After Treatment: The New Normal
What is meant by the “new normal” after cancer treatment?
Life after cancer treatment is often referred to as the “new normal”. Many people talk about how much they are looking forward to their lives getting back to normal when treatment ends. It is common for people who have gone through treatment, including their family and friends, to expect that this will happen—that life will return to the way it was before their diagnosis and they can put the cancer experience behind them. However, many people find it difficult, if not impossible, to just pick up where they left off to before they were diagnosed with cancer. Life after treatment becomes a new normal.
The period after treatment ends is usually a time of change and adjustment. Your everyday life may now include adapting to changes to your body or dealing with unexpected emotional or psychological challenges. Many people feel that the cancer experience has changed them. They don’t feel like the same person they were before they went through treatment. They can often find that their interests and outlook on life have changed. They may want to make changes in their life and live very differently after their cancer treatment.
Life after treatment is usually a time to discover what is normal for you now and how you want to live moving forward. This may mean getting back to a life that is as close as possible to what it was before cancer, or it may be a completely different way of living. It could even be somewhere in between. All of this depends on each person and their individual experience. As you move through your recovery, keep in mind that whatever you are feeling and experiencing is normal!
- How can my new normal affect me? As your treatment comes to an end, it is common to experience a wide range of emotions. You may feel happy and relieved, grateful and ready to celebrate. You may be excited about the future and have many ideas about changes or improvements that you’d like to make in your life. This can include making a career change, going back to school, travelling or practicing a healthy lifestyle. Many people also express a new appreciation for life.
However, even though this recovery time is what you’ve been waiting for, you could have mixed feelings and difficult emotions. You may feel a bit lost, uncertain and anxious about what comes next. You may also feel lonely, sad and angry about what you had to go through.
The cancer experience can continue to affect your body and the way you think and feel after you finish treatment. The challenges you experience as you move forward will depend on several things, including the type of cancer and treatment you had and how you coped with your experience. Everyone’s recovery is as individual and unique as their cancer experience. Some of the most common new normal challenges are listed below.
One of the first post-treatment challenges that is noticed by almost everyone is the loss of the “TLC” (tender loving care) that was such an intense part of the treatment experience. Throughout treatment, there were doctors and nurses to guide you every step of the way, answer all your questions, help you make decisions and support you. You may have gotten to know the volunteers in your oncology department and looked forward to seeing them at each appointment. When treatment is over, many people feel as though they are losing a safety net or leaving a protective environment. It is completely normal to feel this way, as well as to feel a bit lost, nervous or alone without all the medical appointments and interactions with your healthcare team. It is important to remember that even though you will see your healthcare team less frequently post-treatment, they are still there to answer your questions and support you.
As you start your recovery, you may find that you still have some of the side effects, such as fatigue or brain fog, that you experienced during treatment. These can take time to improve. Some side effects can occur months or years after treatment has ended (e.g., lymphedema). These are called long-term side effects and usually depend on the type of cancer treatment you had.
Common physical side effects and issues after treatment include:
- Fatigue
- Low level of energy
- Pain
- Brain fog (chemo brain)
- Sleeping problems
- Menopause symptoms
- Lymphedema
- Neuropathy
- Appetite and/or eating issues
- Lifestyle adjustments resulting from surgery (e.g., colorectal surgery)
- Mobility issues (the ability to move around)
- Sexual issues
It is normal to experience intense feelings and difficult emotions after treatment. These emotions may sometimes feel overwhelming and interfere with your everyday activities. Some people hold back a lot of emotions while they focus on getting through treatment—in recovery, it is normal for those strong emotions to then come to the surface.
Many of the emotions that you may experience in recovery can overlap and be caused by the same issues you felt during treatment. Common emotional challenges after treatment include:
- You may feel lonely when the people that supported you during treatment return to their regular routine.
- You may feel sad about the changes to your health and everything you went through.
- Cancer survivors experience depression after treatment three times more than the general population. This is when the sadness doesn’t go away and may involve other mental or physical symptoms.
- It is common to feel grief for all the things you feel cancer took away from you.
- You may feel angry about what has happened to you and how it has affected your life. You may also feel that your body betrayed you and that can make you angry.
- You may feel frustrated that you can’t do everything that you used to do or that life can’t go back to the way it was. You may also feel frustrated by ongoing side effects like fatigue or brain fog.
