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Managing long-term and late effects of cancer treatment

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									Cancer survivorship information for survivors and carers




Managing long-term and late
effects of cancer treatment



Long-term and late effects will             people who had the same type of treatment        can be difficult to know how long these ‘long
vary depending on the type and              won’t always suffer the same side effects.       term’ side effects will last. In time many long-
                                            For example, not all chemotherapy drugs          term side effects will become less severe or
stage of your cancer as well as the
                                            cause the same ongoing or late effects.          disappear completely. They may include:
type of treatment you had. But all
the common cancer treatments                Children who have had cancer may be at risk      • feeling very tired (fatigued)
                                            of developing late effects as they grow older.
(chemotherapy, radiotherapy,                See ‘Further information’ to find out more
                                                                                             • pain
surgery and hormone therapy)                about support for people in this situation.      • loss of self-esteem and confidence
can cause both long-term and late                                                            • changes in the way you look (e.g. scars, an
effects.                                    Possible long-term side effects                    ‘ostomy’ bag, loss of hair or a body part)

Not everyone who has cancer treatment       Long-term side effects are those that happen     • problems with anxiety, depression
will have long-term or late effects. Even   during or soon after treatment finishes. It        and mood swings
                                                                                             • changes in the way your bladder
                                                                                               and bowel work (e.g. incontinence,
                                                                                               constipation, diarrhoea)
                                                                                             • menopausal symptoms (e.g. hot flushes,
                                                                                               night sweats, weight gain, mood swings)
                                                                                             • problems with eating, drinking and weight
                                                                                             • mouth and teeth problems
                                                                                             • thinning of the bones (osteoporosis)
                                                                                             • fertility problems
                                                                                             • persistent swelling in the
                                                                                               limbs (lymphoedema)
                                                                                             • changes in sex life
                                                                                             • nerve damage which is sometimes
                                                                                               caused by chemotherapy, which can
                                                                                               lead to pain, tingling and numbness,
Managing long-term and late effects of cancer treatment




