What happens after treatment?

Once your blood count and side effects have improved, you will be able to go home. Recovery can take time. For the first 2–3 months after a transplant, you’ll have regular doctors’ appointments, blood tests and medicines. You may also need blood or platelet transfusions.

Always carry a 24-hour telephone number for your hospital or transplant unit. Contact them immediately if you feel unwell, your temperature rises, or you have any signs of infection.

It’s important to take care of your health when you are home. Your doctors and nurses will give you advice which may include:

  • Eat a healthy diet and limit risks of infection from food.
  • Take regular suitable exercise.
  • Avoid crowded places.
  • Use effective contraception.
  • Check whether you need any vaccinations.
  • Talk to your medical team about any holiday plans.
  • Protect your skin from the sun.
  • Prepare yourself for going gradually back to work, school or college.

Going home after a stem cell transplant

When your blood counts have reached a safe level and any side effects have improved, you will be able to go home. You must also be eating and drinking well, and be able to take tablets. As you get nearer to leaving hospital, you may start feeling impatient. Or you may feel anxious about going home and leaving the support of the hospital. It can be hard to adjust to leading an independent life again after spending so long in hospital. When you first go home you should arrange for a relative or friend to stay with you. Or, the hospital staff can arrange for you to have support from carers when you go home.

There will still be some things that you can’t do, and it may seem as though you’ll never get back to your normal life again. But as you recover, you’ll usually find that the focus shifts away from the treatment you’ve been through and back to day-to-day living.


What happens after treatment?

For the first 2–3 months after leaving hospital, you’ll need regular doctor’s appointments and blood tests. These can be done at the outpatient clinic. Occasionally, you may still need blood or platelet transfusions. These can usually be given as a day patient.

You may also have to take regular doses of several different drugs.

Antibiotics such as co-trimoxazole (Septrin®), anti-viral drugs such as aciclovir and anti-fungals are given to reduce the risk of infection. Depending on the results of your blood tests, the dose of your drugs may need to be changed.


Hospital contact

You should always carry a 24-hour telephone number for the hospital with you. If you’re worried, you can ring at any time of day or night to speak to someone who knows about your treatment. The doctors and nurses would prefer you phoned and spoke to them rather than risk being unwell at home.

It’s very important to take great care of your health during this time. Your doctors and nurses will give you advice about the type of precautions you’ll need to take once you are home.

Contact your hospital immediately if:

  • your temperature goes over 37.5°C (99.5°F) or over 38°C (100.4°F), depending on the advice given by your transplant team
  • you suddenly feel unwell, even with a normal temperature
  • you have any signs of an infection – such as feeling shivery or short of breath, having a sore throat or cough, having diarrhoea or needing to pass urine a lot.

If you become unwell, you’ll need to go back into hospital. It’s quite common for this to happen once or twice after high-dose treatment. This is not a major setback, although it can be very worrying.

If you feel unwell and are unable to contact the hospital, ask someone to take you to the nearest hospital immediately.


Eating and drinking

Your doctor or nurse can give you information about your diet once you are home. While your immune system is recovering, try to eat a healthy, balanced diet and avoid possible risks of infection from food.

It’s best to avoid:

  • reheated food
  • raw or lightly cooked eggs
  • shellfish
  • all types of pâté
  • soft cheeses
  • takeaway food
  • pre-wrapped sandwiches
  • cooked sliced meats
  • smoked fish
  • cream cakes
  • food that’s not completely fresh.

Make sure that frozen foods are completely defrosted before you cook them. Wash salads and fruit thoroughly before eating them. You may be told to peel fruit. Don’t eat food after its ‘use by’ date. Take care to keep raw and cooked foods apart.

Once your immune system is back to normal, you can eat whatever you like. Your dietitian or nurse will give you advice.

Check with your doctor before drinking alcohol. Heavy drinking will slow down the recovery of the bone marrow. If your platelet count is low, drinking will increase the risk of bleeding. Alcohol can also interfere with some of the drugs you may be prescribed.


