Q&A: Life After Cancer Care
CancerWise - March 2007
More and more people are surviving cancer – and that is good news. But this phenomenon also is leading survivors and researchers into new, uncharted territory.
CancerWise posed some questions about the late effects of cancer and treatment to Rena Sellin, M.D., medical director of the Life After Cancer Care program and professor of medicine in the Department of Endocrine Neoplasia and Hormonal Disorders at M. D. Anderson.
What is a cancer survivor?
A cancer survivor is commonly defined as anyone who has been diagnosed with cancer, from the time of diagnosis and treatment through the remaining years of life.
Recently, some organizations have expanded that definition to include the people in a cancer patient’s life who have been affected by the diagnosis, from family members to friends and caregivers. In this article, however, the term cancer survivor refers to anyone who has been diagnosed with the disease.
How many cancer survivors are there?
An October 2006 report in the journal Cancer found that Americans' risk of dying from cancer continues to drop, maintaining a trend that started in the early 1990s. Average annual declines from 1993 through 2003 were:
- 1.6% in men
- 0.8% in women
Almost 10 million cancer survivors lived in the United States in 2001, including:
- 2.2 million breast cancer survivors
- 1.6 million prostate cancer survivors
- 1 million colorectal cancer survivors
About 64% of adults with cancer will survive at least five years, and 75% of children will survive at least 10 years.
Why are there so many more survivors these days?
Thanks to new, improved therapies, an increasing number of people are living beyond cancer and enjoying a full life after treatment.
The numbers continue to increase because of:
- Earlier detection
- Improved treatments
- Supportive care of family and friends
- Huge group of baby boomers entering cancer-prone years
What problems can be caused by cancer and treatment?
Staying healthy can be a challenge for survivors because intensive cancer treatments sometimes create specific and long-lasting health issues.
Treatment can cause:
- Lymphedema (abnormal buildup of fluid causing swelling, usually in arms or legs)
- Oral problems
- Weight loss or gain
- Loss of bladder or bowel control
- Menopause symptoms
- Sexual problems
- Weakness and loss of mobility
- New cancers
Should survivors be concerned about the cancer returning?
Most cancer survivors are at risk for recurrence. Many also have an increased risk of developing second cancers.
Certain types of chemotherapy put patients at higher risk of developing:
- Myelodysplastic syndrome (a bone marrow failure disease)
Do survivors of childhood cancers face the same issues?
Survivors of childhood cancers have higher-than-average risk of new cancers as adults. They are five times more likely to have a chronic disease in adulthood.
Children may fall behind in school and may have delays in social development.
Does cancer have lingering psychological effects?
Survivors face a variety of issues that can affect their quality of life, including:
- Depression, anxiety, frustration
- Fear of recurrence
- Cognitive problems, such as memory loss or attention problems
- Changes in self-image, self-esteem
It’s important for survivors to have someone – maybe a pastor, psychotherapist, support group or good friend – who can ease their stress by listening as they talk through these feelings.
When cancer patients return to “normal,” what should they tell their primary care physicians?
When patients leave the care of an oncologist or surgeon, their primary care physicians may be unaware of their experiences or know little about them. It is important to develop a long-term follow-up plan with the oncologist before transitioning to a primary care setting.
This survivorship care plan should include information on:
- Cancer diagnosis
- Potential consequences of cancer and treatment
- Recommended timing and content of follow-up visits
- Other information, including:
- Tips for staying healthy and preventing recurrences or second cancers
- Legal rights regarding employment and insurance
- Availability of psychological and support services
Many survivors don’t need special care, but the oncologist should help the patient and the primary care physician determine what care is needed.
Patients should be proactive by being well-informed about their disease, treatment and consumer rights.
How can survivors help?
They can share their experiences by taking a few minutes to complete M. D. Anderson’s Life After Cancer Care questionnaire. This will benefit others by helping researchers shed light on unanswered questions regarding the long-term health of cancer survivors.
The questionnaire includes questions about survivors’ cancer experiences and their current health. Responses are confidential.
More than 11,000 cancer survivors have completed the questionnaire.
M. D. Anderson resources:
- Life After Cancer Care
- Cancer survivorship
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