Key points
- For many people, the end of treatment brings both relief and worry; getting back to everyday life takes time [3].
- Follow-up is usually every 3 to 4 months for the first 2 to 3 years, then once or twice a year; your exact plan depends on your type of cancer and treatment [1].
- More tests and scans are not always better; in a large study, more frequent scans did not help patients live longer [4].
- Some side effects of treatment, such as heart, bone, hearing or thyroid problems, may appear months or years later; ask which ones to watch for [2].
- Regular exercise, stopping smoking and drinking less alcohol help your health after treatment; in one study, an exercise programme lowered the risk of bowel cancer coming back [1, 11].
- Fear of the cancer coming back is very common and often eases over time; get help to manage it [12, 3].
Life after cancer treatment: why can it be hard?
Many people who have finished treatment say that although they were relieved when it ended, adjusting to their new life was hard [3]. You may still feel tired, your body may still be healing from side effects, you may feel nervous about seeing your doctor less often, or you may fear that the cancer will come back. Sometimes people around you think you should be back to your old self when you are not ready yet [3].
Many cancer survivors see the first few months as a time of change. It is not so much about "getting back to normal" as finding out what is normal for you now; give yourself time and take it one day at a time [3].
Check-ups after cancer treatment: how often?
Everyone who has had cancer needs follow-up care, which means regular check-ups after treatment ends. These visits may include an examination, blood tests or other tests to check both for the cancer coming back and for side effects of treatment and emotional problems [1].
Each person's follow-up plan is different and depends on the type of cancer, the treatment and your general health. In general, most people see their doctor every 3 to 4 months for the first 2 to 3 years, and once or twice a year after that [1]. See also what is cancer recurrence and how is it followed up?
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Get a follow-up plan and a treatment summary
At the end of treatment, ask your doctor for a written follow-up plan and a summary of your treatment: the date of diagnosis, the type and stage of cancer, the pathology report, the names and doses of your medicines, where and how much radiotherapy you had, any surgery, problems during treatment and the signs to watch for. Keep it somewhere safe; you may need it years later [1].
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Ask which doctor will do your follow-up
Your follow-up may be with the cancer specialist who treated you, a doctor who specialises in follow-up care for cancer survivors, or your own family doctor. Keep getting your routine health care from your family doctor, and ask your doctors to send their visit notes to each other [1].
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Ask these questions
You can ask your doctor these questions [1]:
- How long will it take for me to get better and feel more like myself?
- How often should I come back, and which doctor should I see?
- Which tests do I need after treatment, and how often?
- Which symptoms should I watch for?
- What long-term problems might my treatment cause?
- What is the chance that my cancer will come back?
- What can I do to stay as healthy as possible?
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Report any change
At each visit, mention any pain, symptom or worry that is new or will not go away; also tiredness, bladder, bowel or sexual problems, trouble concentrating or remembering, poor sleep, weight change, any new medicines or supplements, changes in your family's medical history and any emotional problems such as anxiety or depression. If a problem comes up between visits, do not wait for your next appointment; tell your doctor straight away [1].
Are more scans and tests after treatment better?
Many people think that the more scans and tests they have, the safer they are, but studies have not shown this. In a large study of more than 2,000 patients whose bowel cancer had been removed by surgery, the group who had CT scans and a tumour marker blood test 5 times in 3 years did not live longer than the group who had them only twice [4].
For women who have finished treatment for breast cancer and have no symptoms, the guideline of American cancer specialists recommends regular examinations and a yearly mammogram, but does not recommend routine blood tests, tumour markers, bone scans, CT scans, PET scans or MRI [5]. Each cancer has its own plan; have the tests your doctor considers necessary for your cancer. Read more about tumour markers and PET scans.
Long-term side effects of chemotherapy and other cancer treatments
Many side effects of treatment get better after it ends. But some side effects last, and others, called "late effects", may appear months or years later. These effects depend on the type and amount of treatment and differ a great deal from one person to another [2]. Ask your doctor which ones to watch for after the treatment you had; early care can prevent them or help manage them better [2].
