Long-Term Physical Effects

Even after cancer treatment ends, it’s common for cancer survivors to continue feeling the physical effects. And the physical changes may not occur for months or years after being treated with surgery, chemotherapy, immunotherapy, radiation therapy or hormone therapy.

Long-term physical effects that cancer survivors can experience include fatigue, mental health changes, cognitive changes (or “chemo-brain”), sexual dysfunction and infertility, lymphedema, neuropathy and chronic pain.

Lymphedema

When lymph nodes are surgically removed or treated with radiation, it increases the risk of lymphedema – a fluid buildup that causes swelling. Signs of lymphedema include clothing feeling tighter, heaviness or fullness in the arms or legs, and pitting (or indentations that remain when swollen skin is pressed).

Lymphedema can develop within the first two years of cancer treatment – but it also occurs much later after surgery and radiation.

Mercy offers specialized lymphedema physical therapy as well as prevention tips. 

Tips for Preventing Lymphedema

To help reduce your risk of developing lymphedema, try to:

  • Avoid hot showers, hot tubs and saunas
  • Avoid insect bites, pet bites, scratches, skin punctures and cuts
  • Avoid needle sticks, such as vaccinations and blood draws
  • Avoid trauma, such as lifting heavy objects
  • Avoid anything constrictive, such as tight clothing and blood pressure cuffs
  • Maintain a healthy weight
  • Limit salt intake and fatty foods
  • Wear long sleeves in the sun
  • Wear a compression garment during air travel
  • Exercise by walking and swimming

Post-Mastectomy Pain Syndrome (PMPS)

PMPS occurs in about 30% of women after breast cancer surgery. It’s described as a “nerve-like” (neuropathic) pain involving the chest wall, underarm or arm that doesn’t go away over time. Other symptoms can include numbness, tingling, a shooting or pricking pain, burning or an itching sensation.

PMPS can lead to decreased range of motion in the arms and shoulders. It’s more likely to develop in women who’ve had lymph nodes removed from their underarms or were treated with radiation after mastectomy. The ongoing pain and symptoms caused by PMPS can impact women’s quality of life.

Several options are available for treating PMPS, including physical and occupational therapy. Talk with your Mercy provider about ways to manage pain and improve mobility.

Chemo-Brain

Cancer-related cognitive impairment (called “chemo brain”) is a complex and often distressing symptom that might not appear until treatment is completed. Common signs include a decline in memory, difficulty concentrating and problems with multitasking. Chemo brain can make returning to work more difficult and may affect interpersonal relationships.

Approximately 50% of patients who report cognitive changes during chemotherapy demonstrate improvement within the first year to 18 months after completion of treatment. 

Tips for Managing Chemo-Brain

Talk with your Mercy provider about your symptoms to find out if chemo brain is causing them. If you’re experiencing chemo brain, tell others what’s happening, such as family, friends or your supervisor at work. They can provide support and may even have helpful suggestions.

Other ways to manage chemo brain include:

  • Stay active and get regular exercise; physical activity is the most effective way to improve cognition and focus
  • Eat a well-balanced diet full of fruits and vegetables
  • Get plenty of sleep each night
  • Avoid alcohol, which can make cognitive symptoms worse
  • Stay organized by keeping day planners, writing sticky notes, or putting reminder alerts on your phone
  • Engage in mentally stimulating activities, such as reading, crossword puzzles and word searches
  • Take up a new hobby or master a new skill, such as painting, crafting, learning a new language or playing a musical instrument
  • Practice stress-relief techniques, such as meditation, spiritual reflection, guided imagery or massage

Peripheral Neuropathy

Chemotherapy can affect the nervous system, resulting in a condition called peripheral neuropathy. This nerve disorder is caused by damage to nerves in the hands, feet, legs or arms.

Signs of peripheral neuropathy include numbness, tingling, pain and muscle weakness in the limbs, hands or feet. Let your Mercy doctor know right away if you’re experiencing these symptoms. When recognized and treated early, peripheral neuropathy may be reversible. 

