Life after a transplant
You'll need to make a few adjustments to your lifestyle directly after a transplant.
For the first few months while your immune system is returning to normal, it helps to try to eat a healthy, balanced diet and to avoid possible risks of infection from food. Eat freshly cooked food and avoid reheated food.
It’s best to avoid:
any food that’s not completely fresh.
Make sure that frozen foods are completely defrosted before cooking, and wash salads and fruit thoroughly before eating. Avoid soft cheeses, unpasteurised food, live yoghurt and dishes containing uncooked or lightly cooked eggs. Once your blood count is back to normal, you can usually eat whatever you like. Your doctor or nurse will usually give you advice about this.
It’s fine to drink a small amount of alcohol, but heavy drinking will slow down the recovery of the bone marrow and increase the risk of bleeding (especially if your platelet count is low). Alcohol can also interfere with some of the drugs you may be prescribed.
Coping with tiredness (fatigue)
Back to top
Feeling that you have no energy at all (fatigue) is common after a transplant. Getting your energy levels back can take many months. Don’t expect too much of yourself, and remember that it’s a gradual process. Pace yourself, and save your energy for the things you want to do or that have to be done. Accept offers of help from family and friends. Gentle exercise, such as short walks, can help increase your energy levels.
To reduce the risk of infection, avoid crowded places such as cinemas, pubs and public transport until your white blood cells are well within the normal range. Your doctor can tell you what your blood count is.
By 3-6 months after your treatment, you should be able to take up a full social life again. However, avoid contact with children who have an infectious disease such as chickenpox or measles. If you’re worried that you’ve come into contact with someone with an infectious disease, contact your transplant team.
Going back to work, school or college
Back to top
When your blood count has gone back towards normal, you can ask your doctor about going back to work, school or college. Ideally, take it gradually by going part-time to begin with. It’s a good idea to discuss with your employer, teacher or tutor a satisfactory way of returning to your work or education in stages.
You might also want to say whether you would like them to talk to your colleagues or fellow students about your illness and treatment before you return. If so, check that you feel comfortable about the way they plan to do this.
Regular gentle walking is good exercise to keep your muscles reasonably toned until your platelet count has returned to normal. Ask your specialist about what kind of exercise is suitable for you when your blood count is still recovering.
After this, you can start doing whatever exercise you like, although it’s wise to gradually build up the amount of exercise you do. Taking regular exercise can help with your recovery and benefit your future health.
After a donor stem cell transplant, you’ll lose your immunity to any illnesses you were vaccinated against as a child. You’ll need to have these vaccinations again in addition to some other vaccinations to protect you against common infections such as flu. After about six months to a year, your doctor will discuss your immunity with you and advise you about when you should have your vaccinations.
There are some types of vaccines (live vaccines) that you’ll need to avoid until your immune system is fully functioning. Your specialist will tell you what vaccinations are safe for you to have and if there are any you should avoid.
For the first 3-6 months after the transplant, you’ll still have to attend hospital regularly and may need blood transfusions. As your blood counts improve and the gap between hospital visits gets longer, you can discuss holiday plans with your doctors. Remember to ask your doctor for advice on travel and discuss any vaccinations needed.
You’ll usually be advised not to travel abroad in the first year after a transplant unless there’s a nearby cancer treatment centre.
After the first year, your immune system should be working well, and you should be able to travel abroad. However, certain types of vaccinations (live vaccines) should be avoided. Again, talk about your plans with your transplant doctors. Your doctors can arrange to send details of your recent treatment if necessary. They may be able to suggest medical centres that could cope with complications if they arise.
It’s helpful to carry a short letter from your doctor that outlines the treatment you’ve received and gives a contact telephone number.
You should avoid too much sun exposure in the first two years after your treatment, as it can trigger graft-versus-host reactions. Always wear a long-sleeved shirt, a hat and a suncream with a high sun protection factor (SPF30 or higher) when you’re in the sun.
People who’ve had cancer often find it difficult to get travel insurance. Our information on getting travel insurance has a list of insurance companies that have specific policies for people who have, or have had, cancer. There's also a video of Alan talking about his experiences of travelling with cancer.
