I have beaten cancer... now what?

The mere mention of the “c word” unleashes an avalanche of emotions in most individuals who receive this diagnosis.Among them fear,anger,denial,and a sense of urgency to repair relationships with loved ones in preparation for the afterlife.
Be that as it may,there is no shortage of cases where “cancer is beaten” and the patient emerges triumphant following a bruising battle with chemotherapy,surgery and radiation treatment.Cancer does not always have to invoke terror,as there are a number of curable cancers including testicular cancer, a certain type of nasopharyngeal cancer and lymphomas(Cancers arising from glands). To this effect,the notion that cancer is synonymous to an immediate death threat could not be further from the truth.
Once a patient has been “cured” there remains a need for regular follow-ups with your oncologist. This is aimed at picking up the first signs of a recurrence(where the cancer may rear its ugly head again after a period of remission),and addressing any long term toxicities that  could have arisen following the initial treatment.
Suffice to say that there are many long term toxicities, but i will focus this article on the commonest drugs in use for the aforementioned cancers and their commonest toxicities,which your oncologist would be on the look out for.
Infertility is an issue of concern considering that  most of the curable malignancies occur in younger people, of reproductive age. This would need to be discussed  with the patient before the treatment.However,in testicular cancer for example,infertility may not only be related to  the treatment,but to the underlying cancer itself.Options of sperm banking  or ovarian preservation  are usually discussed before the commencement of treatment..Although statistics differ depending on the treatment administered and the underlying cancer, the majority of patients would have recovered fertility at the five year mark.
Cardiac disease,hypertension and high cholesterol are also among the late toxicities of treatment especially in patients with testicular cancer and those with Hodgkins lymphoma,particularly those who underwent chest irradiation as part of their treatment. Hence,any shortness of breath,fatigue, and chest pain must be reported to your oncologist on follow up.The management and outcome of these are the same as in the general population.It is equally important on this background to avoid smoking,obesity and to maintain regular exercise,so as to lower your risk of cardiac disease.
Mild kidney insufficiency is common with  some cancer treatments,but fortunately has minimal clinical impact. Some treatments may cause a persistent tingling in the hands and feet that may not fully recover long after the treatment has been completed.

The treatment for malignancies like testicular cancer and lymphomas is usually intensive as the primary intent is cure.However the downside is that patients do run the risk of second malignancies later in life as compared to the general population.These range from leukaemias, to solid tumours like lung,breast and colon.Except for breast cancer,there are no set guidelines for screening,and follow up is left to the discretion of the treating oncologist.
Unexplained fatigue is also a common problem among cancer survivors. Some authorities suggest that there may be a degree of lingering depression. This may be suggested by a reluctance to partake in previously enjoyed activities,and an inclination to spend time in solitude.The prevalence and extent of  the depression is difficult to evaluate as depression as an entity  is difficult to quantify with any degree of reproducibility.
Patients tend to report increasing forgetfulness after completion of  chemotherapy. This has been commonly referred to as “chemo-brain”. Some of the drugs cross the lining of the brain-the Blood Brain Barrier- and this has been put forward as a possible contributory factor.
A lot of willpower, personal strength and perhaps for some, a reliance on a higher power, is required to fully claim one’s life back after cancer treatment and cure.Often,though patients are in remission one cant help but get the feeling that the cancer has not quite left their lives yet. The subtle fear that it might return,the assignment of even the mildest ache and pain to a possible recurrence can rob patients of the opportunity to celebrate their lives and resilience.I am not at all suggesting that cancer survivors must throw caution to the wind and ignore symptoms,but one ought to remember that  not all aches  signal  impending doom.Cancer can hang over one’s head like a dark cloud,and it’s important for patients to make a conscious decision to eliminate fear as the presiding factor in their lives.For as long as one is still gripped by fear and anxiety,victory over this dreaded disease cannot be truly declared.