Surviving cancer can bring new challenges

Millions of adults and children across the U.S. identify as cancer survivors. Beating cancer can transform someone's life and lead to a new sense of gratitude—but it can also usher in a range of physical and emotional challenges.

The following questions and answers were adapted from a webchat that took place on May 19 on abc27.com. It featured Dr. Niraj Gusani, director of the Program for Liver, Pancreas and Foregut Tumors at Penn State Cancer Institute, and Lynn Fantom, a care coordinator at the Cancer Institute.

When are people considered cancer "survivors?"

The common misconception is that "survivors" have finished their treatments and are free of disease. In truth, a survivor is defined as anyone from the day of cancer diagnosis. There are more than 14.5 million cancer survivors in the United States—and that figure is expected to exceed 20 million within a few years.

I've been in remission for a year, but after being treated for two years, I just feel like a shell of myself. How long does it take for this feeling to go away? Will my hair ever go back to the same color?

Many therapies—including chemotherapy, surgery and radiation—can have lasting effects long after they have concluded. Many patients say it takes months—and in some cases, years—for them to feel "normal" again. Overall, the body has a remarkable ability to recover and often will get back to normal over time. But often patients have a "new normal" after cancer treatment and must work with their physicians to adapt to this and optimize their quality of life.

What does a post-cancer diet consist of?

The diet we suggest for patients after treatment is much like any other healthy balanced diet. We stress energy-rich foods that are not too high in fat. There are no foods that can prevent cancer recurrence, but having proper nutrition and maintaining a healthy weight and physical fitness can help any patient be stronger to deal with medical problems that may arise.

What exercises would you recommend doing post-cancer?

Exercise is important and often very safe both during and after cancer treatment. However, you should consult with your physician before doing a specific exercise to make sure you will not harm yourself. For example, in the weeks after abdominal surgery, we don't want patients doing strenuous exercise to prevent formation of a hernia. But after that it is usually safe. Taking it easy is fine, but often patients feel better (and have decreased fatigue) if they do moderate or strenuous exercise.

What kind of emotional support is available for cancer survivors?

It is common for cancer patients and survivors to suffer from depression, anxiety and other forms of emotional distress. We routinely screen for these conditions and offer counseling, social work services and other services to address them. Other ways to help cope with stress include meditation, relaxation, yoga, exercise and simply spending time with friends and family and doing activities you love.

What are the chances my childhood leukemia will come back? For years, I've always been freaked out when I've gotten a sudden fever or feel weak, only to later find it was simply a cold or just regular fatigue.

It is very unlikely that your leukemia would come back, but certain cancer patients may be at greater risk for developing second cancers. Talk to your oncologist or primary physician about your risks, which depend largely on the treatments you were given.

Should you limit your exposure to sick people after cancer? I've heard the immune system is weaker in remission.

It is always important to use good hand washing and other precautions around sick people, whether or not you have cancer. While your immune system can be compromised during cancer therapy, it usually is not compromised afterward—and in fact, the immune system helps the body fend off cancer recurrence. So no, you do not need to avoid sick contacts after cancer diagnosis.