When cancer treatment ends, you may feel a variety of different emotions. Some people feel hope and happiness, while others have worries and fear. No two people are alike.
A person who has had cancer is commonly called a cancer survivor. “Co-survivor” is sometimes used to describe a person who has cared for a loved one with cancer. Survivorship focuses on the health and wellbeing of patients after the end of their primary treatment for cancer.
The following information is provided by the American Society of Clinical Oncology (ASCO).
Understanding Survivorship
According to the ASCO, there are three phases of survivorship:
- Acute survivorship starts at diagnosis and goes through the end of initial treatment. Cancer treatment is the focus.
- Extended survivorship starts at the end of initial treatment and goes through the months after. The effects of cancer and treatment are the focus.
- Permanent survivorship is when years have passed since cancer treatment ended. There is less of a chance that the cancer may come back. Long-term effects of cancer and treatment are the focus.
What to Expect
At the end of treatment, a person will have less frequent contact with the health care team. Survivors may have:
- Relief that treatment is over
- Uncertainty about the future
- Increased anxiety
- Fear that the cancer will come back
- Guilt about surviving, having lost others to cancer
- Physical, psychological, sexual, or fertility problems
- Relationship struggles
Follow-up Care
Your care does not end when your treatment does. You will continue to see your health care team to monitor your overall health. You and your health care provider will develop a follow-up care plan which will serve as a guide for monitoring your health after active treatment. This care could include regular physical examinations and medical tests. The plan is specific to your diagnosis and individual needs.
Watching for Recurrence
One goal of follow-up care is checking for a recurrence. Recurrent cancer is cancer that has come back after treatment. During follow-up visits, your doctor will ask specific questions about your health. Some people may have blood tests or imaging tests as part of regular follow-up care. Your doctor may also tell you to watch for specific signs or symptoms of recurrence.
Managing Long-term and Late Side Effects
During treatment, you may experience some side effects. It is often surprising to survivors that some side effects may linger beyond the treatment period. These are called long-term effects. Other side effects called late effects may develop months or even years after cancer treatment ends. Long-term and late side effects can include physical and emotional changes. Talk with your doctor about your risk of developing long-term side effects.
Where to Receive Follow-up Care
You may continue to see your oncologist or your primary care provider or another health professional. This depends on several factors, including:
- The type and stage of your cancer
- Treatment side effects
- Health insurance guidelines
- Personal preferences.
Questions to Ask Your Health Care Team
Consider asking your health care team these questions about your follow-up care:
- What is the risk of the cancer returning? Are there signs and symptoms I should watch for?
- What should I do if I notice one of these symptoms?
- What long-term side effects or late effects are possible based on the cancer treatment I received?
- Who will be coordinating my follow-up care? Does he or she have experience with cancer survivors?
- How often should I return for a follow-up visit?
- What tests will I need when I go for my follow-up visits?
- What screening tests do you recommend based on the treatments I had?
- How long will I need to continue getting screening tests?
- Do I need to take any special medications or follow a special diet?
- Do I need to be referred to a specialist?
- What can I do to lower my risk of the cancer coming back or developing a second cancer?
- How can I get a treatment summary and survivorship care plan to keep in my personal records?