What happens next? The last day of your treatment is probably something you’ve been dreaming of for a long time. But how will you feel when it happens? There will be a sense of relief, yes – but perhaps some confusion and anxiety, too.
Check-ups after treatment Towards the end of your treatment, your care team will prepare your treatment plan for the future (sometimes it’s called a survivorship care plan). You’ll find out if your care team wants you to see a specialist for regular check-ups (usually every three to six months) or if your local GP can do the job. You’ll also get referrals for any rehabilitation or support services you may need. A copy of the treatment plan will be sent to your GP. From this point on, your GP is likely to be the person to go to if you have any health concerns.
At your regular check-ups you may have blood tests, x-rays or scans as part of ongoing surveillance. If you are concerned about any symptoms between visits, contact either your GP or your specialist straight away – you don’t have to wait until your next check-up.
Maintenance Your treatment plan might include some ongoing ‘maintenance’. Often this involves taking drugs or having periodic injections as part of hormonal or biological therapy. You may experience continuing side effects with these therapies, but remember that the reason you’re having these treatments is to improve your chance of ridding yourself of cancer for good. If you start feeling negative about this continuing treatment, it might help to ask your GP for a referral to a counsellor or psychologist.
Recovering The good news is that many of the side effects you’ve been dealing with will begin to disappear once you’ve finished treatment. The bad news is it could take a while to feel fit and healthy again. It’s not unusual for the side effects of treatment to linger for several months. If you think they’re lasting too long, speak to your GP.
Rehabilitation Cancer treatment may bring physical changes that affect how your body functions: how you move, how you eat, how you speak, how you urinate and defecate and so on. If you need some help to adjust to the new you, your treatment plan will probably include a referral to a rehabilitation service. If you have been treated for your cancer in a private hospital, you may have to make a specific request to be referred for rehabilitation. You can also get referrals from your GP.
Dealing with insecurity You’ll have to wait five years before your care team is comfortable giving you the cancer all-clear. In the meantime, you’ll have questions, doubts and anxieties. It’s impossible to switch off to the possibility that the cancer will return, but you’ll feel better if you don’t dwell on it. If your worries are stopping you from getting a good night’s sleep, talk to your GP or care team. If you’re so fearful you find that you can’t make any future plans, you could find that talking to a counsellor or psychologist will really help.
Words to know
Metastasis the spread of cancer from one part of the body to another
Remission the disappearance of cancer symptoms
Survival rate the likelihood of being alive five years after diagnosis
Survivor anyone who has finished cancer treatment and has no more signs of cancer
Things to ask
What should I be looking out for? Ask your care team about any telltale signs that might indicate you have a problem or that the cancer is returning. Ask them to be as specific as possible so that you don’t overreact to everyday health glitches, unrelated to your cancer.
Expert's insight: Gill Batt The end of treatment often marks the beginning of a new period of sensitivity and anxiety says Gill Batt, director of cancer information and support services at Cancer Council NSW.
“People often say that you become a lot more aware of little niggles in your body and you think ‘Oh, is that it coming back?’. You get a bit of backache: ‘Oh no, has it metastasised? Has it come back?’.
“Talk about it and accept that it is quite normal to have those anxieties. And discuss it with your doctor so you understand what to look out for, so you’re not jumping to bad conclusions about everything.
“You might also want to check back in with your GP. You’ll no longer be going back to your oncologist so your GP will be your new port of call for normal medical treatment as well as any niggles you may have.
“The other thing is that you tend to have new anniversaries. You’ll remember the date that you were diagnosed so that it will be ‘I’m one year on’, ‘I’m two years on’, ‘I’m three years on’… And the other thing you’ll probably worry about is when you go back to your doctor for your check-up. At first that might be every three months or every six months and then that can often become an annual thing.
“People do become very anxious about going back to see if the cancer has come back or not. For a lot of people it’s there in the back of their minds for a long time.”
More help
Australian Cancer Survivorship Centre www.petermac.org/cancersurvivorship (03) 9656 1111 A great source of information for all those who have finished treatment and the people around them.
Cancer Council Helpline 13 11 20 You may be unsure who to talk to now when you have questions about how you’re feeling, emotionally or physically. The Cancer Council Helpline will point you in the right direction.
Photo by John Dunn
SOPHIE GUENANAIN Sophie Guenanain, 29, had surgery to remove cervical cancer 18 months ago. Check-ups every three months are relieving her anxiety, but she admits to the occasional freak-out.
Sophie, a beauty therapist, had moved from France to Australia to learn English. While on holidays back in France, she had a Pap smear with irregular results. Further tests in Australia confirmed pre-cancerous cells on her cervix. Sophie had surgery to remove her cervix and, 10 days later, was given the all-clear. That was 18 months ago. She now has regular check-ups, including three-monthly Pap smears and an annual MRI scan.
“It’s just such a relief to hear that the cancer has gone. You just fight, fight, fight and then you really feel the pressure leaving your body. Throughout the process I tried very hard to be positive. I kept thinking it was going to be fine. But at the back of my mind was always a little thought it could be bad. So you feel so much better, not having to worry.
“Going for my three-monthly check-ups also gives me relief. But I must admit, when you have a tiny little thing going wrong you just freak out completely. I had some unusual symptoms last year and I totally freaked out. I went to see my doctor straight away and there was a little thing different, so 15 days later I went back to him and I had another scan to see if everything was alright. I was fine.
“I feel so lucky that I can make a phone call to talk to my doctor straight away. And as soon as my doctor has my scan results he calls or emails me. I feel fortunate to have that, when I compare it to the French system. You can’t do that in France. My mum, who lives in France, just had an operation and she was concerned about something unusual on her leg. She emailed her doctor but she never heard back from him.
“I’m really very lucky. I’ve had really good follow-up from everybody and that gives me peace of mind.”