While the majority of people adapt well to life after treatment, many people experience ongoing fears or concerns. You may find you need a lot of support – maybe even more than you did when you were diagnosed or during treatment.
Relief: You might be relieved that the treatment has finished and seems to have been successful. You may welcome the chance to focus on other things, such as your usual activities.
Isolation: Many people feel abandoned or less secure when regular appointments with their health care team reduce or stop. This can feel like losing a safety net. You may also feel alone or lonely if your relationships have changed or people don’t understand what you’ve been through.
Fear of recurrence: Fear that the cancer will return is common among cancer survivors. For many, this fear never fully goes away, but most survivors learn to manage it. You may have difficulty distinguishing normal aches, pain or sickness from cancer symptoms.
Uncertainty: Many survivors feel stuck and are reluctant to plan for the future because they feel uncertain about their health.
Frustration: Some people feel frustrated because they think their family and friends expect too much from them. You may still feel unwell and need extra support.
Anxiety about follow-ups: Many people feel anxious in the lead up to follow-up appointments and may feel these appointments ‘bring it all back’. Waiting for test results can also be a very anxious time.
Worry: You may be concerned about side effects: how long they will last and if they will affect your life. Many survivors are worried about financial pressures or being a burden to their family.
Worry about returning to work: Many survivors worry about coping with work and colleagues asking them about their diagnosis and treatment.
Lack of confidence: You may feel differently about your body and health. You may not trust your body and feel it has let you down. Many people feel vulnerable and self-conscious about their body image and sexuality.
Feeling down/depressed: You may feel sad or down about your cancer experience and its impact on your life (see below).
Survivor guilt: Some people feel guilty or question why they have survived their cancer when others have not.
Anger: You may feel angry about your cancer experience and how it has affected your life.
Delayed emotions:You may find your emotions catch up with you now that treatment is over. Many people find this confusing, as they do not expect negative emotions once their treatment ends.
"After treatment I felt very scared and very nervous about what things held for me. You’re seeing somebody every day, day after day, and then suddenly it’s goodbye, we’ll see you in three months. So you’re left on your own to cope with things." – Rosemary
Acknowledging how you are feeling may help you to work through your emotions. Most cancer survivors find that they do feel better over time. However, cancer survivors often experience worry, fear of recurrence, or periods of feeling down for months or even years after treatment.
Friends and family may advise you to ‘think positively’. It is almost impossible to be positive all the time; everyone has good and bad days, before and after a cancer diagnosis. There is no scientific evidence to suggest that positive thinking has any impact on surviving cancer. However, many survivors say that feeling hopeful helped them to cope with their illness and make positive changes, such as increased exercise.
Feeling low or depressed after treatment ends is common. Some people may feel fine at first and then start to feel sad or down a few weeks, months or even years later. Support from family and friends or health professionals may help you cope better during these periods.
Some people feel sad or depressed because of the changes that cancer has caused, or because they are frightened about the future. They may wonder if the cancer will come back, if they will be able to work again and whether their family will cope if they can’t earn enough money. Sometimes you may feel down for no particular reason.
Depression is more than feeling down for a few days. If you have one or more of the following symptoms for a few weeks or more, you should see your GP:
Some of these symptoms can also be caused by other medical conditions. Talk to your doctor about how you are feeling.
"Some mornings I would wake up feeling like I didn’t even want to get out of bed, that real ‘down in the dumps’ feeling. But once I got started, that feeling would kind of lift and things would seem ok." – Elisa
Depression generally won’t go away by itself – specific treatment is needed. Treating depression early may mean that you can deal with the problem quickly and avoid symptoms becoming worse.
There are many effective treatments for depression, which don’t necessarily include medication. Treatment for depression may include therapy provided by a GP, psychologist, psychiatrist or counsellor. Some people are able to get a Medicare rebate for sessions with a psychologist. Ask your doctor if you are eligible. Your local Cancer Council may also run a counselling program.
beyondblue has information about coping with depression and anxiety. Call 1300 224 636. In addition to getting professional help to treat depression, the tips below may help you.
"No matter how good your support people are, sometimes you need someone who’s professionally trained." – Jenny
Reviewed by: A/Prof Jane Turner, Department of Psychiatry, University of Queensland; Polly Baldwin, Cancer Council Nurse, Cancer Council South Australia; Ben Bravery, Cancer Survivor, NSW; Helen Breen, Oncology Social Worker, Shoalhaven Cancer Services, NSW; A/Prof Michael Jefford, Consultant Medical Oncologist, Peter MacCallum Cancer Centre and Clinical Director, Australian Cancer Survivorship Centre; David Larkin, Clinical Cancer Research Nurse, Canberra Region Cancer Centre; Miranda Park, Clinical Nurse Specialist, Cancer Information and Support Service, Cancer Council Victoria; Merran Williams, Nurse, Bloomhill Integrated Cancer Care, QLD; Iwa Yeung, Physiotherapist, Princess Alexandra Hospital, QLD; Danny Youlden, Biostatistician, Viertel Cancer Research Centre, Cancer Council Queensland.