Life after high-dose treatment with stem cell support
For the first few months while your immune system is returning to normal, it helps to try to eat a healthy, balanced diet and 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)
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Feeling that you have no energy at all (fatigue) is common after high-dose treatment with stem cell support. Getting your energy levels back can take 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 hospital team.
Going back to work/school/college
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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 only part-time to begin with. It’s a good idea to discuss this with your employer, teacher or tutor to work out a satisfactory way of returning to your work or education in stages.
You might also want to say whether you’d 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.
Our information about work and cancer gives information about employment rights, disability rights and financial issues for people with cancer.
There is information about education and going back after a transplant on our website for teenagers and young people.
Regular, gentle walking is good exercise to help 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 usually 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 high-dose treatment with stem cell support, your doctor may advise you to have some vaccinations to protect you against common infections such as flu. 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 following your high-dose treatment, you will 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 your treatment unless there is a nearby cancer treatment centre.
After the first year, when your immune system should be working well, you should be able to travel abroad. However, certain types of vaccinations should be avoided. Again, talk about your plans with your doctors. Your doctors can arrange to send details of your recent treatment if necessary. They may also be able to suggest medical centres that could cope with complications, if they arise.
It’s usually helpful to carry a short letter from your doctor outlining the treatment you’ve received and giving a contact telephone number.
People who’ve had cancer often find it difficult to get travel insurance. We have a list of insurance companies that have specific policies for people who have, or have had, cancer.
High-dose treatment won’t affect your ability to have sex. But before leaving hospital it’s a good idea to check if there’s any reason why 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 or weight loss because of the treatment, and those changes can affect your confidence. Fatigue is a common problem after treatment, 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.
Our information on sexuality and cancer discusses the possible problems after treatment and has tips on coping with any difficulties.
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 worth 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 help.
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.
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.
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.
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.
It may be possible to store fertilised eggs (embryos), which 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 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 from an ovary that contains eggs.
Young people may want to read our information on relationships, sex and fertility for young people affected by cancer.