Tips for Peripheral Neuropathy Self-Care

If you’re experiencing peripheral neuropathy, you’ll want to:

  • Turn down hot water heaters in your home to avoid scalding areas of your body with nerve damage
  • Avoid cooking with hot temperatures to prevent burns
  • Wear protective footwear like house slippers to prevent injuries to your feet
  • Ask your Mercy provider about pain management strategies that are right for you
  • Discuss alternative therapies like acupuncture and massage with your provider
  • If you have diabetes, work with your Mercy endocrinologist and dietitian to control your blood sugar
  • Ask your provider about physical therapy services to build strength and improve balance, which helps prevent falls
  • Get additional help from a neurologist or other specialist, as recommended by your Mercy doctor

Physical Fatigue

Fatigue is one of the most common side effects experienced by cancer patients and survivors. Fatigue can impact their physical, psychological and social functioning.

While there are no medications specifically to treat fatigue, lifestyle changes like healthy eating and physical activity can improve it. It’s also important to talk about fatigue with your Mercy provider. Your doctor can determine whether it’s caused by other correctable conditions, such as insomnia, anxiety, stress, depression, thyroid disease, anemia or nutritional deficiencies. 

Tips for Managing Fatigue

To improve symptoms of fatigue, try to:

  • Exercise regularly to build your stamina
  • Stick to a routine; go to bed and get up at the same time each day
  • Fall asleep in a quiet, dark environment, free of noise and light; take a warm bath or shower before bedtime, or try relaxation techniques like meditation
  • Eat a healthy diet full of fresh fruits, vegetables and lean protein. Limit processed foods and carbohydrates
  • Explore integrative therapies like acupuncture, massage, yoga, healing touch and others
  • Keep a diary of how you feel each day. Plan activities during the times you have the most energy
  • Ask for help. Delegate tasks and accept offers of help and goodwill from family and friends
  • The YMCA’s Livestrong program helps cancer survivors adopt an exercise plan and other healthy lifestyle behaviors to improve energy levels

Osteoporosis & Bone Health

Many cancer treatments can lead to a loss of bone density. Osteoporosis is a health condition in which a person’s bones become less dense and more likely to fracture. Osteoporosis can be prevented and treated, but if left undetected it can cause progressive bone loss and serious injury.

Tips for Preventing & Managing Osteoporosis

Take these steps to prevent bone loss and manage osteoporosis symptoms:

  • Eat a well-balanced diet rich in calcium, including low-fat dairy products and dark green leafy vegetables
  • Ask your Mercy provider if vitamin D supplements are right for you and how much you should take
  • Talk with your doctor about exercise that’s safe for you; weight-bearing exercise can help prevent osteoporosis, so try walking, dancing or lifting weights
  • Avoid smoking and tobacco products
  • Get a bone density test to detect osteoporosis before fractures occur and to determine whether you need preventive medication
  • Reduce the risk of falls and fractures by building strength through regular exercise, using a cane or walker for balance, removing area rugs and clutter from floors, and using support handles in bathrooms

Menopausal Symptoms

Women who’ve undergone treatment for any type of cancer can experience menopausal symptoms. Cancer treatment can cause irregularity in a premenopausal women’s menstrual cycles, resulting in symptoms such as hot flashes, vaginal dryness, weight changes and irritability. These changes may be temporary, but sometimes they remain longer after treatment. And women treated for breast and gynecological cancers are particularly susceptible to menopausal symptoms.

Talk with your Mercy provider if you experience menopausal symptoms after cancer treatment. Your provider will discuss options based on your symptoms.

Insomnia or Sleep Disturbances

Insomnia is common in cancer survivors and people undergoing cancer treatment. If you’re having trouble falling or staying asleep, talk with your Mercy doctor. Medication options are available to help treat moderate-to-severe cases of insomnia. 

Tips for Improving Sleep

To help improve the quality of your sleep, try to:

  • Avoid watching television or using electronic devices in your bedroom
  • Keep your bedroom free from light and noise
  • Avoid drinking alcohol, especially before bedtime
  • Limit your daily caffeine intake
  • Avoid eating heavy meals or sugary snacks close to bedtime
  • Don’t exercise within three hours of your bedtime; exercise during the day to avoid disrupting sleep patterns
  • Go to bed and get up at the same time each day
  • Limit daytime naps
  • Incorporate relaxation strategies like meditation, breathing exercises, guided imagery, and gentle yoga or stretching

Keep in mind that post-treatment symptoms are common among cancer survivors, and many are treatable. It’s always best to ask your Mercy provider for assistance in minimizing and managing your symptoms. 

Mercy also offers other resources and programs to support cancer survivors in body, mind and spirit.

For more survivorship information, visit the LIVESTRONG Foundation, the American Cancer Society and the National Cancer Institute.

Survivorship Resources