DEAR MAYO CLINIC: I'm finishing up treatment for lymphoma. I'm wondering what my life will be like after cancer. I don't know what the next steps will be. Can you help?
ANSWER: Finishing lymphoma cancer treatment is a major milestone, but the transition into survivorship can be challenging. During treatment, you have a routine. You may have chemotherapy every few weeks, meet with your care team and repeat that process over and over. Then, hopefully, you get the good news that you're in remission, and your scan looks great. Suddenly, that routine ends.
One of the most important things you can do is have a clear conversation with your care team about what happens next. Ask whether you'll need scans, how often you'll have follow-up visits and laboratory tests, and what symptoms you should watch for. Most lymphoma patients don't require ongoing scans, but regular follow-up visits, lab studies and physical exams may be part of your next steps.
Also, talk about how your cancer care will be coordinated with your primary care physician. Who will handle routine cancer screenings, such as mammograms or colonoscopies? How often should you see your primary care physician? Your care team can help you understand what follow-up makes sense for you.
How long does recovery from lymphoma treatment take?
Your recovery will depend in part on the type of lymphoma you've had and the treatment you received. There are more than 60 subtypes of lymphoma, and each behaves differently. Some are slow-growing lymphomas that can be treated and put into remission but are expected to return at some point. Others are aggressive diseases that may be curable with aggressive treatment.
For people who have been through intensive chemotherapy, a big part of recovery is regaining physical strength. There's also the mental and emotional aspect of processing the cancer experience, which often doesn't start happening until after treatment is over.
Fatigue is common, and it can take time to regain your energy. I tell people to think of their energy like a bank account. Maybe right now you have $100 worth of energy to spend each day. Over time, you may build that up to $150 or $200. But early on, you need to budget it. For example, if you have a big family event that may take most of your energy that day, rest beforehand and recover afterward.
Can exercise help after lymphoma treatment?
Physical activity should be part of that energy budget because it's been shown to improve quality of life and fatigue. Also, studies have found that being more physically active during survivorship is associated with a lower risk of lymphoma relapse. Physical activity comes in many different forms and should be something that you enjoy. An activity such as walking regularly and gradually working your way up can pay off in the long term.
Mind-body activities such as yoga also can help improve quality of life and fatigue. Choose the activity that suits you best, and you're more likely to stick with it.
Another common concern after treatment is peripheral neuropathy, which is the numbness and tingling in the fingers and toes caused by some chemotherapy drugs. It can be bothersome, but the majority of patients find it improves over time. Unfortunately, there isn't a magic pill to make it disappear faster, so recovery can require patience.
How can I cope with fear of lymphoma returning?
For many survivors, the No. 1 concern is the possibility that lymphoma will return. It's important to find a balance between appropriately watching for symptoms and learning to live comfortably with uncertainty. Talking about those feelings can help, whether that's with family and friends or with someone who has been through a similar experience. If anxiety or depression becomes overwhelming, don't hesitate to seek help from a mental health professional.
It also helps to recognize that life may not go back to exactly the way it was before lymphoma. You've been through a major life experience. I encourage people to find and embrace their "new normal" and to be patient and kind with themselves during early survivorship.
Finding your new normal after lymphoma
That new normal doesn't have to be about what you've lost. People can experience what's called post-traumatic growth — positive changes that can occur after lymphoma or another traumatic event. People may find that relationships become stronger, reconsider what matters most to them, make career changes, or prioritize their physical, mental, emotional and spiritual health differently.
Your cancer happened. But ask yourself: What helped me through this? What didn’t? What do I want for myself and my health moving forward?
Survivorship can be physically and emotionally challenging, but it also can be a beautiful time, an opportunity to celebrate the successes of treatment, embrace your new normal and make changes that help you live the best life you can. Join the conversation in the Mayo Clinic Connect Blood Cancers & Disorders Support Group.
Carrie Thompson, M.D., Hematology, Mayo Clinic Comprehensive Cancer Center, Rochester, Minnesota