What to expect after chemotherapy and immunotherapy
What to expect after chemotherapy and immunotherapy
Chemotherapy
After finishing chemotherapy, it can take time for your body to recover. Your immune system will still be vulnerable for the first few weeks and therefore it is still important to be diligent about checking for and avoidance of infections. It may take a number of weeks for some of the side effects of chemotherapy, such as fatigue and change in appetite, to disappear. This usually improves with time but may not be quick.
For some chemotherapy drugs, there can be longer-term side effects that may not completely resolve, such as tingling or numbness in the fingers and toes (called peripheral neuropathy). These are important side effects to discuss with your doctor or nurse. Some chemotherapy drugs can affect your fertility (which your doctor will have discussed with you before commencing treatment) and can also affect your libido. Loss of libido can persist after chemotherapy has finished and it may be helpful to discuss any concerns with your partner and your cancer team.
Most people will require fewer reviews with their cancer specialist after finishing their chemotherapy. The frequency of reviews will depend on the stage and type of lung cancer that you have. As the time between reviews is longer, it is important to notify your cancer team if new symptoms arise between reviews, such as pain or a new cough or new or worsening shortness of breath, as your team may need to see you sooner.
Immunotherapy
Similar to chemotherapy, your body may need time to recover from immunotherapy. Some immunotherapy side effects can be permanent, such as low thyroid levels, and you may need to continue to see your doctor about these side effects longer term.
Some people can develop new side effects from immunotherapy weeks to months after the completion of their immunotherapy treatment. If you experience one of these “delayed” onset side effects, it is important to immediately notify your doctor and nurse as you may need medications to lower the activity of the immune system.
Important new symptoms to watch out for and report include (but are not limited to):
- new and persisting shortness of breath and/or cough
- diarrhoea
- pain in chest or abdomen
- memory or personality changes
- changes in vision
- palpitations of the heart
- skin changes
If you develop a new symptom and are not sure if it is something to be concerned about, it is useful to check in with your nurse or doctor.
After lung cancer treatment
After completion of cancer treatment, some people can feel sad or uncertain or isolated as the time between reviews with your medical team lengthens. Some people experience worsening of their mental health and well-being and experience fear regarding the recurrence of the cancer. It is important to recognise that this is common, and address this if it happens to you.
The ability to return to work, hobbies and day-to-day activities will vary from person to person. It is important to work within your own limits in order to safely return to these activities, and graded exercise and return to work may help to make this transition easier.
October 2022
Dr Wanda Cui has received honoraria from AstraZeneca, Pfizer, Eisai, Merck and Janssen.