On this page: Fatigue | Pain | Tingling or numbness in the hands and feet | Lymphoedema | Memory and cognitive problems | Other physical problems | Changed body image | Sexuality and intimacy | Menopause | Fertility problems | Key points
It can take time to recover from the side effects of treatment. Side effects can be both physical and emotional and vary depending on the cancer type and stage, and the treatment you had.
Some side effects resolve quickly; others can take weeks, months or even years to improve. Some may be permanent. Your body will cope with the treatment and recovery in its own way. It is important not to compare yourself to others.
Common side effects include:
Some people experience late side effects. These are problems that develop months or years after treatment finishes. They may result from scarring to parts of the body or damage to internal organs. If you are concerned about a new side effect, talk to your doctor.
This section outlines many side effects common to cancer survivors and offers suggestions on how to cope with them. For further information and support call Cancer Council 13 11 20.
Fatigue, or feeling exhausted and lacking energy for daily activities, is a common physical side effect of cancer treatment.
Now that treatment is over, you may think you should be full of energy, but often this isn’t the case. If you were unable to be active during treatment, you may have experienced a loss of muscle and fitness. This could contribute to your fatigue. Many people say that fatigue has a big impact on their quality of life in the first year after treatment.
Most people find that their energy returns 6–12 months after finishing treatment. However, some people lack energy for years after treatment and their energy levels may never fully recover.
Many survivors worry fatigue is a sign that the cancer has come back or that it never really went away. This is usually not true.
People have described fatigue after cancer treatment as overwhelming, debilitating and frustrating. Symptoms include:
Many cancer survivors don’t tell their doctor about fatigue because they think that nothing can be done about it. However, your treatment team may be able to help. For example, your fatigue may be caused by low red blood cells (anaemia), an underactive thyroid gland, depression or the side effects of drugs, which your doctor may be able to address.
The tips below may help you. Not all suggestions will work for everyone, but you may find that small changes make you feel better. Talk to your health care team for more suggestions.
"A lot of rest, and doing Pilates and other exercise has helped my ongoing well-being." – Donna
"I had no idea that I would still be feeling tired months after finishing treatment. I didn’t know how to make it better and I was scared that’s how it would be; that I wouldn’t go back to normal, that I would never go back to having energy again." – George
Difficulty sleeping is common among people who have had cancer. Sleep can be affected by symptoms related to the cancer treatment as well as environmental, physical and psychological factors. People who have pre-existing sleep problems can have additional sleep difficulties after their cancer diagnosis.
Pain can have a big impact on your life and prevent you from doing the things you want to do.
Chemotherapy and surgery can injure nerves and cause pain and numbness in certain areas of your body. Your skin may be sensitive in the area where you had radiotherapy; this can last from a few weeks to several months. Scars from surgery may also be painful for a long time.
Controlling the pain may allow you to return to many of the activities you enjoy. Discuss your pain with your doctor so that the cause of the pain can be worked out and the best treatment plan developed. How you manage your pain depends on the type of pain you have. If your pain lasts for a long time or is constant, do something about it before it gets out of control.
Taking medication regularly is often the best way to prevent pain from starting or getting worse. Some people call this ‘staying on top of the pain’. It may mean you can use lower doses of pain relief than if you wait until the pain gets worse.
Let your doctors know how pain is affecting your day-to-day life, as this helps them plan the best treatment for you. A referral to a pain specialist or physiotherapist may help, or your pharmacist might be able to suggest ways to manage the pain.
Pain-killing drugs, called analgesics, are available to treat different types and levels of pain.
Your doctor may also prescribe other drugs. For example, medications normally used to treat depression or epilepsy have been found to help for some types of pain. Taking these drugs may make it possible to control the pain with a lower dose of opioids.
People taking opioids as prescribed by their doctor are generally not at risk of addiction, unless they have had addiction problems in the past. However, you may experience withdrawal symptoms when you stop taking a drug. For this reason, your doctor will reduce your dosage gradually. Talk to your doctor if you are concerned about drug dependence.
You may feel drowsy when you first start taking the medication, but this usually wears off within a couple of days. If the drowsiness continues, talk to your doctor. They may be able to adjust your dosage or change your medication.
For some people, pain can be relieved without taking tablets. Some people have surgery or an anaesthetic injected into their body (nerve block).
A physiotherapist or occupational therapist can suggest exercises or postural changes to address physical or practical problems that are causing your pain.
The following therapies may also help to increase your sense of control over the pain, improve your mood, and decrease your stress and anxiety.
Tingling or numbness in the hands or feet (peripheral neuropathy) is a common side effect for people who have had chemotherapy, and may last for some time after treatment finishes. Peripheral neuropathy can be annoying and frustrating, and may make it difficult for you to return to normal hobbies and activities. It may help to talk to your GP, or see an occupational therapist.
The lack of feeling in your hands and feet can cause safety problems. Protect yourself around the home by following these precautions:
Lymphoedema is swelling that occurs in soft tissue, usually a limb such as the arm or leg, after lymph nodes have been removed during surgery, or damaged by infection, injury, or other treatment such as radiotherapy. The likelihood of developing lymphoedema after treatment depends on the extent of the surgery, your cancer treatment and your body weight. Lymphoedema may be permanent, but it can usually be managed, especially if treated early. Signs of lymphoedema include persistent swelling, which may be associated with new feelings of heaviness, tightness, aches, or pins and needles.
Some hospitals have specialist lymphoedema physiotherapists or occupational therapists who can help to manage lymphoedema. They can provide advice on lymphatic drainage massage and exercises and can teach you simple exercises to reduce your risk.
For more information visit the Lymphoedema Association of Australia website or call Cancer Australia (1800 624 973) for a copy of Lymphoedema - What You Need to Know.
