Long-Term Health Concerns for Cancer Survivors

Posted on July 13, 2022 in Survivorship

Written by Smith, Courtney

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After finishing treatment, most cancer survivors desire a return to normalcy. Unfortunately, lingering side effects from cancer or aggressive cancer treatment modalities can make normalcy hard to achieve. These symptoms range from cognition problems to infertility. They may be temporary or they may persist for years. 

SERO’s radiation oncologists suggest that cancer survivors educate themselves on the side effects they may experience and how to effectively manage these side effects. They also emphasize the necessity of follow-up care, or regular medical checkups for the first two to three years after treatment. 

What Is Follow-Up Care?

Cancer care does not end once active treatment is finished. In most cases, a patient’s cancer care team will create a follow-up plan that calls for regular medical checkups every three to four months for the first two to three years after treatment. During these appointments, your doctor may order specific blood tests or imaging tests like CT scans and MRIs.   

Using these tools, doctors can monitor your recovery and help manage the lingering side effects of your cancer and cancer treatment. Your medical care team will also be checking for cancer recurrence and second cancers.

What Is Recurrent Cancer?

When cancer returns after treatment, it is called recurrent cancer. This happens when a small number of cancer cells survive treatment. Over time, the cells divide and grow into a cancerous lesion that can be detected. 

There are three types of recurrent cancer:

  • Local recurrence means the disease is in the same spot as the original cancer. 
  • Regional recurrence means the cancer has come back to the lymph nodes near the original cancer. 
  • Distant recurrence means the cancer has spread to tissues far away from the original cancer site. 

The probability that your cancer will return depends on many different factors such as your previous cancer type, stage, treatment, age, and individual health. Some cancers have a very high rate of recurrence. Glioblastoma (a common brain cancer), for instance, has a recurrence rate of nearly 100 percent1.  

What Are the Warning Signs of Cancer Recurrence?

The warning signs of cancer recurrence vary depending on the original cancer type. If a patient had breast cancer, for instance, they may notice a new lump in their breast tissue. However, some patients do not experience any symptoms. Or, in the case of regional or distant recurrence, they may experience nonspecific symptoms like weight loss and fatigue. 

If recurrence is suspected, your doctor will order diagnostic tests like a CT scan or biopsy. If recurrent cancer is detected, your cancer care team will stage the cancer and then create an appropriate cancer treatment plan. This plan may be similar to your original treatment plan or it may incorporate different treatment modalities. 

What Are Secondary Cancers?

A secondary cancer is a new cancer that is unrelated to the original cancer. For example, if a patient recovered from breast cancer but later developed colorectal cancer, that would be considered a second cancer. Certain cancer treatments including radiation or chemotherapy can increase a patient’s risk of developing a second cancer, sometimes referred to as a secondary malignancy or treatment-related cancer. 

Long-Term Side Effects of Cancer Treatment

Many people experience side effects during cancer treatment. Long-term side effects can develop months or years after treatment. Usually, these are uncommon and depend primarily on the location of the body receiving treatment as well as the dose of radiation. 

Common long-term and latent side effects of cancer treatment include:



The most common symptom experienced by cancer survivors is fatigue. One study4 even found that upwards of 99 percent of breast cancer survivors experience fatigue, in some cases for several years after treatment. 

Fatigue is characterized by a deep, chronic emotional and physical exhaustion; it is more than just being tired. 

Though fatigue after cancer treatment is not fully understood, scientists assume it is caused by chronic inflammation and autonomic dysfunction (trouble regulating body functions like blood pressure and heart rate). Fatigue may also be caused by pain, emotional distress, anemia, and sleep disturbances like restless leg syndrome. 

Tip: While it may seem counterintuitive, exercising is the best way to address fatigue experienced after cancer treatment.


Dental Problems

If you notice an uptick in cavities after cancer treatment, you are not alone. Chemotherapy and radiotherapy, especially to the head and neck, can change your saliva. Though saliva may seem inconsequential, it actually contains antimicrobial agents which kill disease-causing bacteria. Without enough saliva, many cancer survivors develop xerostomia (dry mouth) which causes tooth decay.

In addition to cavities, cancer survivors may experience other oral symptoms like:

  • Changes in taste
  • Mouth sores
  • Difficulty chewing and swallowing
  • Difficulty opening the mouth
  • Gum disease
  • Pain in the lining of the mouth and tongue

Tip: The bad bacteria in your mouth thrive on sugar. So, take a hard look at your diet and lower your sugar intake. Swap out soda for seltzer water, for instance. Or, instead of a slice of pie after dinner, try fresh berries with homemade whipped cream. 


Other Side Effects

Cancer treatment modalities like chemotherapy and radiotherapy can cause other long-term symptoms. These effects may occur within months of ending treatment or they may randomly appear years later. It is important to discuss these symptoms with your doctor. 

If you are a cancer survivor, you may experience:  

  • Hormonal changes, such as early menopause 
  • Anxiety and depression
  • Post-traumatic stress disorder
  • Incontinence
  • Infertility 
  • Lymphedema, or painful swelling 
  • Neuropathy, or nerve pain
  • Memory and cognition problems
  • Heart problems like congestive heart failure
  • Osteoporosis, or thinning of the bones
  • Sexual dysfunction, like erectile dysfunction or vaginal dryness

Which Cancer Treatments Cause Long-term Side Effects?

High-dose radiotherapy and chemotherapy are more likely to cause long-term side effects than less aggressive treatment modalities. However, all cancer treatments have the potential to cause lasting symptoms.   Your doctors can discuss the potential short-term and long-term side effects associated with your specific treatment and can provide estimates as to the risk of developing each.

Managing Long-Term Side Effects of Cancer Treatment

Though certain side effects of cancer treatment are unavoidable, maintaining a healthy lifestyle can lessen the severity of symptoms. Some healthy habits to adopt after completing cancer treatment include:



Adults should get at least two hours and 30 minutes of moderate-intensity aerobic activity each week. This might include brisk walking, swimming, or even mowing the lawn. 


Eat whole foods

Did you know that certain processed foods are classified as carcinogens7? To lessen the risk of developing a second cancer or other diseases, eat a primarily plant-based diet that is full of fruits, vegetables, and whole grains. 


Stop smoking

At least 70 chemicals in cigarettes are known to cause cancer. Of course, smoking also causes morbidities like chronic obstructive pulmonary disease (COPD) and heart disease.


Avoid alcohol

The CDC suggests adult males limit their consumption of alcoholic beverages to two per day or less and adult females to one per day or less. Consuming more than that may cause cancer, a weakened immune system, high blood pressure, and other problems9.  

What is healthy for one person may not exactly be healthy for another. Discuss needed lifestyle changes with your primary care provider or oncologist after completing cancer treatment. 

Is It Normal to Worry About Cancer Coming Back?

Yes. Many cancer survivors fear cancer recurrence. Some patients even develop post-traumatic stress disorder (PTSD), a psychiatric disorder characterized by anxiety and flashbacks. Counseling and prescription drugs can help you manage these symptoms.  

How Do I Know if My Cancer Has Returned?

Sometimes recurrent cancer causes general symptoms like fatigue and weight loss. But typically, cancer does not cause any symptoms until it has progressed or metastasized. That is why medical checkups and regular testing (e.g. CT scans, ultrasounds, blood tests) are so important.   

Learn More About Recurrent Cancer Risk With SERO

Many survivors are blindsided by the late side effects of their cancer and cancer treatment. That is why SERO’s radiation oncologists always discuss the potential risks associated with radiotherapy before beginning treatment. We also educate patients on lifestyle changes they can make to reduce the likelihood of recurrent or second cancers.