- Fear of recurrence—of the cancer coming back—and uncertain feelings about the future are very common for people who have gone through treatment.
- Stress and anxiety. Worrying about the cancer coming back is a common source of stress and anxiety after treatment. It is also common to experience stress and anxiety before medical appointments and at certain milestones, such as the date of your diagnosis.
- Body image concerns. Many people have a difficult time coping with or accepting how cancer and treatment have changed their body. It is common to feel self-conscious and vulnerable about these changes.
You may find that some or all of your relationships have changed after going through cancer treatment. The cancer experience can bring people closer together, but it can also create relationship challenges and distance. This includes relationships with your partner, other family members, friends and work colleagues.
If you are going back to work after treatment, you may feel uncertain about what to say to colleagues and worried whether you will be able to handle your workload.
You may have financial concerns or needs in recovery, particularly if you can’t return to work.
- Will it get better? The challenges of your new normal will most likely improve with time. Your body and mind will feel better as you recover from cancer treatment and adjust to any changes. How long it takes to feel better and recover depends on the cancer, the treatment and the individual person. Some people recover quickly and get back to their regular activities within weeks. For others, it can take months or even years.
When should I get help after cancer treatment?
It is normal to have less contact with the members of your healthcare team after you have finished treatment; however, it is important to know that they are still there to support you.
Many people feel they should just be able to get on with life after they finish cancer treatment. They may feel they shouldn’t “bother” their doctors with questions or take up their time. But if you are having difficulty coping in recovery—physically or emotionally—don’t hesitate to talk to someone in your healthcare team about your concerns. If you have side effects or symptoms that worry you, or if you are having trouble managing life as you recover, you don’t have to deal with it alone.
It is important for your healthcare team to know what you are experiencing after treatment. This helps them understand your body’s response to treatment and they can help you better manage any issues you may have. They can also help you understand what to expect going forward, which may help you to worry less.
What can I do to help manage my new normal?
There are many things you can do to manage the challenges of your “new normal”. Self-management is an opportunity for you to take charge of your recovery and directly influence your health and wellbeing. Although you still have the support of your healthcare team, you will now be making decisions on your own for how you will move forward. You are the one that knows best what you need to do, and what is possible for you to do, to recover well. Taking an active role in your own care can be empowering as you shape your life after treatment.
Below are some strategies that you may find helpful in managing your new normal.
It takes time to recover and it’s important to give yourself all the time you need. Some people recover quickly, but for others it’s a very gradual process, especially if there are major physical or emotional adjustments. It may even take longer to adjust to life after treatment than to the diagnosis and treatment itself. Some days you may feel good, and other times, it may feel like you haven’t made very much progress. Just take it one step at a time and try not to overdo anything at the beginning. You may also feel like you just need time to rest and relax after everything you went through—this is important too. Be patient and listen to your body and your emotions as you heal. Move forward at a pace that is comfortable for you.
In order to give yourself the time you need to recover, and to feel good about your recovery, it’s important to manage expectations—your own and those of others. Don’t expect too much of yourself too soon. If you have an unrealistic timeline for your recovery, you may end up feeling frustrated and thinking that you will never get better. It can also be hard to know what to expect in your new normal. Try to be open to the experience of life after treatment instead of trying to apply a set of expectations that may not be practical or workable. Feeling that you are not living up to expectations can cause stress, anxiety, guilt and anger.
When you’re working on managing expectations, watch out for the “shoulds”. If you find yourself thinking “I should do this” or “I should feel that”, pause and consider how these thoughts are affecting you. Are they helping your recovery or are they making you feel anxious. Some of the “shoulds” to be aware of as you recover include:
- I should be back to normal. Getting back to your everyday life, including work and social activities, can take time. Don’t try and rush your recovery. Also, don’t expect life to go back to exactly the way it was before you were diagnosed, or wait for this to happen. The new normal means that “normal” may be different for you now. You may also be feeling pressure from family and friends to “get back to normal”. It can be hard to tell people that you are still struggling. It can also be difficult for others to accept that you may feel like a different person now, and don’t want to go back to the way things were. Try to be honest about how you are feeling and about what you are willing to do.
