x

FAQ

How can we define ‘survivorship’?

‘Survivorship’ can have many different meanings, depending on your outlook on the situation. The Canadian Cancer Society suggests a way of defining a cancer survivor as anyone who:
-has finished and is recovering from their active cancer treatment
-is on maintenance therapy
-is having ongoing treatment for cancer that is stable and slow growing
-is on active surveillance
-is in remission

Wherever you are in your recovery, ‘survivorship’ means simply what it means to you. If you believe that you are a survivor, take this label on and be proud of your strength!

< Canadian Cancer Society: Life After Cancer Treatments>

How long will recovery take?

Everyone’s recovery is unique, both in length and form. Sometimes the recovery process from a treatment can take longer than the treatment itself. Some people prefer to get as close to their ‘normal’ life before cancer as possible, while others decide to make changes in their lives or do something they’ve always wanted to- such as travelling, or taking up new hobbies. Whatever you want your recovery to look like, keep in mind that during this period you will have many medical appointments to track your progress, and plan accordingly.

Your physical recovery will be aided by general well-being. Eating well and exercising will help your general health, and your immune system, improve. Quitting smoking will also improve your general health, and lessen the chances of a recurrence. Your skin will be sensitive after skin cancer, so practicing sun safety will also help to keep a recurrence at bay.

Is it normal to feel depressed during the recovery period?

While it seems like a given that you should be happy to complete your cancer treatments, the opposite is true for some people. There are many causes of unhappiness after treatment, including grief over lost time, fear of a recurrence, memories of the difficulties of treatment, changes in your body, or financial stress. These are all valid concerns to be having in the wake of cancer treatment. These can be good things to talk about with friends and family, or in a cancer support group. If you are worried that you may be clinically depressed, consult your healthcare team, whom may recommend you to a mental health professional.

When will I be able to go back to work?

Many people are able to go back to work quickly after their treatments. However, it is wise to speak to your human resources department to determine how your employment and health benefits will be affected upon your return to work, and to see if your employer has any support programs for employees returning to work. While it is against the law to discriminate against someone who has cancer, it is possible that your position at work has changed during your absence. If you are looking for a new job after treatment, be aware that your medical history might make your job hunt more difficult.

What will my medical schedule be like?

Your medical schedule after treatment depends on your cancer, what treatments you received, and your body’s reaction to these treatments. Regardless of these factors, you will be have medical appointments regularly so your healthcare team can monitor your recovery and be able to catch a recurrence, if you have one. These followup appointments may be frightening; it might help to think of them as a tool for you to be in control of your body and your cancer. We recommend that you keep a personal health record for your own benefit. This would include your type of cancer and stage, the date of your diagnosis, dates of tests you’ve had and their results, contact information for your healthcare team, and other pertinent information. Here are some guidelines for your potential followup schedule. Remember to perform a self-examination of your skin monthly in addition to these appointments:

Stage 0: Your doctor will examine your skin every year, but you should self-examine once a month.

Stage IA: Your doctor will see you every three to twelve months for five years, and once a year after that. You should self-examine your skin once a month.

Stage IB, IIA, IIB, IIC: Your doctor will see you every three to six months for two years, then every three to twelves months for two more years, and once a year after that. You should self-examine your skin once a month.

Stage IIIA, IIIB, IIIC: Your doctor will see you every three months for the first year, every four months in the second year, every six months for the next three years, and once a year after that. You should self-examine your skin once a month.

Will my immune system be weaker?

With the exception of immunotherapy, cancer treatments may weaken your immune system. The wound left after a surgery increases the risks of an infection, while radiation and chemotherapy limit the amount of white blood cells produced by your body. Therefore, your body is more susceptible to infections and other illnesses during your recovery. It is advisable to avoid people who have illnesses, such as the cold or flu, and to wash your hands often. Keeping in good health by not smoking, drinking only in moderation, eating well, and exercising will also improve your health. Nutritional supplements such as vitamin A and probiotics are known to help improve the immune system.

< Harvard Health Publications: How to Boost your Immune System>

Will I have additional financial concerns?

