Managing Long-Term Side Effects

Many people are faced with new and unique needs and concerns after finishing treatment for their cancer.

The Adult Survivorship Clinics' specialized Physician Assistants and Nurse Practitioners focus on identifying and managing any late or long-term effects resulting from cancer or its treatment, including:

More than one third of cancer patients who undergo surgery, radiation, or chemotherapy will experience chronic pain. This can significantly impact your quality of life. Depending on the type and severity of the pain, there may be options to help manage it including:

  • Medications- either topical or oral
  • Heat or ice
  • Massage
  • Exercises for relaxation
  • Physical therapy
  • Behavioral therapy
  • Procedures to alleviate pain

Seeing your health care provider may be important in identifying which of these methods would be the most effective. Northwestern also has a cancer pain specialist (add link) and palliative care team that can be contacted at 312.695.0990.

Additional Resources:
The American Cancer Society - Cancer Pain

It is not uncommon for cancer survivors to be overwhelmed by their diagnosis, treatment and treatment-related side effects. In some cases, this stress can lead to feelings of anxiety and depression, and impact many aspects of every day living. The Supportive Oncology Program provides emotional and practical support for patients and their families during all stages: diagnosis, treatment and recovery. Our multidisciplinary team is dedicated to listening and responding to patient concerns, promoting well-being and treating each individual with respect and compassion.

Additional Resources:
Supportive Oncology Team

Fatigue is a very common problem that affects survivors of all types of cancers and can cause significant distress. Try the following suggestions to help with the management of fatigue:

  • Plan your day.
  • Schedule activities during times when you have more energy.
  • Pace yourself during activity.
  • Choose how to spend your energy. Perform tasks you must perform and consider putting off less important tasks for another day.
  • Take short breaks or rest between periods of activity.
  • Let others help you.
  • Evaluate how you perform certain tasks and consider ways to change this to help conserve energy. For example, try sitting instead of standing for certain household tasks like cooking or washing dishes.
  • Exercise! Even if it is just starting with 5 minute walks once or twice a day, increasing your activity level will help improve symptoms of fatigue.

Your health care provider can give you specific direction based on your individual therapy and situation

Additional Resources:
The American Cancer Society - Fatigue

Many people have ongoing numbness or tingling, called peripheral neuropathy, in their hands or feet as a result of damage to the nerves caused by chemotherapy. Please talk with your physician if this is significantly impacting your daily activities or your balance.

Additional Resources
The American Cancer Society - Peripheral Neuropathy Caused by Chemotherapy

Cancer survivors who receive chemotherapy or radiation could have difficulty with their memory or concentration. Potential techniques to help manage this often-distressing symptom include:

  • Use organizational strategies such as planners, notes, and check-lists
  • Take note of specific times of the day when your concentration are the best and try to get tasks done at that time
  • Relaxation and stress management
  • Make sure that your sleep and fatigue are well managed
  • Routine physical activity
  • Limit use of alcohol or other agents that can impact your cognition or sleep
  • Meditation, yoga, and mindfulness techniques

Your health care provider can give you specific direction based on your individual therapy and situation.

Additional Resources
The American Cancer Society - Chemo Brain

Many cancer survivors are concerned about their risk of developing a second cancer. The risk depends on the type of treatment you received for your cancer, your family history and genetics, your lifestyle (i.e. tobacco use), and any environmental exposures you may have had.

Some important tips to reduce your risk of a second cancer include:

  • Achieve and maintain a healthy body weight
  • Engage in regular physical activity
  • Maintain a healthy diet rich in fruits, vegetables and whole grains with limited red or processed meat, sugars and fats.
  • Limit your alcohol consumption to no more than one drink per day for women and two drinks per day for men
  • Avoid tobacco products
  • Practice good sun safety to reduce your risk of skin cancer from exposure to ultraviolet (UV) rays.
  • Follow up with your primary care provider regularly to be sure you are following all health screenings and cancer screening recommendations that are appropriate for someone your age.

Additional resources:
The American Cancer Society - Second Cancers
American Cancer Society - Living with Uncertainty

Insomnia is a common concern during cancer treatment and throughout survivorship. It is important to practice good sleep hygiene.
Here are some tips:

  • Try to go to bed and wake up at the same time every day. Try to avoid day time napping.
  • Exercise regularly for at least 20 minutes, preferably several hours prior to bed time.
  • Avoid caffeinated beverages and alcohol 4 hours prior to bedtime.
  • Do not go to bed hungry, but avoid large meals prior to bedtime.
  • Associate your bedroom with sleep. Avoid radios, television and reading in the bedroom.
  • Make sure the bedroom is dark, quiet and at a comfortable temperature.
  • Use relaxation techniques such as meditation, yoga, deep breathing, or a warm bath prior to bed time.
  • If you cannot fall asleep after 15-20 minutes get up, go into another room and do a quiet activity (read, have a light snack) until feeling tired. Avoid stimulating activities such as television, computers, office work, house work etc.

Follow up with your health care provider if this is a persistent problem or causing you significant distress

Additional resources:
American Cancer Society - Sleep Problems

Following surgery, radiation, or chemotherapy, many patients will experience changes in their ability or comfort with sexual activity.

Many women experience vaginal changes after completing treatment for cancer. Menopause and medications used to treat cancer can decrease estrogen levels and cause vaginal dryness.

This may result in:

  • Discomfort or pain during intercourse
  • Vaginal irritation
  • Change in vaginal discharge.
  • Urinary symptoms such as urgency, frequency or incontinence

Here are some tips for improving vaginal health:

  • Vaginal lubricants can be used to improve comfort during sexual activity.
  • Regular use of vaginal moisturizers, which can be purchased over the counter, can help with vaginal dryness
  • Use of vaginal dilators or vibrators can help to maintain vaginal elasticity

Follow up with your health care provider for other possible treatment options.

Additional resources:
American Cancer Society - Sexuality for women with cancer
American Cancer Society - Sexuality for men with cancer



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