Having cancer changes your life and the lives of those in your life. After the completion of treatment you may have questions about next steps to take. The information in this section is meant to help you cope and understand some of the issues that you may be currently facing after the completion of your cancer treatment.  Know that you are not alone, and please reach out to your doctor and care team if you have any concerns. 

Nutrition Guidelines After Treatment

If you were eating well and maintained your normal weight through treatment, you do not need a special diet. However, if you lost weight before you were diagnosed, if you lost a significant amount of weight during treatment, or if you are still experiencing any difficulty eating, you may need a special diet. If you do develop diet-related issues, talk to your managing physician or primary nurse. After your treatment is done, it’s time to get to a good, healthy weight. So let’s start by following a healthy diet.

What Is a Healthy Diet?

A healthy diet supplies all of the calories, protein, vitamins, minerals, and fluid you need to maintain a healthy weight, optimize bodily functions, restore natural immunity and optimize energy needs.

Water is the most important nutrient. Water makes up over half of our body weight, allows for the transport of nutrients to our cells, allows for the excretion of waste products from our bodies, and ensures the smooth function of all of our organ systems. The U.S dietary guidelines recommend that Americans drink between 64 ounces and 80 ounces of fluid each day. It may sound like a daunting task, but we can all achieve this by drinking four ounces of liquid for every hour that we are awake.

Then there is the question of fueling our bodies. Our body needs sugar for immediate energy needs and to keep our brain sharp.  However, we likely need far less sugar and carbohydrates than many Americans consume on a daily basis to maintain these important functions.  There is growing evidence that diets high in sugar and carbohydrates may lead to inflammation and chronic illnesses.  In selecting your carbohydrates, try to choose foods that provide natural sugars like fruits as opposed to cookies, cakes and candies. When selecting sugars, always think, “should I take an apple or a muffin?” The apple is always the right answer.  We can help you with understanding some good sugar selections throughout your treatments and survivorship.

Information about Vitamins and Choices

The structural parts of our bodies are based on protein. Some protein can be found in starches and vegetables, but more complete protein sources include animal products like meat, poultry, fish, eggs, nuts, milk, and milk products. You should try to eat at least six servings of protein per day. A serving size of meat, fish, or poultry is approximately 3-4 ounces depending on the source.  A serving of milk is one cup, and a serving of eggs is two large eggs.

Vitamins and minerals needed to repair, replace, and fuel our cells and are found in many different foods, but some are more abundant in certain types of food. In general, the foods that are unprocessed contain the most nutrients. Examples include fresh meat, chicken, fish, milk, vegetables, fruit and whole grains.

Iron, although added to most grain products, is not absorbed well from these foods and will probably need to be supplied by other foods in your diet.  Meat, fish, or poultry are the best sources of dietary iron.

Fresh, frozen, or dried fruits and vegetables offer plentiful levels of vitamins and minerals, while canned fruits and vegetables are less abundant sources of these nutrients because of the high temperatures used in the canning process. Adult goals for fruits and vegetables are at least three servings of vegetables per day and at least two servings of fruit per day. One half cup of most vegetables equals one serving. One cup of fruit equals one serving for most fruits.

Milk is such a good source of protein, sugar, vitamins, and minerals that it has its own food group. If you are able to drink milk or eat milk products, they are important nutrient sources in your diet. If you cannot drink milk or eat milk products, the dietitian can suggest other foods or supplements that supply these valuable nutrients.

The most concentrated form of calories in your diet comes from fat. Fats supply us with the fat-soluble vitamins A, D, E, and K and are essential in helping your body function, especially the repair of your nervous system. Be sure to eat healthy fats such as avocado, coconut oil, and/or butter from grass-fed cows (such as Kerry Gold). For cooking use grapeseed oil, which is stable at high heat (olive oil is not). Olive oil or Udo’s oil are great for salads.

As you transition to cancer survivorship, be sure to speak to your dietitian at your practice to help construct a healthful diet and lifestyle that will help you restore health and wellness. There is no single formula that fits everyone. There are resources in your practice as well as the community to help you restore wellness. 

