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Thousands of Americans are living disease-free after cancer treatment. But not all cancer survivors live without side effects from the treatment. Treatments for cancer can include surgery, chemotherapy and radiation. Side effects include fatigue, pain or nerve damage, lymphedema and fear of reoccurrence.

A general rule for cancer patients, family and friends tAo keep in mind is it will take as long as the total duration of treatment to get back to feeling really well. This means that if your last treatment is 12 months after your diagnosis, you can expect it to take another 12 months to get back to normal.

Fatigue is a constant battle during and after treatment. This will eventually pass, but you may need to make adjustments, such as going to bed earlier, lying down when you need a rest and scheduling tasks in the morning if you're more energetic then.

Pain can be a result of surgery, radiation or peripheral neuropathy (chemotherapy damage to the nerve endings of the fingers and toes). You can take medications to alleviate the symptoms, but some patients need further treatment. Discuss the available options with your doctor.

Lymphedema is mainly a side effect of surgery. During cancer surgery, surgeons remove lymph nodes associated with the tumor to check for spread of the disease. Our lymphatic system contains fluid that carries cells throughout the body to help fight infections and other diseases. The interrupted lymphatic system may cause the lymph fluid to pool in the arm, leg or trunk.

If you have lymphedema, wear gAloves or shoes, apply antibiotic ointment and cover any wounds you may have, and visit with a physical therapist about massage therapy and an exercise program. To help prevent lymphedema (or to help alleviate the swelling) you can wear a compression sleeve or stocking. Also try elevating your arm or leg. Be alert for signs of infection - redness, swelling, tenderness and fever - and notify your health care provider immediately to see if you need a course of antibiotics.

Cancer survivors often live with the fear of reoccurrence for the rest of their life. They run to their health care provider for every ache, sure the cancer has returned. This is normal and will diminish over time. Write down any questions, problems and fears to discuss with your health care provider at your regular visits.

For many cancer survivors, however, the side effects are positive. Living with cancer can drastically change lives and may lead to changes in priorities and goals.

For some, spending more time with friends and family takes on a special meaning. Setting goals, no matter how small, may help people living with cancer to feel more in control of their future and provide meaning to their lives.

New personal goals may include eating better, exercising more, quitting smoking and reducing stress. Other goals may focus on relationship, spiritual, social, financial or professional issues.

According to the American Society of Clinical Oncology, some people find that "giving something back" as a volunteer provides a rewarding experience. Some goals may be to talk more openly with family and friends about cancer, to ask an employer or supervisor for a more flexible schedule at work to better accommodate medical appointments or to volunteer to help other people with cancer. Select personal goals that will build confidence and provide satisfaction.

Cancer survivors need to discover a "new normal." Have patience with someone who has been through cancer, and be patient with yourself if you have been through cancer. Time will indeed heal.

Char Houska is a registered nurse and breast care coordinator at St. Patrick Hospital and Health Sciences Center, and a 10-year survivor of cervical cancer. Questions for our clinicians? Please send them to info@saintpatrick.org.

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