[Narrator]

While most survivors who recover from cancer go on to live relatively healthy lives, this by no means minimizes the challenges that other survivors face. These challenges may be of four kinds: recurrence, second malignancy, organ damage, or emotional and social issues.

The first challenge involves the possibility of cancer recurrence. Some long-term survivors experience a recurrence of their original cancer and need more treatment. This might involve the same type of therapy that initially controlled the disease, but often a different kind of treatment, is needed. This is often an excellent opportunity to ask your doctor whether participating in a clinical trial would be one of the best options for you to consider at this time.

In contrast to recurrence of the original cancer, some survivors may face the challenge of "second malignancy"—development of a new and entirely different kind of cancer than they had before. Second malignancies require different types of treatment from the first form of cancer. The earlier a secondary malignancy is caught and treated, the greater the chance for a successful outcome. There are more and more long-term survivors who have experienced second malignancies and have been successfully treated.

A third challenge may come in the form of organ damage. Some long-term survivors find that their cancer or cancer treatments have damaged some parts of their bodies, such as their hearts or lungs, ovaries or testicles, bone marrow, or nervous system. It may take some extra effort on your part to find a healthcare provider who has experience working with long-term survivors and who can make referrals to the appropriate specialists for diagnosis and treatment.

And a fourth challenge involves a variety of emotional and social issues. While many survivors will recover physically, they may have difficulty recovering from emotional or social traumas that may result from their illness and treatment. These traumas are often more difficult for some survivors to deal with than the medical problems. We will hear more about these types of issues later in this program.

[Kevin]

Surviving cancer is more complicated than simply being either sick or well—either having cancer or being cancer-free. Cancer survival is a continual process that requires you to take the best possible care of yourself.

There's one part of being a long-term survivor that I wanted to make sure Alisha knows about. I've survived nine years without a recurrence of cancer—that's very encouraging. But I'm still cautious about keeping track of my health. Since my original cancer has not recurred yet, it most likely will not come back this late. But, I know I'm still at risk for developing other medical problems related to my prior treatment.

[Narrator]

You're probably wondering what you can do to stay as healthy as possible after being treated for cancer. Right now, there is little known about how to prevent some of the late effects of cancer. This means that it's extremely important that you learn how to monitor your health and have regular checkups, as Kevin just said, to catch any changes that you are unsure about. We are also learning more each year about the value of exercise, healthy nutrition, stress reduction, and screenings. Check with your healthcare team for the latest information and specific recommendations in these areas. Meanwhile, here are a few suggestions that may help you develop your own personal plan for life after cancer.

Request an exit interview with your doctor and nurse if you are just completing your treatments, or make a separate appointment if you are a longer-term survivor. Have them help you create a monthly or yearly follow-up plan. Some questions for you to discuss might be: How often do you need to be seen and by whom? What medical or diagnostic tests need to be done and how often? What are the possible risk factors that are specific to you?

Get the name and phone number of someone you can call if you become anxious or have questions. In addition to the numbers of all your doctors, you will want the numbers for your oncology nurse and social worker. They are often much easier to contact than your doctor. They can frequently answer many of your questions, and can help recognize symptoms that may need further attention. They also can refer you to support groups or other community resources that offer continuing support to survivors who are no longer receiving treatment or who are on maintenance therapy.

Ask your doctor or nurse to make photocopies of your medical records for you. These would include surgery, pathology, and x-ray films and reports. Also include details of all cancer treatments, such as the names and doses of all chemotherapy drugs, and the amount and location of radiation therapy. Have them list any problems that may have occurred during therapy, and what to expect now that you are finished. Make sure you have all the medical summaries from your healthcare team. Many survivors have found it helpful to create their own personal summary that describes their diagnosis and treatment history.

Keep track of your medical history. As you collect photocopies of your medical records, you will probably find it helpful to create your own system to save and organize your medical records. This could be a large envelope, a pocket file, or a binder with labeled sections to organize photocopies of your records. You could, for example, have separate sections for your prior diagnosis; your treatments, which should include dates and doses; lingering effects, like fatigue or numbness; risk factors, like thyroid dysfunction and infertility; and your follow-up plan. This way, you will be able to provide a detailed account of your medical history no matter what healthcare provider you see in the future. This is especially important with today's medical climate where people change insurance plans so frequently, or if you move to other parts of your community or to another state.

You may be able to be seen by healthcare professionals at a long-term follow-up clinic, sometimes called a "late effects" or "survivor" clinic. This type of clinic is staffed by experts who care for long-term survivors and who understand the specific issues of this group. While a number of these specialty clinics are available for children and young adults who received treatments as children, very few of these clinics are available for adult cancer survivors at this time. We hope this will change soon.

With increasing numbers of survivors living many years after their initial diagnosis, we are learning that continued support, accurate information, and accessible healthcare are all crucial for those who are fortunate to be long-term survivors. As a matter of fact, their lives depend on it!

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