Thanks to advances in cancer detection and treatment, more patients are surviving and thriving. While navigating your new life after cancer, you may have questions regarding follow-up treatment, emotional care, fertility, sexuality, and healthy living.
Here are some of the most common ones we hear.
- When am I considered a cancer survivor?
- What follow-up care should I receive when my treatment is finished?
- What do the terms “long-term” and “late effects” of cancer mean?
- What types of follow-up tests will I need?
- What is a Survivorship Care Plan?
- How can I manage the fear and anxiety I feel before my follow-up test or appointment?
- What actions can I take to improve my health after completing treatment for cancer?
- What do I need to know about my risk of cancer recurrence?
- What do I need to know about my risk of developing a new cancer?
- Where can I find information for cancer survivors about health insurance issues?
- Where can I find information for cancer survivors about workplace issues?
- I want to have a family someday. Is there anything I can do to protect my fertility?
- What can I do to stay sexually active and healthy?
- Where can I learn more about cancer survivorship?
The term “cancer survivor” can mean different things to different people. For some, the term refers to anyone who has been diagnosed with cancer, regardless of whether they have ever had or are currently in treatment. Others consider a cancer survivor to be someone who has completed active treatment and is free of any signs of disease.
For the purpose of Memorial Sloan Kettering’s Adult Survivorship Program, the transition from cancer patient to cancer survivor occurs after you complete active cancer treatment, as determined by your doctor.
During the survivorship phase of your care, your healthcare provider will carefully monitor you for a period of time determined by your treating physician.
Key components of your follow-up care may include:
- surveillance for disease recurrence
- identification and management of late or long-term effects of cancer treatment
- strategies to keep yourself healthy, such as recommendations for physical activity, diet, and tobacco cessation
- recommendations for cancer screening
- delivery of a treatment summary and care plan
- communication with your primary care provider
If you’ve been treated for cancer at MSK, your team may refer you to one of our disease-specific survivorship programs.
While most cancer survivors lead healthy, active lives, the disease and its treatment can have a long-lasting impact.
Long-term effects begin during, or shortly after, treatment is completed and last for many months or years.
Late effects are those that can occur years after treatment is completed.
Not all cancer survivors experience these effects, but if you are having difficulty, please contact your healthcare provider. There are strategies that can help in identifying and managing physical as well as emotional effects of treatment.
Your doctor or nurse practitioner will recommend specific tests to regularly check for signs that your cancer has returned or that a new cancer has developed. Your team may also order tests to check for late effects of treatment that could affect your health. Some tests may be performed at every visit; others are performed less frequently.
Your follow-up care may include a physical exam and laboratory tests to look for abnormalities in samples of your blood, urine, or other body fluids. Many different imaging technologies are also used to identify a cancer recurrence or second cancer.
A Survivorship Care Plan is a record of your cancer treatment and recommendations for follow-up care.
The Institute of Medicine strongly recommends that once you are done with treatment, your clinicians provide you and your primary care providers with a summary of:
- the cancer treatment you received
- a detailed plan for ongoing care, including follow-up schedules for visits and testing
- recommendations for early detection and management of treatment-related effects and other health problems
The plan should define the responsibilities of each of your healthcare providers. Even if you have this written plan, it’s important to talk with your doctors about your future care.
Oncology nurses and physicians from the MSK Survivorship Program have developed a cancer treatment summary and follow-up plan template. In addition, the National Cancer Institute offers a detailed fact sheet with more information about Survivorship Care Plans.
It’s normal to feel anxious before your follow-up tests and appointments, but there are ways to ease your mind. Tips and strategies include writing down questions about any issues you are currently or have been experiencing — whether it’s long-standing symptoms, emotional aspects, or practical issues such as questions about health insurance — and asking a friend or family member to sit with you while you wait for your scans.
In the days before your appointments, schedule activities that can help distract you from worrying, such as going for walks, talking with friends and family, or doing a calming exercise like yoga.
You may find that your anxiety lessens or disappears over time. But if it becomes overwhelming, persists for many weeks, or makes it difficult for you to keep your appointments, please consider consulting a mental health professional.
There are several important things you can to do safeguard your health.
Quitting smoking is one of the best ways to improve your general health. Quitting will help you breathe easier and feel better overall. It will also reduce your risk of developing certain cancers and will help prevent cardiovascular disease. Learn more about Memorial Sloan Kettering’s tobacco treatment program.
Protect Yourself from the Sun
You can reduce your risk of getting skin cancer by shielding yourself from the sun’s ultraviolet rays. Keep your skin from direct sunlight by wearing protective clothing, applying sunscreen, staying in the shade, and avoiding sunlamps and tanning booths. For more information, read the Skin Cancer Foundation’s guide to sun protection.
Eat a Nutritious Diet
Eating a nutrient-rich diet with plenty of fruits and vegetables can help you feel better and may lower your chances of developing other health problems. Our Eating Your Way to Better Health and Eating Well during and after Your Cancer Treatment guides offer general dietary guidance. Browse our recipes that are selected to help with common symptoms from cancer or treatments.
Achieve and Maintain a Healthy Weight
After cancer treatment, speak with your healthcare provider about whether you need to gain or lose weight. Ask for a referral to one of our nutritionists if you want help in managing your weight.
Exercise after cancer treatment, regardless of how active you were prior to your diagnosis, can improve cardiovascular fitness and muscle strength. Regular exercise may also reduce fatigue in some cancer survivors.
The risk that your cancer returns, or recurs, depends on the type of cancer you had, the stage of the cancer at diagnosis, the treatment you received, how much time has passed since your treatment, genetic factors, and environmental exposure. Your doctor can discuss your personal risk of recurrence with you.
The signs and symptoms of recurrence vary based on the type of cancer and how it has grown. In some cases, you may not feel or see any signs. Therefore, it’s vitally important to attend follow-up visits with your doctor or nurse to monitor your health.
Tell your healthcare provider about any new symptoms you have so that they can be evaluated. However, at the same time, remember that every symptom you have will not be related to cancer.
Some cancer survivors have a higher risk of developing a second primary cancer as a result of their prior cancer treatment, environmental exposures, or genetic factors. Having appropriate cancer screening tests performed at the recommended intervals is an important step in the early detection of these cancers. Discuss what screening tests you should have with your doctor or nurse.
The National Cancer Institute provides additional information about cancer causes and risk factors.
Health insurance questions are important and often complex. To discuss these types of questions pertaining to treatment at MSK, you can call our insurance information hotline at 646-497-9176. Learn more about insurance for MSK patients or find out more about the financial resources available to survivors.
Your cancer history may entitle you to protection under the Americans with Disabilities Act. Your employer cannot discriminate against you as long as you are able to perform the essential functions of your job. If your cancer or the effects of your treatment interfere with your ability to perform your job, your employer may need to provide reasonable accommodations to allow you to continue working. Learn more about work, education, and financial resources.
Many of the treatments that have led to improved survival rates among people diagnosed with cancer also have the potential to impair fertility. However, there are options to preserve fertility before treatment begins and to build a family after treatment is completed. Learn more about options we provide to men and women with cancer.
Cancer and its treatment can affect your sexuality in various ways. People wonder what sorts of concerns other men and women have, how best to bring up the topic, whether they should include their partner in sexual health counseling, and more. Explore our answers to common questions about these and other sexual health topics.
To learn more about cancer survivorship, please visit our Adult Survivorship Program.