Cancer survivors face unique health-care issues

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Patricia Robinson

On June 4, millions of cancer patients and their families celebrated the 25th National Cancer Survivor’s Day. The first Sunday in June was selected as the day to recognize the significant progress we have made in the fight against cancer. Cancer outcomes have significantly improved over the past 40 years, due to advances in prevention strategies, cancer screenings, diagnostics studies and therapies.

In the United States, there are about 12 million cancer survivors, defined as those living with a history of cancer, from the time of diagnosis through the remainder of their lives. Most cancer survivors are middle aged or elderly, with approximately 60 percent age 65 or older, and 35 percent between the ages of 40 and 64. Breast cancer survivors account for 22 percent of all cancer survivors, followed by prostate cancer survivors (20 percent) and colorectal (9 percent). There also are long-term survivors of cancers involving most solid tumors, including gynecologic; bladder, kidney and other urinary tract tumors; melanoma; thyroid; and lung; as well as survivors of leukemia and other blood cancers.

Cancer survivors have unique health-care issues due to their cancer treatments. Late- and long-term physical problems caused by cancer and/or treatments include fatigue, memory and concentration changes, pain, nervous system changes (neuropathy), lymphedema or swelling, mouth or teeth problems, changes in weight or eating habits, trouble swallowing, bladder or bowel control problems and menopausal symptoms.

Survivors also face psychological and lifestyle challenges. A Livestrong Survey found that the majority of cancer survivors worry about their cancer coming back or report not having the energy to do the things they wanted to do; being negatively affected at their jobs; feeling depressed; or having trouble remembering things.

Millions of patients have been cured of cancer, or are in long-term remission. But once active cancer treatment ends, patients still need ongoing care for the physical problems, psychological issues and other consequences of their cancer and treatment. Unfortunately, many patients get lost in this transition from cancer patient to cancer survivor.

To ease the transition, many centers have developed mechanisms to address the health-care needs of cancer survivors. Patients undergo a detailed medical history, physical examination and psychological screening survey. Survivors are educated about the late and long-term effects of their surgery, chemotherapy and radiation. Patients are provided a summary of care, detailing treatment history including drug names, dosages and side effects. Care is coordinated with their treating oncologist and primary care physician.

The National Cancer Institute’s Office of Cancer Survivorship offers excellent advice for cancer survivors undergoing follow-up care. Before your doctor’s visit, make a list of questions to ask. Bring paper to take notes. Ask a friend or family member to accompany you. Ask your doctor or pharmacist about the best way to take medicine, and about possible side effects. Ask if there are local support groups. Request books or other materials to read at home. Keep your own set of records about your follow-up care.

The cancer survivorship clinic also offers lifestyle tips to reduce the chances of developing a second primary cancer: quit smoking; cut down on alcohol; choose foods that are low in fat and salt; and include five servings of fruits and vegetables a day. Maintain a healthy weight. Do 30 minutes of moderate exercise (such as walking, biking or swimming) every day or almost every day to reduce anxiety and depression, improve mood and self esteem and reduce fatigue.

Our goal is to help patients re-establish as near a normal life as possible.

Dr. Patricia Robinson is director of Loyola University Health System’s Cancer Survivorship Program.