When am I considered a survivor?
You are considered a survivor as soon as you're diagnosed with cancer. At Nebraska Medicine, you may be referred for a survivorship appointment after you have completed cancer treatment.
What does survivorship mean?
Survivorship begins at diagnosis, and is the process of living with, through and beyond cancer. After you've completed your cancer treatment, your oncology team may refer you to our Survivorship Program. (You can also self refer whenever you're ready.) When you become a Survivorship patient, we’ll work together to create a summary of all the treatments you’ve had. We’ll also review the potential late and long-term effects that you may be experiencing now, or in the future. All of this information will be packaged together for you and shared with your doctors, including your regular primary care provider.
What do “long-term” and “late” effects mean?
Long-term effects can start during cancer treatment and last after cancer treatment is over. Numbness and tingling in fingers and toes due to chemotherapy treatments, for example.
Late effects of cancer treatment can start months to years after treatment is over. You may have a higher risk of developing heart disease or osteoporosis. However, these issues may not present themselves for years after you've finished cancer treatment, but may still be related to your cancer treatment.
Will I need follow-up tests?
Whether or not you need lab work or imaging after your treatment will be determined by your oncologist and the National Comprehensive Cancer Network (NCCN) guidelines. We are a member of NCCN, a non-profit alliance of 25 of the world’s leading cancer centers devoted to patient care, research and education. We may recommend additional screenings based on the type of cancer treatment you received, like a bone density scan, to check for osteoporosis.
What’s included in a Survivorship Care Plan?
A treatment summary, follow-up recommendations and discussion of late and long-term effects.
I’m afraid or anxious about follow-up tests. How can I manage these feelings?
We encourage you to discuss your feelings with your health care provider(s), and may possibly refer you to an oncology psychologist. Oncology psychologists can help you manage stress and anxiety associated with follow-up tests.
How can I improve my health following cancer treatment? Or avoid long-term effects like cardiovascular issues?
First and foremost, if you’re a smoker, please quit smoking. We have a smoking cessation clinic to help you kick the habit, and are happy to provide referrals.
The second best thing a patient can do: Get to and maintain a healthy weight. Part of our program involves outlining the nutrition guidelines you should follow. These guidelines are recommended by the American Cancer Society. We’ll also give you physical activity recommendations, and we always have dieticians available. Nebraska Medicine also offers a comprehensive weight loss program if you’re interested.
Lastly, always protect yourself from the sun. Our dermatologists recommend a full body skin exam at least once a year for those who have a history of cancer. We also recommend a sunscreen with broad spectrum SPF of 50 or more. It’s important to double check your bottle to make sure it says broad spectrum.
Will my cancer come back?
A lot of patients experience fear of cancer recurrence. We encourage you to discuss this with your oncologist and the survivorship advanced practice provider you’re working with in our program. Referral to our oncology psychologists can help.
Am at risk for developing a new type of cancer?
Yes, unfortunately your risk is higher than the general population. As a cancer survivor, you are at risk of developing a completely new and different type of cancer due to the treatments you’ve had. It’s really important for you to stay on top of all your cancer screenings. Be diligent about things like colonoscopies, gynecologic exams, prostate exams, mammograms and skin cancer exams.
Will be more difficult to get health insurance now that I’m a cancer survivor?
It shouldn’t be, because the Affordable Care Act prevents insurance companies from disqualifying people for having pre-existing conditions. However, it may be more difficult to get life insurance. If you find yourself struggling with this topic, cancerandcareers.org is a great resource to help you navigate practical issues like getting health insurance, or looking for a job. They put together this handy Guide to Insurance for cancer patients and survivors.
We also always have financial counselors and social workers available to advise you with specific situations if you are struggling.
I’m having workplace issues due to my cancer history. What can I do?
Our financial counselors and social workers can help, but cancerandcareers.org also has an amazing section full of helpful resources for this very purpose.
Will I still be able to have kids? How can I protect my fertility?
It’s important that you’re open with your oncology team about your risks for infertility. There are fertility preservation options available. For women that usually means harvesting eggs, fertilizing them and freezing them to be used at a later date. For men, it involves freezing sperm samples for future use.
You can also request a referral to a reproductive endocrinologist.