- I should be able to do what I did before. After treatment, you may continue to have physical effects like fatigue or pain. It may take you longer to do things for a while than before treatment. In some cases, long-term effects from treatment or surgery may make it necessary to make permanent adjustments. Work with the present; don’t compare things to the past.
- I should feel happy. Many people do feel relieved and happy and excited when they finish treatment and want to do something to celebrate. Family and friends are also happy for you, and it’s normal to think you should feel happy after everything you been through. But many people also begin recovery with mixed feelings, and struggle with different emotions including fear, anxiety, sadness and grief. These are valid and important feelings. Everyone’s experience is personal and unique.
- I should be positive. There is a lot of emphasis these days on being positive, and sometimes a lot of pressure too, particularly from family and friends. “Just be positive!” they say. They want you to be happy and not to worry now that you’re finished treatment. Although a positive attitude may help you feel and cope better, it is unrealistic—and stressful—to expect someone to be positive all the time. Everyone has good and bad days, and anger and sadness are real and valid emotions. Being honest about how you feel and coping with your post-treatment challenges as best as you can is taking a positive approach.
- I should feel grateful. Some people feel pressure to feel grateful for having successfully made it through treatment—and they feel guilty if they don’t. However, your experience with cancer may have made you feel sad, angry or resentful: “Why did it have to happen to me?” These are real and valid responses to your experienc
As you recover and get your energy back, you may still need help with certain chores or tasks. Let your family and friends know if there’s anything that you can’t handle on your own yet and how they can support you. After treatment, your support system may not realize that you still need their help.
Be kind to yourself as you go through the recovery process. Do something every day that you find enjoyable or relaxing. It doesn’t have to be complicated—just anything that makes you feel good, such as spending some time in nature, reading or listening to music.
As you begin your recovery, take some time to reflect on your cancer experience and everything you’ve gone through. Think about where you feel you are now, physically and emotionally. Reflect on how life has changed for you and if there are any adjustments you will need to make going forward. Perhaps your experience has changed the way you look at life or maybe you have learned something new about yourself or your relationships. Understanding how cancer has affected you and the challenges you face can help you in your recovery. Even if you feel that you will be able to get back to your everyday life relatively easily, give yourself the opportunity to sort through your feelings of what you experienced and your hopes for your life as you move forward.
As you start your recovery, it can help to identify your needs and priorities. Think about what matters most to you now and what areas of your life you want to focus your energy on as you move forward. Cancer experiences can change how you look at life and what you feel is meaningful.
Some questions that you can ask yourself to help with this self-assessment include:
- What is most important to me in life?
- What gives my life meaning?
- What makes me happy?
- What makes me feel fulfilled?
- Have I learned anything new about myself?
- Are there any changes that I’d like to make to my life?
It is also important to identify if there are any physical or emotional issues that are affecting your recovery. Think about if you want to prioritize managing these concerns. You may need to take some time to realize how your body and/or feelings have changed since your cancer. This may be a factor in identifying what your needs are now.
Review the new normal challenges at the beginning of this section or check out the interactive questionnaire.
Now that your treatment is over, you may be looking forward to feeling better physically and regaining your strength. Perhaps you have some ideas about lifestyle changes you would like to make to improve your physical health. This could be exercising more or eating a healthy diet. Managing your physical wellbeing also means giving your body the time it needs to heal. For example, short, relaxing walks in nature rather than intensive exercise might be a good starting point for your body as you begin your recovery. Listen to your body and don’t push too hard.
Depending on your cancer and treatment, recovery may also include adapting to permanent physical changes, such as those resulting from colorectal surgery or the loss of a limb, which may require help from a physical or occupational therapist.
In general, there are a few basic strategies to help you manage your physical wellbeing as you move forward with your recovery.
- Manage side effects. If you still have side effects—such as fatigue, pain or brain fog—after treatment, discuss the best ways to reduce them with your healthcare team. Some people also experience long-term side effects, such as lymphedema or neuropathy—your healthcare team can help you with specific strategies for these effects or refer you to specialists.
- Manage risk factors. Talk to your healthcare team about any risk factors associated with your cancer, and what you can do to minimize these risks.
- Be physically active. Being physically active can help you regain or build strength, and it can help reduce side effects, such as fatigue. Being active can also help your body cope with stress—physical and emotional. Anything that gets you moving counts, such as walking, yoga, biking, swimming or golfing. Household chores and yard work can be also considered exercise.