| Organ or problem | Treatments that may cause it | What helps |
|---|---|---|
| Heart | Some chemotherapy medicines, such as doxorubicin, epirubicin and cyclophosphamide, the medicine trastuzumab and radiotherapy to the chest; sometimes years later [2] | A heart-healthy, low-salt diet, losing excess weight, exercise, stopping smoking and taking prescribed medicines [2] |
| Lungs | Chemotherapy and radiotherapy to the chest, especially when both were given [2] | Stopping smoking and vaping, exercise, losing excess weight; tell your doctor about shortness of breath or a dry cough [2] |
| Bones | Chemotherapy, steroid medicines, hormone therapy and radiotherapy [2] | Not smoking, foods rich in calcium and vitamin D, walking and weight-bearing exercise, less alcohol [2] |
| Hearing | Cisplatin, high-dose carboplatin and high-dose radiotherapy to the brain [2] | At least one hearing check after treatment; avoiding loud noise [2] |
| Thyroid and hormones | Radiotherapy to the head and neck (thyroid) and to the pelvis (ovaries or testes); may lead to early menopause or infertility [2] | Regular tests; an underactive thyroid is treated with thyroid hormone tablets [2] |
| Memory and concentration | Some chemotherapy medicines and radiotherapy to the brain [2] | Tell your doctor; they may refer you to a rehabilitation or speech therapist [2] |
| Mouth and teeth | Radiotherapy to the head and neck and some chemotherapy medicines: dry mouth and tooth decay [2] | Regular dental check-ups, drinking enough fluids, brushing and flossing every day [2] |
| Swollen arm or leg (lymphoedema) | Surgery to remove lymph nodes or radiotherapy to them; even years later [2] | Tell your doctor early about any new swelling [2] |
| Eyes | Chemotherapy, hormone therapy, immunotherapy and steroid medicines: cataracts [2] | Regular eye checks if you are at risk [2] |
Not everyone gets these effects; only some treatments and doses carry these risks [2].
Numbness and tingling in the hands and feet (neuropathy): this is common after some types of chemotherapy and eases over time, but in studies about 3 in 10 people still had it 6 months or more after chemotherapy [6]. See the guide numbness and tingling in the hands and feet.
For a swollen arm or leg, read the guide on lymphoedema, and for sex and having children, the guide on fertility and sex. If you had a stem cell transplant, see long-term effects after a transplant.
When will I feel normal after chemo? Tiredness after treatment
Recovery after treatment takes time and is different for everyone; you may still feel tired and not want to do too much [3]. Ask your doctor how long it will take for you to get better and feel more like yourself [1].
For tiredness after treatment has ended, exercise, cognitive behavioural therapy (a type of counselling that helps change thoughts and habits) and mindfulness programmes have helped in studies [7]. See the guides fatigue caused by cancer and its treatment and returning to work and daily life.
Does chemo weaken your immune system permanently?
Chemotherapy lowers the number of immune cells. These cells increase again after treatment ends, but some types can take many months to return to their earlier levels. In a study of women with breast cancer, all types of immune cells recovered to some extent after chemotherapy, but some of them were still lower than before 9 months after treatment ended, and the levels of antibodies from some vaccines, such as the tetanus vaccine, had also fallen [9].
Ask your doctor which vaccines you need and when you can have them [1].
Can chemo cause other cancers?
Cancer treatment can sometimes cause a new cancer years later; this is different from the first cancer coming back or spreading. These second cancers do not happen often, and when they do, they are not always caused by the treatment [2]. In a large study of more than 700,000 people who had chemotherapy for cancer, about 1,600 later developed a type of blood cancer; that is fewer than 3 in every 1,000 people. The risk of this blood cancer after chemotherapy was higher than in the general population, but it is still rare [10].
To find any new cancer early, have regular check-ups for the rest of your life, and tell your doctor about any change in your body that lasts more than a few weeks [2]. Do not forget your routine screening tests either [1]; see the guide cancer screening by age.
What helps you stay healthy and lower the risk of cancer coming back?
Regular exercise
Research suggests that staying active after cancer may lower the risk of it coming back and help you live longer. Moderate exercise, such as walking, cycling or swimming, for about 30 minutes every day or most days also reduces anxiety, depression and tiredness. Start slowly and talk with your doctor before you begin [1]. In a large study of patients who had finished chemotherapy for bowel cancer, a 3-year exercise programme with a coach lowered the risk of the cancer coming back, and more patients were alive [11]. Read more.
Stop smoking and other tobacco use
Smoking after treatment raises the chance of a new cancer in the same place or elsewhere in the body [1]. Smoking and other tobacco use also harm the heart, lungs and bones [2]. See how much does quitting smoking lower cancer risk?
Less alcohol
Drinking alcohol raises the risk of some cancers; cut down on how much you drink [1].
A balanced diet and a healthy weight
A healthy, balanced diet is important for your overall health; ask your doctor or a dietitian whether you have any special dietary needs [1]. Excess weight puts extra strain on the heart [2]. See foods that cause and fight cancer.
Screening and vaccines
Ask which cancer screening tests and which vaccines you need, and when [1].
