Survivorship support

Our survivorship support services

Cancer treatment may lead to long-term health issues, such as chronic pain, fatigue, cognitive impairment, depression, anxiety, sexual dysfunction and sleep disorders.

Survivorship support to help our patients manage cancer’s side effects is a top priority at City of Hope.

After primary treatment is completed, patients are introduced to the survivorship team, whose services have four key goals:

  • We offer strategies to prevent and detect new or recurrent cancers, including making recommendations for screening options for other cancers and a familial genetic risk assessment, as appropriate.
  • We provide interventions for long-term and late effects resulting from cancer and/or treatments. We help our patients manage both the medical and emotional impacts of their disease and provide health education regarding diagnosis, treatment exposures and potential late and long-term effects.
  • We coordinate communication between specialists and primary care providers to help see that patients’ needs are met.
  • We offer guidance about diet, exercise and living a healthy lifestyle after cancer.

Whether you are at one of our hospitals, or at home in between visits, we're here to help. Members of your care team are only a phone call away.

Early intervention

Cancer therapies may affect your health for a long time or increase your risk of developing other conditions later. The disease may affect you psychologically and emotionally, including triggering fears about a recurrence.

Our survivorship support program is designed to help maintain your health and improve your quality of life. The program also provides research-based information about age-appropriate health screenings.

We help our patients and their caregivers plan for anticipated long-term and late side effects. We believe that patients see better outcomes with early intervention by proactively planning for long-term side effects. Doing so positively impacts strength, support and healing. The goal of survivorship support is to empower our patients with options and develop a treatment plan accordingly.

Survivorship support treatment planning takes into consideration, and plans for, the possibility of three categories of side effects:

  • Short-term, including weight loss, sexual dysfunction
  • Late effects, including secondary tumors, fertility concerns, quality-of-life issues, cardiovascular risk

Our survivorship support services are delivered in a variety of ways. It can be as simple as educating you about ways to cope with a potential side effect of cancer treatment. Or we may conduct more in-depth research to identify available options and how they may fit your needs. Throughout your cancer journey, our team works with you to develop ways to improve and maintain your health.

Common emotions and fears of survivors

Cancer treatment can be an emotional roller coaster, with some up days and some down days. When treatment ends, new emotions may surface. You may feel relieved that it’s over, but at the same time feel anxious about the future. These feelings are a normal part of cancer survivorship.

Cancer patients commonly report the following emotions after completing treatment:

  • Anxiety
  • Fear
  • Insecurity
  • Sadness/depression
  • Uncertainty
  • Embarrassment
  • Guilt

Fear of the cancer returning, known as a recurrence, is common and understandable. The fact that you are no longer actively receiving treatments, or that your medical status is not being watched as closely by your health care team, may leave you feeling vulnerable.

The way each survivor handles fear of recurrence is unique. You may experience moments of panic or find that your fears of recurrence diminish over time. It’s helpful to remind yourself that even if cancer returns, new treatments may be available that were not previously.

Tips for follow-up care

Staying on top of your health is a critical component to survivorship. The following tips may help:

Schedule follow-up visits with your doctor. Follow-up care allows your doctor to identify changes in your medical condition and provide recommendations for maintaining a healthy lifestyle. Your specific survivorship care plan, including how often you should see your doctor and what to expect at these visits, will depend on a number of factors, including your cancer type and stage, the treatments you had, and your age and general health.

Become an active participant in your wellness plan. Work with your care team to develop a wellness plan that includes ways you can take care of your physical, emotional, social and spiritual needs. Include other professionals, such as counselors, in your care plan as needed. Actively participating in your survivorship plan will help you feel more in control of your health and well-being.

Eat a healthy and nutritious diet. Eating well may help you regain your strength, rebuild tissue and feel better overall. You may turn to a dietitian to design individualized, nutritious meal plans. Choose fruits, vegetables, beans and whole grain foods, and avoid foods high in sugar, fat and salt. Also, you should avoid smoking, avoid or limit your alcohol consumption, and excessive sun exposure.

Stay physically active. Maintaining light exercise and physical activity may help you relax, relieve stress and reduce fatigue. Your care team may recommend setting both short-term and long-term goals. If you have physical limitations, even activities like stretching may help you feel better. It’s important to pace yourself and get plenty of rest. A physical therapist can help develop an appropriate exercise program.

Maintain open communication with your health care team. Be sure to let your doctor know if you are experiencing pain, fatigue, difficulty sleeping, sexual dysfunction or other symptoms after treatment. Remember that every symptom does not necessarily indicate that the cancer is returning. Your health care team is available to help provide ways to manage your symptoms.

Tips for moving on after treatment

Sometimes treatment is not the most difficult part of the cancer journey. Many patients struggle to regain a sense of normalcy once treatment is over. It may be helpful to seek counseling or talk with other survivors to learn ways to allay your fears about the future. Other suggestions for navigating life after treatment include:

Accept your fears. It is important to remember that you can control how much you let the fear of recurrence impact your life. Accept that you are going to experience some uncertainty and focus on finding ways to manage these feelings. Don’t be afraid to move on with your life because of fear that you may get cancer again.