- Eat a healthy diet. Food can make a big difference in how your body feels. Try to follow a well-balanced diet that includes plenty of fruit, vegetables and whole grains. Limit foods that are processed and high in sugar.
- Manage stress. Stress and anxiety can make your body feel generally tired and unwell, and they can also worsen side effects such as fatigue and pain. Exercise is one way to help manage stress; but you can also explore relaxation techniques. Examples of these are meditation, breathing exercises and guided visualization.
Your emotions in recovery can be as all over the place as they may have been for you in treatment—maybe even more so. All of this is normal. Recognizing and acknowledging the range of emotions you are experiencing will help you find effective ways to work through them.
- Be honest about how you feel. You will be better able to manage your emotional wellbeing if you are honest about your feelings, especially with yourself.
- Talk about your emotions. Sharing difficult emotions with someone you trust, such as a family member or friend, can help reduce their impact. You could also consider talking to a professional for advice, such as a psychologist, if you are having trouble managing your emotions.
- Connect with people. Spend time with people that you care about and make you feel good, such as family, friends, work colleagues or neighbours. You could also consider connecting with others by joining a community or support group, or by volunteering.
- Manage stress and anxiety. Stress and anxiety are common emotions after treatment for a lot of people. You may be worried about what comes next or if the cancer will come back, or about going back to work and having to face your colleagues. Stress and anxiety are difficult on their own, but they can also intensify other emotions like sadness and anger. There are also a number of post-treatment challenges that can provoke stress and anxiety: fear of recurrence, body image concerns and medical appointments and waiting for test results. There are many strategies that you can try to manage stress, including exercise, meditation, deep breathing exercises and guided visualization.
- Be physically active. Physical activity is not only good for your body—it is beneficial for your mental health and for managing difficult emotions. As with managing your physical wellbeing, anything that gets you moving counts, such as walking, yoga, biking, swimming or golfing. Household chores and yard work can also be considered exercise and a good way to start slowly. See Get Moving.
You may find it helpful to consider if any of your relationships are affecting your recovery. During treatment, you may have experienced changes in your relationships with family and friends that trouble you. These changes can persist after treatment, or new challenges may develop. Think about the relationships that are different now and which ones are important for you to work on.
Some common reasons that people find their relationships have changed include:
- Friends and family expect you to be the way you were before, but you no longer feel like the same person.
- You feel that family and friends don’t understand what you’ve been through. They may not understand why you might need to talk about how cancer affects you even though treatment is over.
- People that you thought you could rely on were not there for you during treatment.
- You and your partner found it difficult to be intimate while you coped with the challenges of treatment and now it seems that you both are not as close.
- Family and friends are reluctant to let go of their supporter roles and let you get back to everyday life.
- Family roles have changed tasks that you did before are now being done by others who don’t want to give them up. The same tension can arise if you no longer want to have exactly the same role in your family that you had before.
In most cases, honest conversation is the most effective approach to managing your relationships. This is not always easy, but it’s hard to improve a situation or move forward without a clear understanding of everyone’s feelings.
- During recovery, it may be a priority for you to reconnect with your partner. Talk about what you both had to face during your treatment, and your emotions and concerns. Discuss ways that you can explore being intimate without feeling any pressure.
- Be as honest as you can with family and friends about how you feel. Try to help them understand where you are now in your life and what you need.
- Talk to your children about your cancer experience and encourage them to ask questions.
Managing relationships may also include dealing with people who are not that close to you, such as neighbours and work colleagues. You should never feel obligated to discuss or explain your cancer experience if you don’t want to or are not comfortable doing so. You can thank people for their concern if they ask questions, and just let them know that you are doing well.
Mind-body therapies, such as mindfulness, meditation, relaxation strategies and yoga, may help you feel calm and more in control. They may also help you deal with difficult emotions and physical issues, such as pain and fatigue.
During treatment, it’s normal to stay close to home and follow a routine that gives you comfort. After treatment, especially if you are dealing with side effects or other physical changes, it can be difficult to move out of your comfort zone. Pushing yourself to go out a little more or trying something new can help you build confidence and get used to being out in the world again.