Sunscreen
Always use sunscreen to lower your risk of skin cancer [1].
Depression and anxiety after cancer treatment ends; fear of the cancer coming back
After treatment you may feel both relief and worry; some people feel sad or even develop depression [3]. Probably the most common fear is that the cancer will come back [3]. In a review of studies with more than 9,000 people, more than half of cancer survivors had some fear of the cancer coming back, and about 1 in 5 had severe fear; this fear was more common in women and younger people [12]. Upcoming scans or tests can also make worry worse; some people call this "scanxiety" [3].
This fear is normal and often eases over time. These things help [3]:
- Tell your care team honestly about your worries; they can explain your own chance of the cancer coming back.
- Write down your symptoms and feelings in a notebook, and prepare your questions before each visit.
- While waiting for test results, spend time with friends and family or do something that keeps your mind busy.
- Try relaxation exercises, moderate exercise and talking with loved ones or support groups for cancer survivors.
- If the fear is more than you can handle, ask your doctor to refer you to a counsellor or psychologist.
See the guide anxiety, depression and fear of cancer coming back.
When should I contact my doctor?
After treatment has ended, tell your doctor soon about:
- Any pain, symptom or worry that is new or will not go away, and any change in your body that lasts more than a few weeks [1, 2].
- Shortness of breath, dizziness or swollen hands or feet, especially if you had medicines such as doxorubicin or trastuzumab or radiotherapy to the chest; these can be signs of a weak heart [2].
- A dry cough, wheezing, fever or shortness of breath after chemotherapy or radiotherapy to the chest [2].
- New swelling in an arm or leg on the side that was treated [2].
- Ringing in the ears or a change in your hearing [2].
- Diarrhoea with mucus that does not get better, or bleeding from the back passage, if you had radiotherapy to the abdomen or pelvis [2].
- Sadness, fear or distressing thoughts that have upset your peace of mind and daily life [2]. If you have thoughts of harming yourself, call your local emergency number straight away.
Chest pain, severe shortness of breath or loss of consciousness is an emergency; call your local emergency number. Remember that a new symptom does not necessarily mean the cancer has come back [1].
Frequently asked questions
What happens after the last chemo treatment?
Most side effects of treatment gradually get better after it ends [2]. From now on you will have follow-up visits, and it is a good idea to ask your doctor for a follow-up plan and a treatment summary [1]. Getting back to your usual routine takes time, and it is normal to have mixed feelings in the first months [3].
Does a new pain or symptom mean the cancer has come back?
Not necessarily. It is normal to worry about every ache after cancer, but many new symptoms are problems your doctor can easily treat. Tell your doctor about symptoms that are new or will not go away, so that the cause can be checked [1].
Does chemo shorten your life? What is life expectancy after cancer treatment?
Chemotherapy is given to cure or control cancer. Some treatments can cause late effects years later, such as heart problems or, rarely, another cancer [2, 10]; regular follow-up helps find and treat these problems early [2]. Your care team can tell you the chance of your type of cancer coming back [3]. See also how long do people with cancer live?
Do I need a PET scan or tumour marker test every year after treatment?
Usually not, unless your doctor thinks it is needed for your cancer. For example, after treatment for breast cancer, women without symptoms are advised to have regular examinations and a yearly mammogram, not routine scans or tumour markers [5]. In bowel cancer, more frequent scans also did not help patients live longer [4].
Should my follow-up be with the cancer specialist or my family doctor?
Either is possible. Your follow-up can be with the specialist who treated you, a doctor who specialises in follow-up care for cancer survivors, or your family doctor. Decide this with your care team, and keep getting your routine care from your family doctor [1].
Why do I feel sad after treatment when I should be happy?
Related pages
- What is cancer recurrence and how is it followed up?
- Anxiety, depression and fear of cancer coming back
- Fatigue caused by cancer and its treatment
- Can you exercise during cancer treatment?
- Returning to work and daily life
- Just diagnosed with cancer: what to do in the first weeks
- Cancer screening by age: which tests do you need?
Survivorship follow-up and late effects (for doctors)
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- Follow-up intervals (NCI): in general every 3–4 months for the first 2–3 years, then once or twice a year; give the patient a written follow-up plan and treatment summary (pathology, names and doses of drugs, sites and total amounts of radiotherapy, complications and signs to monitor) [1].