Coping with tiredness

Feeling that you have no energy at all (fatigue) is common after a stem cell transplant. Getting your energy levels back to normal 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 that you want to do or need to do. Accept offers of help from family and friends. Gentle exercise, such as short walks, can help increase your energy levels.

There’s lots of useful information in our section on coping with fatigue.


Exercise

Regular, gentle walking is good exercise to keep your muscles toned. Ask your specialist which type of exercise is suitable for you while your blood count is still recovering. After this, you can start doing whatever exercise you like, although it’s wise to increase the amount gradually. Regular exercise can help with your recovery and benefit your future health.


Socialising

When possible, you should avoid crowded places until your immune system has recovered. This includes cinemas, pubs, shopping centres and public transport at busy times. You should be able to have a full social life again 3–6 months after your treatment. You should 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.


Having sex

A stem cell transplant won’t affect your ability to have sex. But 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 depressed. You may have body changes such as hair loss or weight loss that can affect your confidence. Tiredness is also a common problem.

Some people may worry that sex will never be an important part of their life again. 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 feel ready.

Let your doctor or nurse know if you’re having problems with your sex life. There may be things they can do to help. If you feel uncomfortable talking to your doctor or nurse, you can call us on 0808 808 00 00.

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.

Our section on sexuality and cancer discusses possible problems following treatment and have tips on ways of coping.

Contraception

Although your fertility may be affected, it’s still important to use effective contraception after treatment to avoid pregnancy. Doctors and nurses usually advise you to avoid getting pregnant or fathering a child soon after treatment. This is because in the first few months, you will be taking medicines that could affect a developing baby. Your doctor or nurse will tell you how long you need to use effective contraception for.


Hormone replacement therapy (HRT)

Women whose treatment has caused an early menopause may have symptoms such as hot flushes, dry skin, dryness of the vagina and a low sex drive. Hormone replacement therapy can relieve many of these symptoms. If your doctor hasn’t already talked to you about HRT, you could ask about it to see if it would be suitable for you.


Going back to work, school or college

When your blood counts have recovered, you can ask your doctor about going back to work, school or college. You should do this gradually, by going part-time to begin with. It’s a good idea to talk to your employer, teacher or tutor about the best way of returning. Think about whether you want them to tell other people about your treatment before you return. Check that you feel comfortable with the way they plan to do this.

Our section on work and cancer has more information about employment rights and financial issues.

We also have information about education and going back after a transplant for teenagers and young people.


Vaccinations

After a transplant, your immune system may have ‘forgotten’ some of the vaccinations you had before. This means you may have lost your immunity to some of the illnesses you were vaccinated against as a child. You may need to have some of these vaccinations again. You will also need vaccinations to protect you against common infections such as flu. Your haematology doctor will discuss your immunity with you and give you advice 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 has recovered. Your haematology doctor will tell you which vaccinations are safe for you to have and which you should avoid.


Holidays and travel

As your blood counts improve and the gaps between hospital visits get longer, you might start to think about going on holiday. You should talk to your haematology doctor about any plans before booking a holiday. You will usually be advised not to travel abroad in the first year after a transplant.

After the first year, your immune system should be working well, and you should be able to travel abroad. You will need to ask about any vaccinations you may need. It’s helpful to carry a letter from your doctor that explains the treatment you’ve received and gives a contact telephone number. Your doctors may be able to suggest nearby medical centres that you could contact if you have any problems while you’re away.

After your transplant, you should protect your skin from the sun. If you have had a donor stem cell transplant, this can trigger graft-versus-host reactions.

You are also more at risk of developing skin cancer. Always wear long-sleeved tops and a hat when in the sun. It’s important to remember you can burn even through clothing if you’re out in hot sun for a long time. Use a suncream with a high sun protection factor (SPF) of 30 or higher.

People who’ve had cancer often find it difficult to get travel insurance. We have a section on travel and cancer that has helpful, practical tips about travelling.


Back to Stem cell and bone marrow transplants explained

Your feelings

You may experience difficult feelings after your treatment. Talking to those close to you can help.