- Get out of the house. Run an errand, go for a short walk, meet a friend for coffee—any small outing can help you feel better and move forward.
- Volunteer. Consider volunteering a few hours a week for a cause that is close to your heart.
- Learn a new skill. Is there anything you’ve always wanted to learn how to do? Maybe you’ve thought about taking a cooking course or learning how to play a musical instrument. It could even be something like Googling how to fix your bike.
If you intend to go back to work, make a plan for your return. This will help you feel more comfortable and confident when you do return to your job. Some things to think about include: Are you ready to go back full-time or should you to start back gradually? Do you need any special accommodations for the work you do? What do you want to tell your colleagues about your illness? You may also want to consider if you would like to look for a new job or if you would prefer not to return to work at all. Take the time you need to figure this out, so the transition is as smooth as possible. For more information, see the Back to work factsheet.
For details on financial concerns or challenges that you may have to cope with in recovery and how to manage these, see the financial issues factsheet.
Support can be as important in recovery as during treatment. It’s normal to feel a bit lost when you don’t see your healthcare team as regularly anymore. Also, family and friends may not check in with you as often as they used to. You are facing a new set of challenges, and the way forward may not always be clear—but you don’t have to face everything on your own. Support can be an important tool to help you move through the recovery process.
- Talk to a friend or family member. Expressing your feelings and fears to someone you trust can help relieve stress and provide an opportunity to brainstorm ways to cope.
- Join a support group. Some people find it very helpful to talk about their concerns with others who have had similar experiences. You can also learn how others have handled their challenges, such as treatment side effects, going back to work and the fear of recurrence. You may get ideas that might work for you. A support group can also help you feel less alone.
- Try professional counselling. A professional counsellor, such as a psychologist or social worker, can help you work through your fears and difficult emotions, and explore ways help you manage them. If at any point you are feeling depressed, you should talk to a professional.
- Explore support resources for going back to work and financial issues. Going back to work after cancer treatment can be physically and emotionally stressful. If you are unable to go back to work, you may have financial concerns that make you feel stressed and anxious. There are many resources that can help you manage these challenges. See the factsheets on back to work and financial issues for more information.
⚠ Important information about cannabis
Some patients use cannabis to help them manage cancer-related symptoms. However, overall, the research is still unclear. It is important to talk to your doctor before trying cannabis. For more information on what cancer patients should know about cannabis, go to: www.bccancer.ca/health-info/coping-with-cancer/medical-cannabis.
How can caregivers help?
A caregiver can support a recovering cancer patient struggling with or adapting to their new normal in several ways. The self-management strategies in this document can help the caregiver or support person recognize areas where they might be able to help. These include:
- Ask the patient if they are feeling any stress or pressure about “getting back to normal”.
- Let the patient know you are there for them if they want to talk.
- Discuss with the patient any changes in the roles of family members, including their own.
- Ask the patient if you can help with anything.
Available services
The Quebec Cancer Foundation supports people with cancer and their loved ones throughout Quebec, through services suited to their needs and daily concerns.
Services offered
Several services and activities offered by the Quebec Cancer Foundation can be useful to help ease your new normal concerns as they offer corporate support programs such as educational conferences; financial assistance programs; legal services, and complementary lodging centres/accommodations.
Psychological support and information services in the form of hotlines and document libraries are dually offered.
The Quebec Cancer foundation also features additional services like community events. You may reference documentary resources on this subject on their website.
Contact
1 (800) 363-0063
The mission of the Quebec Breast Cancer Foundation is to promote the well-being of cancer patients and their families through research, innovation, support and awareness.
They offer many services including information and support hotlines, as well as resources adapted to the needs of people affected by cancer and their families.
Services offered
My Active Health: a service that helps by offering physical activities on a regular basis which contribute to improving quality of life, such as:
- My mobile application
- My exercise videos
- My oncologic yoga
- Dragon Boat Teams
Psychosocial support: The Quebec Breast Cancer foundation offers psychosocial support. The social workers from the support service can also help form strategies with you to address your concerns post treatment.
