Living as a Lung Cancer Survivor

Being able to say you survived lung cancer is a major milestone. Because cancer treatment has advanced so dramatically over the past 20-30 years, there’s a lot of hope for lung cancer survivors today. Many are able to live for many years after their cancer is considered in remission. 

There are some important things you can do in your day to day life that can help with a healthier lifestyle and catching any cancer that may return as soon as possible. 

Don’t Skip Follow Up Care with Your Lung Cancer Specialist

While it’s easy to think you feel fine and everything is normal, it’s critical that you keep the follow-up appointments with your cancer specialist. These will be every few months shortly after you’ve gone into remission. As time goes, and based on your health, follow up appointments may be spread further apart.

What to Expect at an Oncology Follow-Up Appointment

These occasional appointments are a good time for cancer survivors to ask questions. There is a lot of information out there for cancer survivors, but your oncologist is familiar with your specific case and how the treatments you received might be affecting you after everything is completed.  

Also, talk about anything that seems abnormal. Symptoms and changes you experience may or may not be related to cancer coming back. They could be signs of another health condition that you’ll want to catch early, or they could be related lung cancer. Note that new side effects from cancer treatment can appears weeks, months or even years after treatment is complete. 

Testing

Your oncologist will order testing to be done, typically a few days before your follow-up appointment. These may include:

• 0-2 Years after remission – Chest CT every 6 months, but could be every 3 months.
• After 2 years – Low dose CT once a year, sometimes twice
• Ongoing blood work can help watch for tumor markers that could indicate that cancer cells are starting to grow again

There are other tests your oncologist might consider ordering once they’ve had a chance to talk with you. There can be longer-term side effects of cancer treatments they may want to assess. For example, a percentage of lung cancer survivors may develop chemo-related hearing loss down the road. Getting a hearing test every so many years, may be added to the list of things to watch for.

Oncologists will less commonly recommend PET scans and MRIs, as a routine follow up. However, if your tumor markers have increased, they may request these types of imaging tests. 

Follow-up testing can produce significant “scanxiety”, as many cancer survivors call it.  As the appointment nears, this feeling of fear about what the oncologist may find typically gets stronger.  Of course, any kind of anxiety is bad for your health.  So it’s important that as a lung cancer survivor, you develop stress-management skills and gain access to resources you need to manage that extra anxiety-inducing event in your life effectively.

Keep Medical Records Organized for Future Primary Care Physicians

During and after lung cancer treatment, you’ll want to keep track of everything related to your care. Many people keep a binder or folder that they take to visits. You could also keep this electronically. But be sure to appropriately and securely back it up. 

Even after 5 years, it’s critical that you keep all of this in a safe place. If, for some reason, you had to switch oncologists, you’ll want your new team to be aware of past tests you had and what previous scans looked like for comparison. This can help you avoid costly extra testing and lost time when time is of the essence.

Ultimately, it’s your choice how closely you follow your plan. And there are no guarantees when it comes to cancer. But you do have the power as a lung cancer survivor to significantly reduce the chances of cancer coming back or progressing when you follow your oncologist’s future care plan.

Take Action to Reduce Your Risk of Cancer Returning

There are some lifestyle changes you can put in place to help lower the risk of lung cancer returning. 

• Quit smoking. We can’t emphasize this enough. Stop smoking if you have not stopped yet. Do it now. Talk to your doctor if you need help. As many as 60% of lung cancer survivors resume smoking after treatment with devastating results. Continuing to smoke during treatment, significantly decreases the effectiveness of treatment. And smoking after treatment significantly increases the chances of lung cancer coming back. There is no getting around this. There are effective medications, behavioral therapy, temporary substitutes, and other treatments, which may be covered under insurance.  This is a critical piece to help avoid recurrence or second cancer. If you don’t stop smoking, you are 200% more likely to have a recurrence.
• Reduce or eliminate exposure to secondhand smoke
• Eat a balanced diet. This is good for many aspects of your health! 
• Be sure you have your home tested for radon and fix any cracks in the foundation to keep this odorless gas out of your home as much as possible. 

Researchers have also found that people taking beta carotene (Vitamin A) supplements as a smoker are at increased risk of developing lung cancer. But so far no link has been established with eating beta carotene-containing foods like squash, carrots, and sweet potatoes, which have nutrients your body needs.

In addition to paying attention to the above risk factors, you can lower your risk by:

• Staying active to maintain a healthy weight 
• Avoiding or reducing the amount of alcohol you drink

Watch for Second Cancers

People who have survived lung cancer do have a higher risk of developing a completely different type of lung cancer, or cancer in another area of the body. This is not recurring cancer, but rather something completely different. Go to your cancer screening appointments as recommended by your general practitioner or your oncologist. 

Survivors of non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) are at increased risk of cancer of the:

• Lungs
• Larynx (voice box)
• Mouth and throat
• Pancreas (regulates insulin and blood sugar)
• Bladder 
• Thyroid (regulates various hormones connected to appetite, metabolism, and bone health)

NSCLC lung cancer survivors also have a higher risk of developing cancers of the:

• Stomach
• Small intestine
• Colon (large intestine)
• Rectum
• Kidneys