You’ll also reduce your risk of heart disease and other smoking related illnesses.
    • if you are overweight, lose the extra weight.
  • Consider:
    • Taking supplements to make up for any nutrients you are not getting in your regular diet. Your doctor or a dietitian/nutritionist may have suggestions about which supplements to take, if any. 
    • Hormonal therapies to prevent a recurrence.
    • Getting a pet. Pets have been shown to be good for your emotional and physical health. For information, click here.
    • Gene testing to decide whether to take additional steps.
    • Complementary treatments such as meditation and massage.
• Comply with drug regimens.
  • Save money when purchasing drugs
  • Store and dispose of drugs safely
• Prepare for visits with your doctors. 
  • Keep track of your symptoms, if any. We provide a Symptoms Diary to help. (A push of a button turns it into an easy-to-read graph to save precious time with your doctor).
  • Keep an ongoing list of questions and concerns so you don't have to try to remember things when you're under the pressure of a short period of time with the doctor. We provide a Prioritizer to help.
  • For more information, click here.
• Take care of your mouth. An infection could spread throughout your body.
• Consider getting a pet.if you do not have one. Studies show that pets can help quality of life and possibly even the length of life.
• Be sure there is  humor in your life - preferably on a daily basis.
• If your relationship with your doctor is not ideal, try to fix it. If it becomes difficult for you, consider looking for another doctor. See: How To Deal With Bumps In The Relationship With Your Doctor, How To Switch Doctors
• Take a few moments to think about what to do if there is a medical emergency, or how to continue medical care if there is a disaster. 

Health Insurance

• If you don’t have health insurance, do whatever you can to get it.  Despite 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. For more information about how to obtain health insurance, click here. Also see: How To Qualify For Medicaid. (Once you get health insurance, see: How To Maximize Use Of Your Health Insurance Policy)
• If you do have health insurance, do whatever is necessary to keep it. Health insurance may be the most important asset you have. Also, see: How To Maximize Use Of Your Health Insurance Policy
  • 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.  Before electing COBRA, find out what individual policies you may be eligible for in your state or coverage you may be able to obtain through a spouse, significant other or parent if you are under age 26. 

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.
• Do your best to carry basic insurance such as Homeowners/renters Insurance. 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 breast cancer, the more likely you will also be able to get Disability Income Insurance and/or Long Term Care Insurance.

Finances

• People with medical expenses represent over 60% of the people filing for personal bankruptcy. Over 75% of those people had health insurance.
• If you are having difficulty paying medical bills or other debt, there are time tested techniques to use. For information about how to deal with a financial crunch or crisis, click here. If all else fails, consider bankruptcy.
• If you have a positive cash flow, a bit of financial planning for a survivor will help 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.
  • Start by creating an Emergency+Fund.
  • Refine your investment strategy to fit your health situation.
  • For information about these subjects, see Breast Cancer: Post Treatment: Finances  

Government Benefits

There are no government benefits which distinguish between breast cancer and other health conditions.  To learn about government benefits for which you may qualify, see: www.benefits.gov

Emotional Well Being

• Emotional swings can continue for years. The severity of emotional swings generally lessens over time, but can surface at unexpected times.
• There are steps to take to help you cope including breast cancer support groups and programs that will connect you with other women who have had a similar breast cancer experience.
• For more information, see Breast Cancer: Post Treatment: 6 Months Plus: Emotional Well Being

Work Issues

• Looking for work
• At Work
• On Disability (including thinking about returning to work)
• Small Business Owner
• Self Employed

Day To Day

• 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. They may not talk about your cancer, but that doesn't mean they don't still think about it at times.
• If you want to have children, consider the options that are still open.
• For information about each of these subjects, see:Breast Cancer: Post Treatment: 6 Months Plus: Day to Day

Planning Ahead

• If you haven’t before, now is a good time to get your legal affairs in order. In fact, this would be a good time for your entire family to focus on these subjects. Stuff can happen to any of us at any time. (Shifting the focus to the family unit also takes away any fear on their part that you are taking these steps because of breast cancer news that you are not sharing).
• At the least, execute documents known as Advance Healthcare Directives which let you stay in control of the medical care you do or do not want if you become unable to speak for yourself or become unconscious. The documents are free and don’t require a lawyer. (Also let the person who will be in charge of your directives know that we have an article: How To Enforce Advance Health Care Directives
• If you have children, make plans in case you are temporarily or permanently unable to care for them. See: Children 101
• Consider creating something like an Ethical Will which tells your children what you learned during your lifetime and family history. Or perhaps create a video or photo scrap book of your times together.
• Keep control of what happens to your assets if you die by at least having a will. Wills also help prevent family fights. Wills are not expensive, and may even be free. See: Wills 101
• Thinking about, and talking about, funeral plans will save unnecessary stress and a good deal of money. See: Funerals 101
• NOTE:  Check all documents, securities accounts and banks accounts with beneficiaries on them to be sure:
  • The beneficiary you want is listed. 
  • If there is more than one beneficiary, the split between them is clear.

NOTE:

• 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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