Don't overreact to every ache and pain. You may be more likely to notice symptoms like aches and pains in your body than you did before cancer. Remember that even though you had cancer, you can still get common illnesses like a cough or cold. However, you should communicate any concerns you have about your current health status with your doctor.

Foster relationships with others. Now that your treatment is over, some family and friends may expect you to get on with your life, while others may be overly attentive, constantly asking how you feel. Talking about it may help you feel better, or you may not want to be reminded of the cancer at all. It is important that you express your preferences to others.

Try to maintain a positive self-image. After treatment, you may have to adjust to changes in your physical appearance and/or abilities. Remember you are still the same person on the inside, and helpful resources are available, such as a rehabilitation therapist or an image consultant.

Nurture your emotional and spiritual well-being. It is not uncommon to experience emotional or spiritual distress when you’re diagnosed and after cancer treatment is over. A counselor or therapist and/or a spiritual advisor can help you develop ways to cope with your feelings.

Find ways to enjoy life. Consider trying a new hobby or activity. Creative outlets, such as drawing, painting, music and poetry, may help you express yourself and relieve stress. Keeping a journal, reading a book, watching a funny movie and spending time with family and friends may also be rewarding activities.

Join a support group with other survivors. Once treatment is over, some patients find that they don’t feel the same kind of support they had during treatment. It may be helpful to join a support group where you can share your feelings and concerns with other survivors who have had similar experiences.

Face forward. Now that treatment is finished, the process of moving on with life begins. This is an opportunity to take stock of the things that matter most to you. You may have learned how to take better care of yourself. You may also value your relationships with others in a new way. Although you can't change having had cancer, you can change how you live life going forward.

Tips for coping if cancer returns

Even when you’ve done everything you were supposed to, sometimes cancer returns. Just as you did before, you must gather as much information as possible and develop an action plan.

Tips for coping with cancer recurrence:

Embrace acceptance. You may wonder if you did anything to make the cancer come back. Although this feeling is normal, blaming yourself doesn’t help. Try not to focus on what could have been. Instead, try to accept the situation and use your inner strength to move forward.

Do what is right for you. If cancer returns, your treatment goals may change, or they may be the same as with your first diagnosis. Think about what is important to you now and make thoughtful decisions about your treatment. Let your cancer team know your goals. Only you can decide what is best for you.

Set goals. Develop a plan that helps you live your life as fully as possible. It can help to set both short-term and long-term goals. Set small goals for each day, such as taking a walk, making a phone call, having lunch with a friend, reading a chapter of a book, etc. With places to go and things to do, you will feel more productive and fulfilled and you'll get your mind off cancer.

Use lessons learned from the past. You have already battled cancer before. You are more experienced and knowledgeable this time around. Use what you learned in the past to deal with your present situation. Remember that as difficult as it was, you got through it. The same coping skills you used during your initial treatment can give you the strength and confidence you need now.

Manage your symptoms. The symptoms of cancer recurrence can impact your quality of life. It is essential that you work with your care team to manage your symptoms, such as pain, fatigue, difficulty sleeping, etc. Improving physical symptoms may also improve your mood and overall well-being.

Seek emotional support. Feeling angry and upset about a cancer recurrence is completely normal. It’s important to find support so you can express these feelings. Aside from family and friends, it helps to share feelings and concerns with others who are dealing with cancer recurrence and who have been where you are now. In addition to support groups, you may also decide to seek private counseling.

Nurture your spiritual well-being. Spirituality can be a source of strength for many people. Cancer recurrence can make you take stock of your beliefs. You may find comfort exploring more deeply what is meaningful to you. Prayer, meditation, spending time in nature or writing in a journal are just a few of the ways you can nurture your spiritual well-being.

Share with your loved ones. Your loved ones may also need time to adjust to the news, come to terms with their own feelings and adjust to changing family roles. Remind your family and friends that you are still the same person you always were. Let them know that they can support you just by listening and being at ease with you.

Plan ahead. Even when you are healthy, it helps to be prepared and make provisions for your family’s future. Although it’s difficult to talk about these issues, if you have not already done so, you may decide to update your affairs through an advance directive or living will. Planning ahead may also help you worry less about the future, take control of the situation and protect those you love most.

Be open with your care team. Speak openly about your needs and concerns with your cancer team. Take the time to discuss the available options with your doctors and your family members. Even if you are happy with your current doctor, this may be a good time to get a second opinion to explore your options. You need to be comfortable with your decisions.

Do things you enjoy. Try to participate in activities that matter most to you. Creative outlets, such as drawing, painting, music and poetry, may help you express yourself and relieve stress. Also consider keeping a journal, reading a book, watching a funny movie, going fishing, making a scrapbook and spending time with family and friends.

Stay hopeful. When cancer returns, it can change the way you look at life. It's important to stay hopeful. You may have hope for new treatment options, hope for relief from symptoms, or hope for good times with family and friends. Hope can motivate you and make you feel empowered.

NOTE: This information is not intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to making decisions about your treatment.