The journey continues...
Overall the outlook for a young person with a blood cancer is very promising. The side effects of treatment can be managed and with follow-up for long-term survivors, you have every chance of beating blood cancer.

However, getting the ‘all clear’ after your treatment isn’t the end of the story. Follow-up is extremely important for all cancer survivors and as a young person you should attend follow-up care for many years, although local clinics organise things differently from each other. You may never experience any long-term effects of your treatment but these are some of the things your doctors will check:

Thyroid function
Radiotherapy to the neck area can sometimes cause damage to the thyroid gland. This is the gland responsible for controlling your metabolism. If it is not functioning properly, a simple daily tablet may be needed to correct the problem.

Secondary cancers
Long-term complications that can occur following treatment for blood cancer include secondary cancers but, thankfully, these are rare. The risk of developing a secondary cancer depends on many factors including:

• Type of treatment received
• Age at diagnosis 
• Your sex
• Time since completion of therapy
• Genetic risk factors
• Acquired risk factors e.g. smoking – especially in those who have received radiotherapy to areas including the lungs. 
• Breast cancer is the most common secondary cancer in women who have received radiotherapy to the chest during treatment of lymphoma.  Although all women are advised to perform self-breast examinations, it is even more important following the completion of treatment. There are many sources of information detailing when and how a breast examination should be performed.

Heart complications
Some chemotherapy drugs (anthracyclines) can have adverse effects on heart tissue, such as the weakening of muscle. This means that your heart must work much harder to keep up with your demands.  Follow-up is important if you have received this type of drug. You may have to have regular scans if your consultant finds evidence of heart disease. It also may mean special monitoring during childbirth.

Weakening of heart muscle doesn’t have to mean a complete lifestyle overhaul, but it does mean that certain sporting activities are not recommended. These include physically demanding sports such as rugby and weight lifting. 
Activities such as dance, swimming or tennis are encouraged.

Dental problems
Radiation to the mouth area and intensive chemotherapy can cause an increased risk of dental decay. It is important to attend regular check-ups and inform your dentist that you have had treatment. Generally, problems resulting from lower face irradiation are more severe in children rather than young people, but it is still sensible to be vigilant about dental care.

After treatment, will I be able to get insurance?
Some survivors of cancer, including blood cancer, can find it very difficult to get life and even travel insurance because of their health history. You are obliged to disclose your cancer and treatment when applying for insurance otherwise the policy becomes void. Larger and more established insurance companies are more likely to be able to provide insurance for you but there are brokers who specialise in providing cover for cancer survivors. The Leukaemia Foundation may be able to assist you with finding a sympathetic broker.

What about travelling?
When you are in remission you still have to attend regular check-ups, so when is it OK to go travelling? Your consultant is the best person to ask about this and will be able to tell you when it is safe for you to go abroad and help you to organise appointments while you are away if needed.

Parents are normally a little scared when their children decide to skip-off around the world but when they do this after having blood cancer; terrified is a more appropriate description! Explain why you want to go travelling and ask your consultant to reassure your family that it is as safe as it can be for you to go.

For more information about legal issues involving health and lifestyle changes please take a look at WorkWelfareWills. This useful site provides information about Centrelink, insurance, privacy, and more.