- Intensity of colorectal cancer follow-up (COLOFOL): 2509 patients with stage II or III disease after surgery; CT of the thorax and abdomen plus CEA at 6, 12, 18, 24 and 36 months vs at 12 and 36 months. 5-year overall mortality 13.0% vs 14.1% (risk difference 1.1%; 95% CI −1.6 to 3.8; P=0.43), cancer-specific mortality 10.6% vs 11.4% (P=0.52) and recurrence 21.6% vs 19.4% (P=0.15) [4].
- Breast cancer (ASCO 2013): history and physical examination every 3–6 months for the first 3 years, every 6–12 months in years 4 and 5, then annually; after breast-conserving surgery, a mammogram 1 year after the initial mammogram and at least 6 months after completing radiotherapy, then yearly. CBC, chemistry panels, bone scans, chest radiographs, liver and pelvic ultrasound, CT, FDG-PET, MRI and tumour markers (CEA, CA 15-3, CA 27.29) are not recommended for routine follow-up of an asymptomatic patient [5].
- Neuropathy (CIPN): meta-analysis of 31 studies (4179 patients): prevalence 68.1% (57.7–78.4) in the first month after chemotherapy, 60.0% (36.4–81.6) at 3 months and 30.0% (6.4–53.5) at 6 months or more; risk factors: baseline neuropathy, smoking, abnormal creatinine clearance [6].
- Fatigue (ASCO–SIO 2024, 113 RCTs): after completion of treatment, exercise, CBT and mindfulness-based programmes are recommended (CBT and mindfulness particularly for moderate to severe fatigue); yoga, acupressure and moxibustion may also be recommended. L-carnitine, antidepressants and wakefulness agents are not recommended, and psychostimulants are not routinely recommended [7].
- Heart (ASCO 2017): high clinical suspicion and a low threshold for cardiac evaluation in any survivor who received potentially cardiotoxic therapy; in higher-risk survivors, routine surveillance with cardiac imaging after completion of therapy may be warranted [8]. Details: cardiac monitoring during cancer treatment.
- Immune reconstitution: in 88 patients with breast cancer, B, T and NK cells were significantly reduced 2 weeks after chemotherapy (B cells to 5.4% of pre-treatment levels); B and CD4+ T cells remained depleted 9 months after chemotherapy (P<0.001), and anti-pneumococcal and anti-tetanus antibody titres fell and did not recover during the study [9]. Vaccination: infection prophylaxis and vaccination.
- Therapy-related MDS/AML: SEER, 700,612 adults given initial chemotherapy for a first solid cancer (2000–2013) who survived at least 1 year; 1619 cases. Risk after chemotherapy was raised for 22 of 23 solid cancers (all except colon); relative risks 1.5 to more than 10 and excess absolute risks 1.4 to more than 15 cases per 10,000 person-years; median survival after diagnosis 7 months [10].
- Exercise (CHALLENGE): 889 patients with resected colon cancer after adjuvant chemotherapy; 3-year structured exercise programme vs health education; median follow-up 7.9 years: disease-free survival HR 0.72 (0.55–0.94; P=0.02), 5-year disease-free survival 80.3% vs 73.9%; overall survival HR 0.63 (0.43–0.94), 8-year survival 90.3% vs 83.2%; musculoskeletal adverse events 18.5% vs 11.5% [11].
- Fear of recurrence: individual participant data meta-analysis of 46 studies (9311 respondents), FCRI-SF: score of 13 or more in 58.8%, 16 or more in 45.1% and 22 or more in 19.2%; lower with increasing age and higher in women, across all cancer types and all times since diagnosis [12].
Scientific evidence
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Scientific evidence
4 itemsStructured Exercise after Adjuvant Chemotherapy for Colon Cancer
American Cancer Society nutrition and physical activity guideline for cancer survivors
Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable
Management of Anxiety and Depression in Adult Survivors of Cancer: ASCO Guideline Update
References
12 referencesShow all references, 5 with a study cardClose the reference list
Numbers in the text, such as [1], refer to these sources. Sources with a “Study card” button are summarised in the site’s evidence library.
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- 6Incidence, prevalence, and predictors of chemotherapy-induced peripheral neuropathy: A systematic review and meta-analysis
- 7Management of Fatigue in Adult Survivors of Cancer: ASCO-Society for Integrative Oncology Guideline Update
- 8Prevention and Monitoring of Cardiac Dysfunction in Survivors of Adult Cancers: American Society of Clinical Oncology Clinical Practice Guideline
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This page is based on reputable scientific sources and was last updated on 28 October 2026. The content of this website is for educational and informational purposes only and does not replace consultation, diagnosis or treatment by a specialist physician. Consult your treating physician about any treatment decision.
Printed from the website; the full and up-to-date version: https://drdabiri.com/en/guides/after-cancer-treatment/