Life after treatment for breast cancer

Adjusting to life after treatment

For most people, the cancer experience does not end on the last day of treatment. Life after cancer treatment can present its own challenges. You may have mixed feelings when treatment ends, and worry that every ache and pain means the cancer is coming back.

Some people say that they feel pressure to return to “normal life”. It is important to allow yourself time to adjust to the physical and emotional changes, and establish a new daily routine at your own pace. Your family and friends may also need time to adjust.

Cancer Connect on 13 11 20 can help you connect with other people who have had breast cancer, and provide you with information about the emotional and practical aspects of living well after cancer.

Follow-up appointments

After treatment ends, you will have regular appointments with your cancer specialist and GP to monitor your ongoing health. This is known as shared care. Your doctors will see how you are going on hormone therapy (if this is part of your ongoing treatment), help you to manage any long-term side effects such as lymphoedema, peripheral neuropathy or heart issues, and check that the cancer has not come back or spread.

During these check-ups, you will usually have a physical examination. You will also be able to discuss how you’re feeling and mention any concerns you may have.

Check-ups after breast cancer treatment are likely to happen every 3–6 months for 2 years. They will become less frequent after that if you have no further problems.

You are likely to have a mammogram and, if needed, an ultrasound every year. You won’t need a mammogram if you’ve had a double mastectomy. If there is a concern the cancer may have come back, you may have a bone scan and a CT, PET or MRI scan. After 5 years with no sign of cancer, women aged 40 and over can continue to have a free mammogram through the national breast cancer screening program.

When a follow-up appointment or test is approaching, many people find that they think more about the cancer and may feel anxious (“scanxiety”). Talk to your treatment team or call Cancer Connect on 13 11 20 if you are finding it hard to manage this anxiety.

Between follow-up appointments, let your doctor know immediately of any symptoms or health problems.

Dealing with feelings of sadness

If you have continued feelings of sadness, have trouble getting up in the morning or have lost motivation to do things that previously gave you pleasure, you may be experiencing depression. This is quite common among people who have had cancer.

Talk to your GP, because counselling or medication – even for a short time – may help. Some people can get a Medicare rebate for sessions with a psychologist. Cancer Council may also run a counselling program in your area.

For information about coping with depression and anxiety, call Beyond Blue on 1300 22 4636. For 24-hour crisis support, call Lifeline on 13 11 14.

What if the cancer returns?

Sometimes, breast cancer does come back after treatment, which is called a recurrence. This is why regular check-ups are important. In most cases, early breast cancer will not come back (recur) after treatment. Although the risk is higher with locally advanced breast cancer, many people will not experience a recurrence.

There are some things that increase the risk that cancer may come back. These include if the cancer was large or the grade was high when first diagnosed, if it was found in the lymph nodes, or if the surgical margin was not clear. Your risk may also be increased if the cancer was hormone receptor negative or if adjuvant treatment (e.g. radiation therapy, chemotherapy, hormone therapy) was recommended after surgery but was not started or completed. This does not mean the cancer will definitely come back or spread.

Regularly looking at and feeling your breasts to know what is normal (being “breast aware”) can help find cancer in the treated or other breast.

If you have had a double mastectomy with or without a reconstruction, you should also regularly look at and feel your new shape and get to know your “new normal”. Tell your specialist, breast care nurse or GP if you notice any changes. Breast cancer can also return in other parts of the body, such as the bones, liver or lungs. Most symptoms will not be a recurrence, but if you notice any changes to your health, see your doctor and let them know that you have had breast cancer.

It is important to continue taking the drugs your doctor prescribes, even months or years after your treatment. Talk to your doctor before you stop taking any drugs, as these drugs may be helping to stop the cancer returning.