Followups

Follow ups after cancer treatment are important to identify any changes or issues with your health. Follow ups involve regular medical checks to ensure the cancer hasn’t reoccurred, spread to other parts of the body or identify if another form of cancer developed. These visits also address the ongoing symptoms and effects after cancer treatment. Be sure to be honest with your doctor and express any concerns that you have. 

During each follow up visit, patients should tell their doctor about:

  • Any symptoms that may be an indication the cancer has returned
  • Any pain that is bothersome
  • Any physical problems that interfere with daily life 
  • Any medicine or supplements you are currently taking
  • Emotional difficulties including anxiety of depression
  • Changes in family history 

What is Survivorship?

 Survivorship is defined as the state or condition of being a cancer survivor. At this point in a cancer survivor’s life, they are now transitioning into a new way of life.

Living with cancer refers to the experience of receiving a cancer diagnosis and any treatment that may follow. During this time:

  • Patients will undergo treatment and may be asked to join a clinical trial to study new cancer therapies.
  • Patients and their caregivers may be offered services to help cope with emotional psychological and financial concerns.

Living through cancer is the period following treatment in which the risk of cancer recurring is relatively high. Many patients are relieved that treatment is over, but anxious about no longer seeing their cancer doctor on a regular basis. During this stage patients typically see their cancer doctor two to four times a year depending on their circumstances.

Living beyond cancer refers to post-treatment and long-term survivorship. While two out of three survivors say their lives have returned to normal, one-third report continuing physical, psychosocial or financial consequences. During this stage:

  • Most survivors return to the care of their primary physician
  • Ideally, survivors will have developed long-term health 

Your practice is committed to your survivorship and your specific needs. You may receive care documentation pertaining to:

  • Diagnostic tests and results
  • Tumor characteristics including site(s),stage, grade, hormone status, biomarker results
  • Details on treatment:
    • Type of treatment (surgery, chemotherapy, radiation, transplantation, hormone therapy, gene therapy or other)
    • Agents used (regimen, total dosage)
    • Beginning and ending dates
    • Indicators or response to treatment
    • Toxicities
  • Support services provided (psychological, nutritional, other)
  • Contact information for treating institutions and key individual providers
  • Name of key point of contact and coordinator of continuing care 

Palliative Care

Palliative care also known as supportive care is care that focuses on improving the quality of life by relieving symptoms from cancer. Palliative care is appropriate when a patient has advanced disease and symptom management is the highest priority in order to maintain or improve the quality of life. Any medical professional can provide palliative care by addressing the symptoms of cancer, but some specialize in care for specific illnesses. A palliative care team is multidisciplinary and consists of different medical professionals to provide the best care to you as the patient. Palliative care can be received in addition to cancer treatment. When a patient reaches a point in cancer treatment where it is no longer helpful to treat the cancer, then transition to palliative care can be made.

Hospice Care

When an individual’s cancer progresses and limits his or her life, a decision may made to forgo aggressive treatments. This is when a consideration is given to end of life care. Hospice is a philosophy of care to maximize comfort and quality of life. Hospice care is provided by teams consisting of both professionals and volunteers. The disciplines represented include medicine, nursing, social work and pastoral care. The physician overseeing care can be the individual’s oncologist or his or her primary care provider. The hospice medical director is a physician who coordinates between the patient’s designated doctor and the hospice team and can be called upon as a consultant to assist in management. Hospice care is most commonly provided at home, but also can be implemented when an individual is in a long-term care facility. Medicare and many private insurance companies have hospice benefits available to patients. 

Advanced Directives

An advanced directive is a document in which an individual indicates goals of care and distinct wishes to be executed when the terminal phase of life is inevitable. It is encouraged to prepare this document ahead of time. Such a document should be updated at regular intervals to reflect changes in treatment goals and personal aspirations as end of life approaches over time. If you do not have an advanced directive prepared, your palliative care teams can assist with the development of this important document.