                                                  or functions can be very hard to deal with.         • Look after yourself. This means taking
                                                  Certain side effects may be annoying but              care of your mind and body. Try to eat a
                                                  manageable (e.g. numbness in the hands                well-balanced diet with lots of fresh fruit
                                                  and feet). However, others can be more                and vegetables, exercise regularly and
                                                  severe and have a big effect on your quality          get plenty of sleep. Lack of sleep, a poor
                                                  of life (e.g. infertility, changes to your sexual     diet, alcohol and recreational drugs can
                                                  life or developing another type of cancer).           worsen fears and anxiety. But remember
                                                                                                        to treat yourself every now and then.
                                                  There are things that can be done to
                                                                                                        ‘Everything in moderation’ is a good motto.
                                                  help control or treat many long-term
                                                                                                        We don’t want life to become boring!
                                                  and late effects from cancer treatment.
                                                  It is important you find the right support          • Limit alcohol. Drinking alcohol increases
                                                  to help you manage and cope with any                  the risk of certain cancers. If you do drink
                                                  side effects you have or may develop.                 alcohol, it is recommended you drink no
                                                                                                        more than two standard drinks a day. You
                                                  The following tips may help                           should avoid binge drinking (excessive
                                                  • After finishing treatment, it is helpful to         drinking in one session) and have one
                                                    have a survivorship care plan: a written            or two alcohol-free days per week.
     usually in the hands and feet (neuropathy)
                                                    record with details of the cancer diagnosis,      • Quitting smoking. If you smoke, quitting
   • changes in memory and concentration            treatments and an ongoing plan of care.             is particularly important as it can reduce
     sometimes affecting people who have            This will provide both you and any other            the chance of developing a new cancer,
     been treated with chemotherapy                 health professionals you may need to see            improve appetite and overall health.
     (‘chemo-brain’ or ‘chemo fog’)                 with a good knowledge of your cancer ,              If you need help quitting, speak with
   • heart, liver and lung problems.                the treatment you have received, what               your GP, or call the Quitline. Quitline is
                                                    to expect following treatment and what              a telephone information and advice or
   Late effects                                     you can do to look after yourself. Speak            counselling service for people who want to
                                                    with your treatment team about providing            quit smoking. You can call the Quitline on
   These can happen years after                     you with a survivorship care plan.                  131 848 confidentially from anywhere in
   treatment finishes and may be                                                                        Australia for the cost of a local call only.
   permanent. They can include:                   • Keep your follow-up appointments.
                                                    Tell your doctor about any symptoms               • Be physically active. Exercise is regarded
   • lung, heart and liver problems                 you have. It is always best to have them            as beneficial for people with cancer both
   • developing another type of cancer              checked rather than worry. If you no longer         during and following cancer treatment.
                                                    have follow-up appointments, be sure to             Exercise is also important to reduce the
   • clouding of the lens in the eye, which can     report any symptoms to your GP or get a             risk of many cancers. ‘Moderate-intensity’
     cause difficulty with vision (cataracts)       referral back to your cancer specialist.            exercise is recommended for people who
   • infertility                                  • Talk to your doctor about whether or                are undergoing cancer treatment or who are
   • bowel problems                                 not you are at risk of developing late              in the recovery phase. ‘Moderate intensity’
                                                    effects from your treatment. In some                refers to the level of effort required by you
   • thyroid problems (the thyroid is                                                                   to experience a change in your heart rate
                                                    cases they may be able to alert you to the
     a gland in the neck that makes                                                                     and breathing. Brisk walking, swimming
                                                    signs and symptoms of late effects. But
     some types of hormones)                                                                            and cycling are especially recommended.
                                                    this won’t be the case with everyone.
   • tooth decay                                                                                      • Be Sun Smart. The sun’s ultraviolet (UV)
                                                  • Ask your doctor for help with any ongoing
   • changes in bone density (osteoporosis)         side effects. Don’t let them go on for too          radiation is a major cause of skin cancer. It
                                                    long before asking for help. You may need           is important to wear a factor 30 sunscreen,
   • persistent swelling in the
                                                    a referral to other health professionals such       wear sensible protective clothing, wear
     limbs (lymphoedema)
                                                    as a dietitian, specialist nurse or counsellor.     a hat and limit your time in the sun. It is
   • memory problems.                                                                                   about taking a balanced approach to UV
                                                  • Be healthy. While we are still uncertain            exposure to help with vitamin D levels
   Getting help and support                         whether or not we can prevent late                  whilst minimizing the risk of skin cancer
                                                    effects from cancer treatment, it may
   Any change in how your body looks, feels                                                             with appropriate sun protection methods.
                                                    still help to stay as healthy as you can.
Managing long-term and late effects of cancer treatment



          Further information

               Cancer Council (13 11 20) booklets
               include ‘Life after cancer: a guide
               for cancer survivors’. Call the
               Cancer Council to find out about
               Life after Cancer forums.
               Through the Cancer Council
               Helpline (13 11 20) you can speak
               with a cancer nurse: ask about
               Family Cancer Connect and support
               groups and other support services
               that may help you. Cancer Connect
               is a free phone peer support service
               that puts people in touch with
               others who’ve had a similar cancer
               experience.
               www.cancer.org.au

          If you had cancer as a child and need
          further information about possible
          late effects from your treatment:

               CanTeen (1800 226 833) provides
               support for young people aged 12 to
               24 who are living with cancer.
               www.canteen.org.au
               The Children’s Cancer Centre (03
               9345 4855) is at the Royal Children’s
               Hospital, Melbourne.
               www.rch.org.au
                                                       Australian Cancer Survivorship Centre
               The Peter Mac Late Effects Clinic
               (03 9656 1111) has a team of            Locked Bag 1, A’Beckett Street
               health professionals who provide        East Melbourne VIC 8006
               personalised care and information.      Phone: 03 9656 1111
               www.petermac.org                        Email: contactacsc@petermac.org
               Redkite (1300 722 644) provides         www.petermac.org/cancersurvivorship
               emotional support to children and
               young people (up to the age of
               24) and their families through the
               difficult cancer experience.
               www.redkite.com.au

          All of these services may be
          accessed through their websites.

								
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