After Chemotherapy for Breast Cancer

This information explains what to expect after you complete chemotherapy for breast cancer.

Most people are relieved when they finish chemotherapy, but some people may feel worried. For months, you’ve seen your doctor and nurse very often. They could answer your questions and reassure you at each visit. Now that you’ve finished chemotherapy, you won’t see them as often, but you will likely continue to have questions and concerns. It’s important to remember that just because you’ve finished chemotherapy doesn’t mean that you’re on your own. Your doctor and nurses will continue to care for you now and in the years to come.

Side Effects After Chemotherapy

After you finish chemotherapy, you may have some remaining side effects. While most go away soon after your last dose, others may last for weeks or months. Some of these side effects are listed below. For more information on each side effect, talk with your nurse.

Blood counts

After your last dose of chemotherapy, your white blood cell count will go down. It should begin to return to normal about a month after your last treatment. Your red blood cell count may also go down, but it should return to normal around the same time.

Hair loss

If you lost your hair, you should start to see it grow back 14 to 21 days after your last chemotherapy treatment. The amount of time is takes to grow back varies from person to person.

 

When your hair grows back, it may be a different color or texture. These changes are normal. Over time, most people’s hair returns to its original color and texture, but some people may have long-term changes.

Neuropathy

Some chemotherapy medications can cause neuropathy (numbness or tingling in your hands and feet). It may get worse after you have your last chemotherapy treatment. Most patients notice improvement 2 to 4 months after chemotherapy, but the neuropathy can take up to 1 year to fully go away. For some people, it never completely goes away.

Nausea, vomiting, and taste changes

You may experience nausea and vomiting after your last chemotherapy treatment. It should go away within 2 to 3 weeks.

Your appetite may continue to be affected due to taste changes you may have experienced during your treatment. Your taste should return to normal within 1 to 2 months after chemotherapy. In the meantime, there are things you can do to help with these changes. Talk with your nurse if you’d like more information.

Fatigue

Your fatigue (feeling unusually tired or weak) will improve over time. You may have lost some muscle and strength during your treatment and will need to slowly build it up again. Walking or doing another form of light exercise each day will help with this.

“Chemo brain” and stress

“Chemo brain” is a very common complaint during and after chemotherapy treatment. People describe it as mental changes that may include poor memory, difficulty finding words, and the inability to focus and concentrate. This can interfere with your life, including caring for your family and managing your job.

Some things that help with chemo brain include keeping a calendar, writing everything down, and exercising your brain with puzzles and reading. Try to focus on 1 task at a time instead of multitasking. You can also work with an occupational therapist in Cognitive Behavioral Rehab. For more information, speak with your healthcare provider.

Try to avoid having expectations for yourself that are too high. This can add to your stress level and frustration. Most people say it takes 6 to 12 months after they finish chemotherapy before they truly feel like themselves again.

Fear of recurrence

Fear of recurrence (cancer coming back) is very common for many people who have finished chemotherapy treatment. You may become concerned about new symptoms you’re experiencing and wonder if they’re related to breast cancer.

It’s important for you to tell your doctor about any new symptoms. Many of these issues are normal parts of healing and your body returning to a “new normal” after breast cancer treatment. However, your team is always available to discuss your concerns or fears with you. You can call or send electronic messages to your doctor or nurse through MyMSK (also called the Patient Portal). You can reach MyMSK by typing my.mskcc.org/login into your internet browser. It may also be helpful to speak with a social worker, therapist, or chaplain, or to join a support group.

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Integrative Medicine

Our Integrative Medicine Service offers therapies that may help you manage the side effects after chemotherapy. Some services we offer are:

  • Acupuncture
  • Massage
  • Yoga
  • Other relaxation techniques

These services can help control pain, nausea, fatigue, anxiety, depression, poor sleep, and other symptoms. For a complete listing, please visit our web page at www.mskcc.org/cancer-care/treatments/symptom-management/integrative-medicine, or call 646-888-0800 to make an appointment.

 

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Follow-up Care

You will see your doctor every 6 months for the next 5 years. You may see your doctor more or less often depending on your recovery. If you have any questions or concerns, you can call your doctor’s office at any time.

At each visit, your healthcare team will ask you if you’ve noticed any changes in your health. You will also have a physical exam, blood work (which may include tumor markers, depending on your stage of cancer), and any necessary imaging tests.

It’s important to also follow-up with your primary care doctor for your routine health care. This includes blood pressure checks, cholesterol monitoring, and standard lab work. It’s important that your doctors at Memorial Sloan Kettering (MSK) have all your health information, including your primary care doctor’s contact information.

In 2 to 5 years, your care will be transferred to a survivorship nurse practitioner (SNP). An SNP is a member of the MSK Breast Cancer team who works closely with your doctor.

As your breast cancer-related needs decrease, your follow-up care may be transferred from MSK to your local primary care doctor. The timing for this depends on your type of breast cancer and treatment, but the transition usually occurs about 10 years after treatment.

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