Free virtual clinic: a service of first aid offered to people affected by breast cancer. The aim is to help manage the secondary effects that arise after treatment and those that persist long term. The clinic is:
- Easy-to-use
- Accessible 24/7
- Better monitoring and screening
- Management of secondary effects that arise after treatment and those that stay permanent at long-term
- Promotion in health and healthy life habits
- Coordination of care between specialists and generalists
*It is also possible to share your experiences with people that have gone through the same thing by their online communities:
- Facebook group Parlons cancer du sein
- Facebook group Club stade 4
Contact
1-855-561-ROSE
General information
The Canadian Cancer Society offers support for people with cancer and their family, friends and caregivers.
Their information specialists are there to answer your questions and offer up-to-date, reliable information on topics that include:
- cancer treatment and side effects
- clinical trials
- coping with cancer
- emotional support services
- prevention
- help in the community
- complementary therapies
Services Offered
Helpline: The information specialists at the Cancer Information helpline are available Monday to Friday in English and French from 8am to 6pm. For other languages, they can access an interpreter service.
Online community: CancerConnection.ca is the Canadian Cancer Society’s online community. This service helps people with cancer and their families share experiences and create supportive relationships.
Contact
General information: https://cancer.ca/en/
Cancer Information helpline: (Toll free) number: 1-888-939-3333
To access their website and live chat: https://cancer.ca/en/living-with-cancer/how-we-can-help/talk-to-an-information-specialist
Online community: https://cancer.ca/en/living-with-cancer/how-we-can-help/connect-with-our-online-community
Service locators
Below is a list of organizations that can help identify local support services for you and those that support you. The quality of the services has not been verified by e-IMPAQc. Before using these services, verify with your healthcare practitioner.
The Canadian Cancer Society offers a service locator resource where you can find services and programs in your city or nearest your postal code.
Contact
1-888-939-3333 (Monday-Friday)
The Regroupement des Organisations Communautaires en Oncologie (ROCO) offers a service locator resource specific to the province of Quebec. It lists support resources available by region.
Contact
514-506-3503
The Cancer Information helpline is available Monday to Friday in English and French from 8 h to 18 h HE. For other languages, they can access an interpreter service.
Contact
Toll free: 1-800-363-0063
Regroupement des Organisations Communautaires en Oncologie (Provincial – Quebec) (French)
The Regroupement des Organisations Communautaires en Oncologie (ROCO) offers a service locator resource specific to the province of Quebec. It lists support resources available by region.
Quebec Cancer Foundation (Provincial – Quebec)
The Quebec Cancer Foundation offers a resources directory of community, association and public resources by region or postal code.
The foundation also has a document lending service. Their materials (books, web resources, online articles, webcasts) cover a wide range of topics related to cancer. It is free to borrow and materials are sent by mail or email anywhere in Quebec.
Acknowledgement of sources
The content of this document has been adapted from the following sources:
- American Cancer Society. Living well after cancer treatment. 2023.
- Canadian Breast Cancer Foundation. Life After Cancer Treatment. 2010.
- Canadian Cancer Society. Life after treatment. 2023.
- Canadian Cancer Society. After treatment ends. 2023.
- Cancer Care. After Treatment Ends: Tools for the Post-Treatment Cancer Survivor. 2023.
- Cancer Care Alberta. After Treatment: Information and Resources to Help you Set Priorities and Take Action. 2022.
- Cancer Care Manitoba. Moving Forward after Cancer Treatment: Follow-up Care Plan. 2017/2018.
- Cancer Council of Australia. Living Well After Cancer. 2021.
- Net. Survivorship. 2023.
- Healthlink BC. Cancer Support: Life After Treatment. 2023.
- Looking Forward. Rebuilding your life after cancer treatment. 2016.
- National Cancer Institute. Cancer Survivorship: A New Normal. 2023.
Healthcare professional endorsement
The content of this document has been reviewed and approved by a team of healthcare professionals and clinical experts.
Disclaimer
Please note that this fact sheet is not intended as a substitute for consultation with a healthcare professional. Rather, it was designed to complement interventions by your treating team. If you have questions about your health, or any medical issue, you should contact a healthcare professional right away. You should not delay seeking medical advice, or disregard professional medical advice, because of information in this fact sheet. Before beginning any health treatment, always consult your doctor. All care has been taken to ensure that the information contained in this document is accurate at the time of publication. e-IMPAQc is not responsible for any injury or damage to persons or property arising out of, or related to, any use of the fact sheet, or because of any errors or omissions.
Reproduction and copyright
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