After cancer treatment, many survivors want to find ways to reduce the chances of their cancer coming back. Some worry that the way they eat, the stress in their lives, or their exposure to chemicals may put them at risk. Cancer survivors also find that this is a time when they take a good look at how they take care of themselves and their health. This is an important start to living a healthy life after cancer.

When you meet with your doctor about follow-up care, you should ask about developing a wellness plan that includes ways you can take care of your physical, emotional, social, and spiritual needs. You may not be used to talking with your doctor as a partner in planning for your health, so it may be hard for you at first, but it is very important that you do it. The more you do it, the easier it will become.

Research is just beginning to show what people can do to lower their risk of getting certain cancers. But we don't yet know why cancer comes back in some people and not others.

Making changes in the way you eat, exercise, and live your life may not prevent your cancer from coming back. However, making these changes can help you feel better and may also lower your chances of developing other health problems.

Changes you may want to think about:

• Quitting smoking. Research shows that smoking can increase the chances of developing cancer at the same site or another site.
• Cutting down on how much alcohol you drink. Research shows that drinking alcohol can increase your chances of developing certain cancers.
• Eating well and exercising.

Eating Well After Cancer Treatment

1. Eat a variety of healthful foods, with an emphasis on foods from plant sources.

• Eat five or more servings of vegetables and fruits each day.
• Choose whole grains—rather than processed (refined) grains and sugars.
• Limit eating red meats, especially high fat or processed meats.
• Choose foods that help you maintain a healthy weight.

2. Adopt a physically active lifestyle.

3. Maintain a healthy weight throughout the rest of your life.

4. Limit drinking alcohol, if you drink at all.

Source: American Cancer Society Recommendations for Nutrition and Physical Activity for Cancer Prevention, 2002

Exercise After Cancer Treatment

Few studies have been done to find out whether physical activity affects survival after cancer treatment. More research is needed to answer this question, but studies have shown that moderate exercise (walking, biking, swimming) for about 30 minutes every—or almost every—day can:

• Reduce anxiety and depression
• Improve mood
• Boost self-esteem
• Reduce symptoms of fatigue, nausea, pain, and diarrhea

During recovery, it is important to start an exercise program slowly and increase activity over time, working with your doctor or a specialist (such as a physical therapist) if needed. If you need to stay in bed during your recovery, even small activities—like moving your arms or legs around—can help you stay flexible, relieve muscle tension, and help you feel better. Some survivors may need to take special care in exercising. Talk with your doctor before you begin any exercise program.

Your Body After Cancer Treatment

Although your treatment has ended, you are still coping with how it affects your body. It can take time to get over the effects of cancer treatment. Each person's schedule is different. You may wonder how your body should feel during this time and what may be a sign that cancer is coming back. This section talks about some of the problems that can occur when treatment is over. Some of the most common effects people report are:

• Fatigue
• Pain
• Lymphedema, or swelling
• Problems with their mouth or teeth
• Problems with weight and eating
• Loss of bladder or bowel control
• Menopause symptoms
• Changes in their sex lives

What you experience may be related to the type of cancer you had and the treatment you received. It is also very important to remember that no two people are alike, so you may experience changes that are very different from someone else's, even if they had the same type of cancer and received the same treatment.

Fatigue

"I can walk and keep busy," said one testicular cancer survivor, "but it gets very tiring. If I sit in a chair and really want to read or watch something, I'm gone in about 30 seconds, and it is a deep sleep."

Some cancer survivors report that they still feel tired or worn out after treatment is over. In fact, fatigue is one of the most common complaints during the first year after treatment.

Rest or sleep does not "cure" the type of fatigue you may have after cancer treatment, and doctors do not know its exact cause(s). The causes of fatigue are different for people who are receiving treatment than they are for those who have completed treatment:

Fatigue during treatment can be caused by cancer therapy. Other problems can also play a part in fatigue, like anemia (having too few red blood cells), poor nutrition, not drinking enough liquids, and depression. Pain can also make fatigue worse.

Researchers are still learning about what may cause fatigue after treatment.

How long will fatigue last? There is no "normal" pattern. For some, fatigue gets better over time. Others, such as those who have had bone marrow transplants, may have less energy for years after their final treatment.

Some people feel very frustrated when fatigue lasts longer than they think it should and gets in the way of their normal routine. They also may worry that their friends, family, and coworkers will get upset with them if they complain of fatigue often.

Getting Help With Fatigue From Your Doctor or Nurse

Talk to your doctor about what may be causing your fatigue and what can be done about it. Ask about:

• How any medicines you are taking or other medical problems you have might affect your energy level
• How you can control your pain, if pain is a problem for you
• Exercise programs that might help, such as walking
• Relaxation skills
• Changing your diet or drinking more fluids
• Medicines or nutritional supplements that can help
• Specialists who might help you, such as physical therapists, occupational therapists, nutritionists, or mental health care providers

Tips: Fighting Fatigue

How do you fight fatigue? Here are some ideas that have helped others:

Plan your day. Be active at the time of day when you feel most alert and energetic.

Save your energy by changing how you do things. For example, sit on a stool while you cook or wash dishes.

Take short naps or rest breaks between activities.

Try to go to sleep and wake up at the same time every day.

Do what you enjoy, but do less of it. Focus on old or new interests that do not tire you out. Try to read something brief or listen to music.

Let others help you. They might cook a meal, pick up something at the store, or do the laundry. If no one offers, ask for what you need. Friends and family might be willing to help but may not know what to do.

Just say "no" to things that do not matter as much to you now. This may include housework and other chores. By using the energy you have in rewarding ways, you can live a fuller life.

Think about joining a support/education group for people with cancer. Talking about your fatigue with others who have had the same problem can help you learn new ways to cope.

Tags: Cancer

About the Author

The National Cancer Institute's research programs are extensive and contain many innovative initiatives. I invite you to explore our Web site to find out more about the exciting work being conducted here at NCI and by NCI-supported scientists throughout the country. More