Emotional late effects of cancer treatment

Emotional late effects, such as depression and anxiety, can develop months or years after cancer treatment. Some people find it more difficult to cope after treatment has finished, even if they felt they were coping well at the time.

There are many reasons why emotional late effects happen. They can be linked to physical changes, fatigue, pain or other symptoms caused by cancer and its treatment, as well as changes to your relationships or your general health.

Fear of cancer coming back

You may worry that your late effects are signs that cancer has returned (recurrence). Many cancer survivors experience this fear, and it may come and go for many years.

This fear may be worse before follow-up appointments or while waiting for test results. This is sometimes called “scanxiety”. It can also appear on birthdays or anniversaries of the date you were diagnosed, when you hear about other people having a cancer recurrence, or when you have symptoms like those when you were first diagnosed.

See your GP if you are worried about cancer returning. A counsellor or psychologist may be able to help you manage this fear.

Listen to Cancer Council's Managing Fear episode of The Thing About Cancer podcast series.

Post-traumatic stress

You can experience post-traumatic stress after a cancer diagnosis or during treatment, but it can also happen after cancer treatment finishes.

Symptoms of post-traumatic stress include:

• disturbing memories or nightmares
• avoiding people, places or events that remind you of cancer
• emotional distress when reminded of cancer
• always feeling “on alert” for danger.

If these symptoms happen for more than a few days or if they are stopping you from going to medical appointments or doing normal activities, talk to your GP. Treatment may include medicines or therapy provided by a psychologist or counsellor.

Depression and anxiety

Depression and anxiety are common after cancer treatment. Both conditions can affect your thoughts, physical health and behaviour – some of the symptoms are listed below. Talk to your GP if you are experiencing any of these symptoms.

Signs of depression

• Persistent sadness or low mood
• Loss of interest in activities
• Difficulty concentrating
• Fatigue or low energy
• Changes in sleep or appetite
• Neglecting responsibilities and self-care
• Thoughts of self-harm or suicide

Signs of anxiety

• Excessive worry or fear
• Racing thoughts
• Feeling overwhelmed
• Muscle tension or headaches
• Stomach upset, nausea or diarrhoea
• Tingling or numbness
• Changes in sleep