Previously the term 'Survivor' was used for all patients with a cancer diagnoses that was thought to be fairly certain to be cured.

Other patients can live with generally stable cancer but may have the uncertainty that it could come back. These patients also felt they were 'survivors' of their cancer and wanted support with surviving cancer. Other patients just did not like the term 'survivor'.

Therefore, with the patients suggestion the term 'Living with and Beyond' was developed and encompasses all people that have been diagnosed with cancer, whether they are clear of their cancer or have stable disease, with ongoing support being provided or receiving ongoing treatments.

Follow up care will depend on your specific cancer, stage of diagnoses, treatment received, any ongoing health issues due to your cancer diagnoses or the risk of long term effects on your health and future.

To begin with, your follow up appointments will be more frequent with your specialist team. This is to assess and monitor your response to treatment, any side effects that you may experience and ensure you have no other concerns relating to your cancer.

As time goes on your appointments will begin to be spaced out as any side effects from treatment should have settled. However, majority of recurrences generally, are picked up between clinic appointments opposed to whilst in clinic.

Due to this, the follow up process needs to be more patient focused. Therefore, health professionals in the hospital or community are aware there is more advantage for cancer patients to be supported in self-managing their recovery and encouraging healthier lifestyles in the future. This is a main focus to living with and beyond cancer.

With this in mind all patients once treatment has finished should have a follow up plan discussed and guidance given on looking after yourself and who to contact if you have any concerns between visits.

We want to ensure all patients are provided with guidance around late side effects that may be experienced some time after treatment.

As more people survive cancer we are more aware of side effects that can develop in the future post treatment. As an example Osteoporosis is one form of a late side effect. Please be aware the health concern may not be a late side effect to treatment. If you think you may have a new concern please contact your GP or specialist team.

This will depend on your type of cancer to what tests you may have as part of your follow up.

It may include blood tests and scans. These are important to check for early signs that the cancer may be active. However, there needs to be a balance between the risk of the cancer recurring and the anxiety caused of having repeated tests taken with the possibility of extra doses of radiation from repeated scans.

Once the post treatment follow up stage has finished. Most scans will only be requested if there is a change that could indicate a recurrence.

Please do contact your specialist team if you feel you would like more information on this.

• Macmillan Cancer Information and Support Centre here in the RUH
• For advice and support you can also call the Macmillan help line on 0808 808 0000, 9.00am to 8.00pm

Most people will find the time from having their tests to waiting for their clinic appointment very worrying. The unknown, loss of being in control and potentially unexpected news can be very upsetting. Having to return to the Oncology department can be very difficult for some people as it can bring back past emotions. Some people struggle with having scans such as MRI's.

If you are particularly concerned when your specialist team suggest having tests you can ask why they are doing them and what will happen if any changes are found.

If you are particularly worried about having a test, such as an MRI ask your team or GP to prescribe a light sedative for prior to the scan to help relax you.

If the thought of having the scan is really causing you distress some simple relaxation techniques could help. The Macmillan Cancer Information Centre can contact the hospital therapies team for you to offer some of these relaxation tips. Or refer you to our HOPE programme.

You can improve your health before treatment, whilst completing your treatment and after by being physically active, maintaining your weight and eating a balanced diet.

Keeping active

There has been research into keeping active whilst on treatment and after treatment for your cancer. The Macmillan centre can refer you for an exercise programme through the Oncology rehab team whilst receiving your treatment and whilst in follow up within the RUH

Some useful websites below:

The Macmillan booklet 'Move More' your complete guide to becoming more active.

Maintaining a healthy weight

This can be hard as treatments you are given can cause weight gain by following a healthy eating plan this can be managed.

If you have lost weight that is not intentional and are struggling to regain weight or would like advice on a healthy wellbeing balanced. Ask your specialist team or your GP for a referral to a dietician if you would like help managing this.

Recipe book available on be.Macmillan website or from the Macmillan cancer information centre A12 within Oncology Department.

Recipes for people affected by cancer