While most people adapt well over time 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.
You might be relieved that treatment has finished and seems to have been successful. You may welcome the chance to focus on other things, such as your usual activities.
Many people feel 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 lonely if your relationships have changed or people don't understand what you've been through.
Fear of the cancer coming back
Fear of recurrence is common. Most survivors learn to manage this fear.
Many survivors are reluctant to plan for the future because they feel uncertain about their health. This is very challenging, but you can learn to manage it effectively.
Some people feel frustrated because they think their family and friends expect too much from them. Others feel frustrated because they can't do the things they want to do.
Some people feel guilty or question why they survived their cancer when others didn't. This can be confronting.
Anxiety about follow-ups
Many people feel anxious before follow-up appointments and may feel these appointments "bring it all back". Waiting for test results can also be a very anxious time.
You may be concerned about treatment side effects: how long they'll last and whether they'll affect your life. Many survivors are worried about financial pressures or being a burden to their family. Other survivors worry about returning to work and dealing with questions from colleagues.
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. Or you may not be physically able to do some of the things you did before treatment. Many people feel vulnerable and selfconscious about their body image and sexuality.
You may feel sad or down about your cancer experience and its impact on your life.
You may become tearful and emotional very quickly, particularly when someone asks how you are. This is very normal, but it can be embarrassing for some people.
You may feel angry about your cancer experience and how it has affected your life.
You may find your emotions catch up with you now that treatment is over. Many people do not expect negative emotions once their treatment ends and find this confusing.
Accepting your feelings
Acknowledging how you are feeling may help you to work through your emotions. It is common for people with cancer to feel quite distressed at some point in their cancer experience. Most cancer survivors find that they do feel better over time.
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 doing more exercise or improving their diet.
Feeling down or depressed
Feeling low or depressed after treatment ends is common. Cancer survivors often experience worry, fear of recurrence, or periods of feeling down, for months or even years after treatment.
Some people feel sad or depressed because of the changes that cancer has caused, or because they are frightened about the future. Many people feel disconnected from their life before cancer. They may wonder 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.
Support from family and friends, other cancer survivors, or health professionals may help you cope better during these periods.
Signs of depression
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 general practitioner (GP):
- feeling very sad and low most of the time
- loss of interest or pleasure in activities you normally enjoy
- having negative thoughts about yourself a lot of the time
- eating more or less than usual
- unintended weight gain or loss
- feeling very tired, slowed down or lacking energy most of the time
- having trouble concentrating
- loss of interest in sex (low libido)
- sleep changes or problems, e.g. not being able to fall asleep, waking in the early hours of the morning or sleeping much more than usual
- feeling restless, agitated, worthless, guilty, anxious or upset
- having little or reduced motivation
- being extremely irritable or angry
- thinking that you are a burden to others
- wishing you were dead
- thinking about hurting or killing yourself.
Some of these symptoms can also be caused by other medical conditions. Talk to your doctor about how you are feeling.
"Although some people bounce right back, once treatment was over, I questioned my values and reasons for being here." – Emma
Getting help with depression
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 medicine. Treatment 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 GP if you are eligible. Call 13 11 20 to see if your local Cancer Council runs a counselling program.
Some people find online programs helpful in dealing with depression and anxiety, e.g. moodgym.com.au, mycompass.org.au or mentalhealthonline.org.au. You can find a list of health and wellbeing apps at healthdirect.gov.au/health-and-wellbeing-apps.
The organisation beyondblue has information about coping with depression and anxiety at beyondblue.org.au. If you'd like to talk to someone about how you are feeling, call Lifeline on 13 11 14 or beyondblue on 1300 22 4636. In addition to getting professional help, the tips below may help you.
"After my treatment, a psychologist explained that it's common to feel like you've had the rug pulled out from underneath you after a major trauma. It's also common to question your view of the world and your beliefs. Knowing that, and how normal it is, helped tremendously." – David
Managing your mood
- Take care of yourself. Eat a well-balanced diet with lots of fresh fruit and vegetables, and drink plenty of water.
- Avoid excessive amounts of caffeine and alcohol.
- Try to do some physical activity every day – this will help you sleep better and improve your mood.
- Set small and achievable goals and review your priorities. Don't expect too much from yourself.
- Share your fears and concerns with someone close to you. Having someone know exactly how you feel can help you feel less alone.
- Spend time outside in the fresh air. A change of scenery might make you feel better.
- Try not to judge yourself too harshly. Self-criticism can lead to increased feelings of hopelessness. Learn to be kind to yourself.
- List activities you used to enjoy and plan to do one of these activities each day.
- Write down how you're feeling or express yourself in painting, music or singing.
- Get up at the same time each morning, regardless of how you feel. Make an effort to have a shower and get dressed.
- Allow yourself a "low mood day" every now and again. You don't have to be "up" every day.
- Practise letting your thoughts come and go without getting caught up in them.
- Consider complementary therapies, such as massage, yoga, meditation or reflexology (hand and foot massage).
- Keep a record of positive things that happen each day.
- For more information see Emotions and Cancer.
- For many people who have finished cancer treatment, life has changed and is not quite the same as it was before their diagnosis.
- Many survivors don't feel the way they expect to after their treatment ends. You may find you need time to recover, physically and emotionally, once treatment is over.
- Many people find they need time to reflect on their cancer experience. With time, they find a new way of living – a "new normal".
- It's common to have many different feelings after treatment ends.
- Some of your feelings may be similar to those you experienced when you were first diagnosed with cancer.
- Common feelings include relief, isolation, fear of the cancer coming back, uncertainty about the future, frustration with family and friends, anxiety about checkups, worry about side effects, concern about financial pressures or returning to work, lack of confidence, and anger.
- Many survivors find they need ongoing support after their treatment finishes.
- Acknowledging and talking about how you're feeling may help you manage your emotions.
- It's common to have some worries and periods of sadness for months or years after treatment.
- Feeling low after treatment finishes is common. Talk to your GP, a counsellor, psychologist or psychiatrist if you are feeling down or depressed.
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.