Managing Long-Term Side Effects After Cancer

Treatment is hard on the body, and recovery takes time. Some side effects fade quickly once treatment ends. Others last weeks, months, or longer. Tiredness and nerve tingling are two common examples. This is common, and it does not mean treatment failed. It is part of healing.

Fatigue is one of the most common. It is a deep tiredness that does not fully lift with rest, and it can carry on after treatment ends. Nerve problems are also common. Doctors call this peripheral neuropathy, and it causes tingling, numbness, burning, or pain, usually in the hands and feet. Some people notice memory or concentration changes, often called chemo brain. Sleep, mood, appetite, and weight can change too. Which effects you get, if any, depends on the treatment you had.

Some effects show up later, months or years after treatment. These are called late effects. Depending on your treatment, they can include bone thinning, heart or lung problems, hearing or eye changes, thyroid or other hormone changes, lymphedema (swelling when lymph fluid does not drain as it should), and a small risk of a second cancer. Your team can tell you which ones apply to you.

Gentle, regular activity such as walking can ease fatigue and lift mood. Good sleep habits, pacing your days, drinking enough fluid, and eating well all help recovery. For neuropathy, memory changes, or lasting fatigue, your care team can suggest strategies, treatments, or a referral. Physical and occupational therapists can help with strength, balance, and daily tasks.

Neuropathy also raises the risk of falls and burns, because you may not feel the floor, a hot pan, or hot water properly. Check your hands and feet daily for cuts or sores, wear shoes indoors and out, clear loose rugs, use rails and grab bars, and ask someone else to check the water temperature before you bathe or shower. Use oven mitts and take care with sharp objects in the kitchen. Do not start a new medicine or supplement for neuropathy without asking your team first.

Tell your team about side effects that persist or bother you. Many can be improved, and some lasting symptoms are worth checking to rule out other causes. You do not have to simply put up with them.

• Call 911 or go to an emergency department if you have chest pain, sudden shortness of breath, fainting, or sudden weakness or numbness on one side of the body.
• Call your care team the same day if you have a temperature of 100.4°F (38°C) or higher or shaking chills; new or fast-spreading numbness or weakness; trouble buttoning clothes, holding objects, or walking steadily; or a cut, blister, or burn on a numb hand or foot that looks red, swollen, or infected.
• While treatment is still running, the fever line is stricter. CDC treats a fever during chemotherapy as a medical emergency. Ring your team at once at 100.4°F (38°C), day or night, and go to an emergency department if nobody picks up.
• Call your care team within a day or two if fatigue suddenly gets much worse, an arm or leg becomes swollen or feels tight, you have new shortness of breath on stairs, or memory or mood problems are getting worse instead of better.

• National Cancer Institute — Coping: Late Effects
• National Cancer Institute — Nerve Problems (Peripheral Neuropathy) and Cancer Treatment
• National Cancer Institute — Fatigue and Cancer Treatment