"I had some lymphoedema in my right arm. This causes me little trouble unless it is a particularly hot day or if I have exercised too much. I have regular massages to keep the fluid moving." — Amanda
Many cancer survivors say they have difficulty concentrating, focusing and remembering things. This is often called ‘chemo brain’, as it is common after chemotherapy. However, some cancer survivors who did not have chemotherapy also report similar problems.
These memory and cognitive problems can also be caused by:
‘Chemo brain’ usually improves with time, sometimes taking a year or more. Researchers still aren’t sure exactly what causes the memory and concentration problems experienced by some cancer survivors, but there is ongoing research to try to find out.
Tell your doctor about any memory or cognitive problems you are having. Ask for a referral to a health care professional such as an occupational therapist who can advise you on strategies to overcome these difficulties and improve memory.
Cancer survivors can also experience a range of other physical problems after treatment.
Changes to how your bowel or bladder works can be very distressing and difficult to adjust to. Some medications and cancer treatments can cause constipation, diarrhoea, or incontinence of the bowel or bladder. Some people have a stoma because of their treatment. These changes may be temporary or ongoing and may require specialised help or products.
Sometimes radiotherapy to the chest and heart area leads to an increased risk of heart problems after treatment. Risk factors for radiation-associated heart damage include:
If you have received radiotherapy to the chest or whole body, or combined radiotherapy and chemotherapy, talk to you doctor about your heart health.
You may have problems with your mouth or teeth, or find it difficult to swallow. These problems can affect your ability to eat, drink, manage your weight or talk. Depending on the type of cancer and treatment, these problems may be temporary or ongoing. It may help to see a dietitian or speech pathologist.
Surgery or cancer treatment may have affected your balance or ability to walk or move around. A physiotherapist or occupational therapist may be able to assist with these problems.
Some chemotherapy drugs can affect your hearing. Some people lose the ability to hear high-pitched sounds or develop a constant ringing in their ears, known as tinnitus. Tell your GP if you notice any change in your hearing or if these symptoms don’t go away. If you would like more information about managing these or any other problems, call Cancer Council 13 11 20.
Treatment for cancer can change how your body looks and works. How you feel about yourself (your self-esteem) may be affected by:
It will take time to adjust to these changes physically and emotionally. Many cancer survivors say they feel angry and upset by the changes caused by the cancer and its treatment.
You may worry about how your family and friends will react, and whether your partner or a potential partner will still find you physically attractive. It may help to let others know how you are feeling. They probably want to provide support and reassurance that they still love you, and hearing what they have to say may boost your confidence.
If you don’t feel comfortable talking to friends or family, consider speaking to your health care team or a counsellor. It may help to talk to someone who has had a similar experience. Call Cancer Council 13 11 20 for information on support services.
This is a free community service program dedicated to teaching people how to manage the appearance-related side effects caused by cancer treatment. Workshops are offered throughout Australia. See information about upcoming Look Good...Feel Better workshops.
Cancer and its treatment may affect your sexuality and intimacy in physical and emotional ways. These changes may be temporary or ongoing and can be difficult to deal with.
Sexual difficulties can affect any cancer survivor, but those most likely to experience long-term sexual problems include:
Some people say they were not prepared for the sexual changes caused by treatment. Others say that they avoid all forms of intimacy including hugs, kisses and sharing feelings in fear that this may lead to sex when they don’t want it. Some people worry that they will never be able to have an intimate relationship again.
You may not even be aware that you aren’t taking an interest in sex or being as intimate as you were before. If you have a partner, they may be confused or feel uncertain about how to react.
Talk openly with your partner about how you’re feeling, what you want and any fears you have about sex. Ask your partner about how they are feeling. They may be worried about hurting you or appearing too eager. You may want to ask your partner to do things differently or talk about other ways of being intimate.
Menopause means that a woman’s ovaries no longer produce eggs and her periods stop. The average age for a woman to experience natural menopause in Australia is 51.
Some cancer treatments, including certain chemotherapy drugs, radiotherapy to the pelvic area, hormone treatment and surgery to remove the ovaries (oophorectomy), can cause symptoms of menopause. These symptoms can be temporary or permanent.
For women who want to have children, menopause can be devastating. Even if your family is complete or you didn’t want children, you may have mixed emotions or worry about the impact of menopause on your relationship. See more information about fertility. Some women find menopause difficult because they feel it has taken away a part of their identity as a woman.
When menopause occurs suddenly as a result of cancer treatment, symptoms may be more severe because the body hasn’t had time to get used to the gradual decrease in hormone levels. Symptoms may include hot flushes, mood swings, trouble sleeping, tiredness and vaginal dryness. Many of these symptoms will eventually pass, although this may take months or a few years.
Some women who have already been through menopause find that these symptoms return during or after treatment.
Menopause also increases your risk of developing thinning of the bones (osteoporosis). Ask your doctor how to manage or prevent this.
Men who are taking hormone treatment or have had their testicles removed may experience menopausal symptoms similar to women.
Some cancer treatments can cause temporary or permanent infertility (inability to have a child).
Although chemotherapy and radiotherapy can reduce fertility, women may be able to become pregnant after treatment, and men may still be able to father a child.
Your doctor may suggest you wait a certain period of time before trying to conceive, in order to give your body time to recover, and allow eggs or sperm to become healthy again. Some form of contraception must be used during this time.
If you are told your infertility is permanent, you may feel a great sense of loss and grief, even if your family is complete. You may feel angry, sad or anxious that the cancer and its treatment caused these changes to your body or your plans for the future. Talking to a counsellor about how you are feeling might help.
See Fertility and Cancer for more information or call Cancer Council 13 11 20.
If you have trouble conceiving after cancer treatment, ask your doctor for a referral to a fertility specialist.