11 Things to Expect After Lung Cancer Treatment
The day has come: You’re moving into a new chapter of your lung cancer journey. Whether you’re in remission and treatment is officially over or you’ve moved into a maintenance phase of treatment, this transition can bring unexpected changes—good ones and not-so-good ones. With so much of the cancer conversation revolving around treatment, it’s not uncommon for people entering survivorship to face new anxieties and questions about what comes next, especially when the very nature of “life after lung cancer” is evolving.
Lung Cancer Survivorship Is Changing
At what point is lung cancer treatment deemed “over?” That’s an evolving question, says Carolyn Presley, M.D., a lung oncologist at the Ohio State University Comprehensive Cancer Center in Columbus. Thanks to treatment advances, more people with late-stage lung cancer are living much longer after diagnosis. “We’re really trying to change the definition of survivorship for patients because with these newer treatments, people are living years rather than months. So you might still be on your treatment, but you’re still surviving,” she says. So no matter the circumstances of your survivorship—in remission or in maintenance treatment—here are 11 things you may expect.
While you may have thought finishing lung cancer treatment would leave you feeling elated, having mixed emotions is incredibly common, even with a positive outcome, says therapist Elaine Wittert, L.C.S.W., who works with cancer patients at Cedars-Sinai Medical Center in Los Angeles. “When you’re going into survivorship and returning to your pre-cancer lifestyle, it’s a really tricky time,” she explains. You may experience battling feelings of happiness and relief along with anxiety and worry. Know that this is 100% normal—and seek out a therapist or a support group where those feelings can be explored and validated, Wittert suggests.
Struggles With Friends and Family
Those mixed feelings can be especially tricky to understand for well-meaning loved ones who want to celebrate with you. “They may think that if you’re not in the same place as they are, you’re being a party pooper or you’re being negative. That can be really hard,” Wittert says. Cancer causes not only you but your loved ones to grapple with the concept of death, and that can be uncomfortable for some, leading them to brush negative feelings aside, Wittert says. “If you don’t feel you have a place to express those negative emotions, therapy is a perfect place to go.”
Anxiety and Fear of Recurrence
The worry that your cancer will return (or, if you’re in maintenance, worsen) is a common issue at this stage, Wittert says. This can also manifest in insomnia. “Maybe during the day, you’re busy, so you’re less aware of that underlying fear, but at night it’s common to have racing thoughts,” she explains. If you’re having trouble putting the brakes on those worries, Wittert recommends cognitive-behavioral therapy, which can teach you to challenge inaccurate or unhelpful thinking patterns that are causing distress.
Changes in the Foods You Like
Many people in this stage of their lung cancer journey report shifts in taste and appetite—and these two things go hand in hand, Dr. Presley says. There are things you can do to help, she says, like trying different types of foods and getting creative with seasonings. “Things that you may not have liked before may actually taste good to you now,” she says. “Trying to increase the variety of foods and expanding your palate can be really helpful.” Aim for smaller, more frequent meals that are high in protein and calorically dense (think a handful of nuts or peanut butter on crackers).
It’s not uncommon to feel guilty when you’ve entered remission for lung cancer. During your treatment, you likely met and befriended other people living with cancer—and you may feel strange about no longer being on that path with them. “Their treatment may not have had the same outcome, and you may have known people who have passed away,” says Wittert. “It’s common for people to have a type of survivor’s guilt.” If you find yourself struggling with these feelings, it can be helpful to work through them in therapy, Wittert says.
Neuropathy, or numbness or tingling in your hands and feet, is another symptom that people commonly report after lung cancer treatment, whether you’ve had chemotherapy or immunotherapy, Dr. Presley says. “Neuropathy can really affect your function,” she explains. “If it’s in your hands, it may be hard for you to button a shirt or open a jar.” Thankfully, there are medications that can help with some of the pain and numbness, but there’s not yet a treatment that can totally reverse it, Dr. Presley says.
If you had chemotherapy for your lung cancer, you may experience “chemo brain”—even after chemo is finished. “You tend to be more forgetful and your mind is fuzzy,” explains Wittert. “That can last for months or even years after treatment is over.” It’s important to be gentle with yourself during this time of recovery, she says. If you’re really struggling, see if your treatment center has a cognitive rehabilitation program available for survivors—this can help you retrain your brain and work through some of the fog, Wittert says. Exercise and meditation can help too, according to the American Cancer Society.
If you find yourself feeling angrier or sadder than usual after treatment is over, it may be a sign that you’re grieving, Wittert says. “A lot of people think grief is just death-related, but the definition of grief is actually just ‘a normal reaction to loss,’” explains Wittert. “In terms of recovering from lung cancer, it could be about loss of opportunity or identity.” A therapist can help you navigate that sense of loss about what your life may have been like had you not had cancer, which can be a cathartic experience, she says.
Fatigue is one of the most commonly reported symptoms in people who have completed lung cancer treatment or are in maintenance therapy, Dr. Presley says. The best treatment for this extreme tiredness? Exercise, she says. “It seems counterintuitive, but increasing physical activity actually boosts your immune system, your mood, and has the best evidence for treating cancer-related fatigue.” Taking a 20-minute walk a few times a week is a great place to start. (Sometimes signs of fatigue look similar to depression—if you’re having trouble feeling pleasure or hope reach out to your doctor.)
…Or Increased Energy
As your recovery moves forward, you will likely discover renewed pep in your step, says Dr. Presley. What’s more, over time, any depression you may have felt with your diagnosis may begin to lift, too—and that can also help feel more energized. The key to staying there? Making sure to stay physically active, Dr. Presley says. Moving your body creates your own source of internal power.
Fewer Uncomfortable Symptoms
Another major benefit to look forward to after lung cancer treatment is improvement in your cancer symptoms overall. For example, lung cancer-related symptoms like cough or shortness of breath may improve after treatment—along with overall pain levels. “People see a lot of improvement in pain as they either finish or continue on maintenance treatment,” Dr. Presley says.
Welcome to Survivorship
Being prepared as you enter this new phase of your cancer journey can help you manage the changes you’ll experience. “We think diet and nutrition, physical activity, and mental and emotional health are really the three underpinnings of survivorship care,” says Dr. Presley. So when in doubt, prioritize these key areas of your life—and keep in close contact with your health care team should any changes arise. That also means showing up for all your follow-up appointments with your doctors—most recommend every three months for the first few years after treatment, according to the American Cancer Society.
Lung Cancer Survival Rates: American Cancer Society. (2020). “Lung Cancer Survival Rates.” cancer.org/cancer/lung-cancer/detection-diagnosis-staging/survival-rates.html
Chemo Brain: The American Cancer Society. (2020). “Chemo Brain.” cancer.org/treatment/treatments-and-side-effects/physical-side-effects/changes-in-mood-or-thinking/chemo-brain.html
Fatigue: American Cancer Society. (2020). “Managing Fatigue or Weakness.” cancer.org/treatment/treatments-and-side-effects/physical-side-effects/fatigue/managing-cancer-related-fatigue.html
Lung Cancer Survivorship: American Cancer Society. (2020). “Living as a Lung Cancer Survivor.” cancer.org/cancer/lung-cancer/after-treatment/follow-up.html