Life after cancer is never the same as before. Photo / Getty Images
From worries about recurrence and body image to going back to work, the end of treatment can be the beginning of new concerns
After nearly two years of breast cancer treatment – including a mastectomy and multiple rounds of chemotherapy – I was finally told there was no evidence of cancer in my body. My lifesaving treatment was over and my surgeon, while briskly discharging me, advised, “Go and live your life.” Euphoric, right? Perhaps skipping off to ring the famous chemo bell? Not exactly. The end of treatment was almost as shocking as the diagnosis itself.
No longer on the relentless conveyor belt of appointments with constant specialist care, I found myself thrust into a suddenly unfamiliar world. Beyond the physical scars and lifelong side effects, I carried an invisible psychological burden: mistrust of my body and the ever-present fear of cancer’s return.
In that, I am far from alone. Research from support organisation Life After Cancer shows 92% of survivors found post-cancer life more challenging than treatment.
Yet, there is hope. Life after cancer can become an opportunity to rebuild. A recent AXA survey revealed eight in 10 cancer survivors gained a new outlook on life, valuing family and time over material wealth.
With resilience and the right support, life after cancer can be fulfilling — a chance to build stronger relationships and find clarity in what truly matters. Here are some of the most common challenges survivors face after treatment, with expert advice on how to address them.
Just because cancer no longer appears on scans doesn’t always mean it’s gone forever. A new cancer can form in the same spot, or stray cells can travel through the body, spreading to other organs and sometimes becoming incurable years after treatment. Knowing this can make every ache, pain or even a runny nose terrifying.
Studies show survivors are 27% more likely to experience anxiety than the general population, and that rises to 50% 10 years or more after diagnosis. Robin Muir, a specialist counsellor and clinical psychologist at cancer care charity Maggie’s, says fear of recurrence is “the No 1 reason” post-cancer patients seek psychological help. This fear, he says, is “made worse by having less contact with doctors despite many questions about their body”.
Muir advises starting with acknowledgment: “People often push fears away due to pressure to be ‘positive’ and ‘strong’, but worry is normal. Follow-up tests and scans can trigger ‘scanxiety’, which can feel unmanageable.”
What helps? “Let key people in your life know your anxiety might spike around scan time. Be proactive – use relaxation techniques, exercise, mindfulness and social connections to reduce stress.”
Cancer survivors can become hyper-vigilant, interpreting any symptom as a recurrence and seeking investigations that increase anxiety. Muir suggests asking your health professionals about specific signs to watch for, including any truly urgent ones, “so you don’t worry about everything else”. Over time, fear often reduces as part of adjustment, he says.
Rosamund Dean, a breast cancer survivor and the author of Reconstruction, recommends writing down new symptoms and setting a two-week reminder. “This gives your brain permission to forget about it for now. If the symptom is still there when the reminder pings, get it checked.”
Fatigue – a profound tiredness that doesn’t disappear after a good night’s sleep – is the most commonly reported physical side effect of cancer treatment, says Muir. “People finish treatment and try to throw themselves back into normal life. But this is often not possible because of fatigue. They try again, even harder, and this can lead to a vicious circle of boom and bust.”
He says, “People may think, ‘I can’t do what I used to. What does that say about me?’ They feel like a failure and as if they are letting themselves or others down.” Muir encourages patients to accept that fatigue is normal and to pace themselves.
“Even the best athletes alternate chunks of activity with periods of rest,” he says. “Keep some fuel in the tank. The end of cancer treatment is not a full stop; it’s the beginning of recovery. Take small, manageable steps rather than aiming for a big leap.” This especially applies to the world of work, where a slowly phased return can be more successful than trying to rush back. Legally, cancer counts as a lifelong disability, so you have extra rights in the workplace.
Exercise is proven to help reduce cancer fatigue, with people who exercise three times a week showing significant improvements. Whether it’s walking, yoga or gentle strength training, or even short bursts of movement during the day, staying active has been shown to improve physical and mental wellbeing. As a bonus, exercise can also halve the risk of cancer coming back.
Few escape cancer without battle scars. The loss of a breast, a stoma or even amputation can be the price of survival. Some cancer survivors find their hair never fully grows back. These changes, says Muir, “impact massively” on body image and relationships.
“People can become averse to looking at affected parts of their body,” he explains. “They avoid intimacy and mirrors. At the same time, they may feel embarrassed or ashamed of feeling ‘vain’ instead of grateful to be alive, but how we look is an important part of who we are.”
Individual therapy can help, but support groups are particularly valuable. “Meeting others who feel the same way can foster self-compassion and acceptance. It can help you believe that it’s reasonable to grieve the loss of body parts or changes to your appearance.”
For intense negative feelings, Muir recommends confronting the changes gently. “Looking at your body in a kind way rather than avoiding it can help. Massaging scars with moisturisers or oils can also foster a sense of reconciliation with your body.”
“When people are diagnosed with cancer, they often step aside from the roles that provide identity and self-esteem,” says Muir. “Work, caring for grandchildren, even making dinner – these activities can vanish. Returning to normal life can feel daunting.”
“People can become quite institutionalised by cancer treatment,” Muir continues. It’s important to ease into these activities. “Your confidence may be low, but getting out and about can help. It may only be walking for 15 minutes every day, meeting a friend for coffee or going to the shops.” You might also want to plan a treat such as a holiday.
Survivors may feel pressure to resume old roles. But Steph Davies, the founder of Life After Cancer, encourages survivors to redefine their values. Instead of fighting to go backwards, ask yourself:
These answers can guide decisions such as taking on commitments or setting boundaries. “Let your values lead,” she says. “This helps create an authentic, fulfilling post-cancer life.”
Support from friends and family can diminish when cancer treatment ends. “Survivors tell us people stop asking how they are,” says Davies. “They may also hesitate to burden loved ones with their feelings because they think their friends and family have already gone through a lot.” This can lead to loneliness.
Davies advises being honest but clear. “Say, ‘I just need you to listen – you don’t have to fix it'. Or, ‘I’d love for you to understand what I’m going through'.” Writing down feelings before sharing can also help survivors feel more confident.
Alternatively, connecting with others who understand first hand can be invaluable. Support groups, whether in person or online, provide a safe space to share worries. Davies says, “Our coaching course offers an optional WhatsApp group, so there’s always someone to lean on.”
She says: “Life after cancer isn’t necessarily about going back to the person you were before: it’s about moving forward into a life that reflects who you are now.”
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