A donor stem cell transplant won’t affect your ability to have sex. But before leaving hospital, it’s a good idea to check if there’s any reason you can’t go back to your normal sex life. If your platelet levels are low, you might be advised to avoid sex until they improve.
It’s not unusual to find that your sex drive is reduced for some months after treatment. This may be because you feel anxious or low. You may have body changes, such as hair loss and weight loss, because of the treatment, and those changes can affect your confidence. Fatigue is a common problem after the donor stem cell transplant, and you may just feel too tired.
Some people may worry that sex will never be an important part of their life again. It often involves a period of adjustment for you and your partner, and with time, most difficulties can be overcome.
Cuddles, kisses and massages are affectionate and sensual ways of showing how much you care for someone, even if you don’t feel like having sex. You can wait until you and your partner feel ready - there’s no right or wrong time.
We have more information about sexuality and cancer.
Hormone replacement therapy
Women whose treatment has caused them to have an early menopause may have menopausal symptoms such as hot flushes, dry skin, dryness of the vagina and a low sex drive.
Most women can be helped by hormone replacement therapy (HRT), which can relieve many of these symptoms. If your doctor hasn’t already talked to you about HRT, it might be worthwhile asking them about it to see if it would be suitable for you.
Let your doctor or nurse know if you’re having problems with your sex life. They may be able to reassure you, or there may be things that can be done to improve the problem.
If you feel uncomfortable talking to your doctor or nurse, you may want to call us.
Some people may find it helpful to talk to a sex therapist. You can contact a therapist through the College of Sexual and Relationship Therapists.
In most cases, high-dose treatment causes women’s periods to stop and will stop men from producing sperm. The effects on your fertility will depend on the intensity of the treatment you have. Your specialist will be able to advise you on how the treatment is likely to affect your fertility.
It’s important to talk to your cancer specialist before treatment starts. There may be ways of preserving your fertility so that you may be able to have children in the future.
You can usually store sperm before your treatment starts. It can be used later along with fertility treatment when you’re ready to have a family. Storing sperm for use in the future is also important for teenage boys. We have more information about cancer and fertility for men.
It may be possible to store fertilised eggs (embryos) that can be used in the future when you’re ready to try to get pregnant. If you don’t have a partner, it may be possible to store unfertilised eggs. Collecting eggs can take several weeks, so there will need to be a delay in treatment. In some women, this may not be advised if treatment has to start sooner. A new and extremely experimental technique, which doesn’t involve egg collection, is removing and freezing tissue containing eggs from an ovary.
Fertility is a very important part of many people’s lives, and not being able to have children can seem especially hard when you already have to cope with cancer. Some people may find it helpful to talk through their feelings with a trained counsellor. If you need more specialised help, your doctor can arrange this for you. We have more information about cancer and fertility for women.
Long-term or late effects
Back to top
Some side effects that develop during treatment may take a long time to improve or may occasionally become permanent (long-term effects). Other effects can develop years after treatment has finished (late effects).
A number of problems can occur after your transplant that may vary from being mild to more serious. This is due to the effects of the treatment you had before your transplant and is also because your new immune system is not as effective as your own.
Always let your doctor know about any problems you have.
Possible long-term or late effects include:
Cataracts - These are small dark spots that form in the lens in your eye making it difficult to see. Let your doctor know if you have any problems with your vision. Cataracts can be removed by a small operation.
Low levels of the thyroid hormone thryroxine (hypothyroidism) - You’ll have blood tests to monitor your thyroxine levels. If you develop hypothyroidism, you’ll be given thyroxine tablets.
Bone thinning (osteoporosis) - Steroids and low levels of sex hormones can increase your risk of developing osteoporosis. Let your doctor know if you have any problems with your bones. Weight-bearing exercise, such as walking, helps keep your bones healthy.
Increased risk of cancer - Having a transplant can increase your risk of developing a second cancer. However, you’ll be closely monitored by your transplant team so any problems with your health can be picked up and treated early. You can reduce your risk by not smoking, eating healthily, taking regular exercise, drinking sensibly and protecting yourself from sun exposure. It’s good to take part in any screening programmes for breast, cervical or bowel cancer that you’re offered.
Many people go on to make a full recovery after a transplant with little or no health problems. You’ll be followed-up for many years by your transplant team or a haematology team at your local hospital.