Your financial situation after treatment depends on how long you have been absent from work, your health benefits, and your medical expenses. During your recovery, there may also be continuing costs for medication or equipment. Once you are back to work, claiming some of your medical costs on your income tax return might help to alleviate your financial stress. Your life and travel insurance premiums may also change given your new medical history. Keep in mind that you may not be able to return to full time work right away.

If you are unable to go back to work for a long period of time, or not at all, you could look into your disability benefits. These benefits pay a percentage of your salary, but are dependent on your employer’s coverage. You might also qualify for governmental benefits through the Canada pension plan disability program.

Should I be concerned about a recurrence?

Having a melanoma in the past increases the chances of a recurrence; therefore it is important to keep your body healthy during your recovery period. Eating well and exercising will make you feel better, and help the recovery of your immune system. Quitting smoking and practicing sun safety in the wake of skin cancer will also minimize your chances of a recurrence. As you will be seeing your doctor regularly while you are recovering, make sure to ask him about any questions or concerns you might have. Ask your doctor what symptoms to look out for so you don’t worry about every ache and pain, and if you notice one of these symptoms, call your doctor right away, even if it is between appointments. Your medical schedule after treatment will be as follows (or similar):

Stage 0: Your doctor will examine your skin every year, but you should self-examine once a month.

Stage IA: Your doctor will see you every three to twelve months for five years, and once a year after that. You should self-examine your skin once a month.

Stage IB, IIA, IIB, IIC: Your doctor will see you every three to six months for two years, then every three to twelve months for two more years, and once a year after that. You should self-examine your skin once a month.

Stage IIIA, IIIB, IIIC: Your doctor will see you every three months for the first year, every four months in the second year, every six months for the next three years, and once a year after that. You should self-examine your skin once a month.

If you are experiencing anxiety around a recurrence, speaking about it to family, friends, or a counsellor can help. It is also advisable to keep your medical insurance for as long as possible in case of a recurrence.

Will my friends and family treat me differently?

It is natural for changes in your medical status to strain your relationships with friends and family. Your general perspective has probably altered considerably, making it difficult for you to relate to those around you. Your friends and family might not know how to treat you during your recovery, or assume that you’re back to your healthy and energetic self, which you might not be yet. In contrast, they might be overprotective of you, when you’re looking for independence in your recovery. Ask your family and friends to be patient with you, and share your feelings. Be honest about what you feel up to doing; their behaviour towards you will not change unless you tell them what you need, and your relationship may become stronger as a result. If you find yourself unable to talk about your experience with cancer to friends and family, it might be helpful to look into a support group, such as the one run by Save Your Skin. Speaking to other cancer survivors about your shared experience may help to alleviate any resentment you have towards other people in your life for not being able to relate to this experience.

Is it safe to get pregnant after cancer treatments?

If you are wanting to have a child after your treatments, the first step is to contact your healthcare team. Their recommendation will be based on your age, the kind of treatments you received, whether your cancer has genetic links, and your chances of a recurrence. It is recommended that, regardless of which treatment you received, that men wait at least a year for their sperm to heal, and that women wait for around six months for any eggs that may have been affected by treatment to leave the body. Babies who are conceived during or too soon after treatment may have a higher chance of birth defects. Certain cancer treatments, such as radiation and chemotherapy, may negatively affect your fertility or reproductive organs. Be prepared for the possibility that it might be inadvisable, very difficult or impossible to become pregnant after cancer treatments.

Will there be side effects during my recovery?

Physical side effects after treatments depend on the treatment(s) you received, and how your body coped with them. Side effects can include nausea, fatigue, pain, incontinence, menopausal symptoms, nerve damage, and problems with your digestive system and organs. Ask your doctor what kinds of side effects are possible given your medical history in order to prepare yourself. Also be aware that your immune system may have been weakened by your treatment (especially in the case of chemo and radiation therapy), and you may be more prone to infections and other illnesses during your recovery.

If your lymph nodes have been removed by surgery or damaged by radiation therapy, you may also be at risk for lymphedema. Lymphedema is when the buildup of lymph fluids in the body causes swelling. This can be a long-term or short-term condition. Symptoms of lymphedema include decreased flexibility in joints, feelings of heaviness in the arms or legs, feelings of tightness in the fitting of clothing and jewelry (without weight change), and recurring infections in the same area. Let your doctor know if you notice any of these symptoms, as lymphedema is easier to manage when it is caught early.