Life After Cancer: The ‘New Normal’

Finishing cancer treatment is a major cause for celebration. However, many survivors face a new set of challenges as they begin processing the difficult experience they just went through and start thinking about what comes next. During cancer diagnosis and treatment, all of the energy and focus is spent on getting through the treatment. Once it’s over, the focus switches to establishing “the new normal”—a life that is often much different than it was before cancer.

We spoke to Deborah Mayer, PhD, RN, director of cancer survivorship at UNC Lineberger Comprehensive Cancer Center, about adjusting to life after cancer.

What can people expect after cancer?

In addition to physical changes such as weakness and fatigue, it is also common for survivors to experience a new wave of emotions ranging from fear and anxiety to guilt and depression. This may come as a surprise, since most people would expect those emotions to disappear once treatment is over. However, this is not the case for some. People who have just survived cancer often live with a fear that the cancer will return and an anxiety about how it could affect their future.

It is also not uncommon for survivors to experience anxiety or depression as they wrestle with the idea that life won’t be the same as it was before cancer. Survivors’ guilt is also a very real experience, as they feel fortunate to have survived but guilty that others haven’t. And it’s normal for survivors to feel sad about losing frequent contact with their oncology team, whom they have grown accustomed to seeing on a regular basis.

What are the chances that the cancer returns?

It’s hard to know for sure. The likelihood of recurrence depends on a number of factors including the type of cancer, the stage the cancer was caught and the individual person’s body. The chances of recurrence are highest the first few years after the treatment is finished, but the good news is that the chance of recurrence decreases over time and continues to decrease as time passes.

What kind of follow-up appointments does a cancer survivor need?

Once treatment ends, each person’s oncologist or oncology nurse helps them develop a survivorship plan. Each plan includes a review of the diagnosis and treatment received and maps out what type of appointments and tests the person will need in the following months and years. Typically, a cancer survivor will visit with his or her oncologist for a checkup every three months immediately following the conclusion of the treatment.

After a year or two, the visits will decrease to every six months and then once a year. It may be discomforting not to see the oncologist as often as they did during treatment, but this feeling is completely normal.

What can people do after treatment to deal with the emotional and physical toll of cancer?

The No. 1 thing people can do is walk. Walking has a great impact on mood, sleep and energy. While researchers are still figuring why exactly it works so well, going on at least a 15- to 20-minute walk three to five times a week can do wonders for your body, mind, emotions and overall health. I also suggest maintaining a healthy diet with more vegetables and less processed and red meat and alcohol. We all should be doing that, but it has tremendous benefits for survivors.

Survivors may also want to consider getting emotional support from other cancer survivors as they begin adjusting to the new normal. Survivors oftentimes find that they can receive a deeper level of support from people who have experienced the same things. Those interested in this kind of support can find a number of local programs and online communities. I also recommend the Springboard Beyond Cancer site, which has resources for people during and after treatment.

It will also be important to see their primary care provider after treatment ends. They may be taking care of other issues, not related to the cancer, such as diabetes and high blood pressure, as well as well visits and yearly flu shots.

If there are ongoing issues related to the cancer or its treatment, it may be useful to get additional help such as seeing a physical or occupational therapist.

How can family and friends provide support to a cancer survivor?

Once a loved one receives the news that the cancer is gone, family and friends will be excited and anxious for life to return to normal. One of the best ways they can support their loved one is to first appreciate and understand that while the cancer may be over, their loved one will need to recover and will be establishing a new normal. Some survivors say that part of the difficulty of dealing with life after cancer is their family and friends not understanding their emotions or why life can’t return fully to the way it was before. Family and friends should also be ready to provide emotional support when it’s time for follow-up appointments and tests. These moments can be especially difficult times when fear and anxiety resurface.

 Learn about survivorship resources at the UNC Lineberger Comprehensive Cancer Center.