M. D. Anderson Cancer Center
Date: April 2008
Duration: 0 / 04:10
Return to Cancer Survivorship
I remember the day that my last chemo was done, I was both thrilled, but frightened, like "now what? Now what happens to me, I just, what, what do I do?”
Hi, I’m Minerva Perez. Suzanne’s words certainly struck a chord with me as I imagine they did for you, too. Thanks to early detection and improved treatments, millions of Americans are surviving cancer. In fact, there are more than 10 million cancer survivors in the United States and over 20 million worldwide. For health care professionals, survivorship is an emerging issue, a new frontier.
Well, I think that we are now entering into a new phase in the medical chronicles of cancer care. Whereas in the 20th century cancer was considered a fatal disease, today many types of cancers are either curable or chronic, and patients will live through the cancer or with the cancer for years.
My assumption was that there were these two categories, you know, that you either went in and you got treated, and you got into what I now would call a complete remission, and went on about your business, or you died. And what has happened now, with all the advancements in treatment is there's a third category, which is people who don't die anymore, thank goodness, but instead they're kept in a sort of a suspended partial remission, which means that they're going to be under continual treatment for the rest of their lives.
There are 3 stages of survivorship: Living with cancer, Living through cancer, and Living beyond cancer. Living with cancer begins at the moment of your diagnosis. The focus is on treatment… getting rid of the cancer, if possible, or controlling the cancer to the point where you can live with it long term. .
When you have cancer, your first thought is let’s get it treated, get it gone. But then, our survivors, you know 10 years down the road, they’re healthy, living their life, and they go, ‘I can’t have children.' For our young cancer patients, one of the things that we like to talk to them about, if they are wanting to consider having a family at a later time is for a woman, egg donation or for a man, sperm donation so that they do retain that opportunity to have children at a later time.
Cancer treatment during this stage may involve surgery, radiation, chemotherapy, biologic agents, or a combination, and all of these treatments can have an impact physically, emotionally, and socially.
After this first stage of survivorship, the living through cancer stage begins. For some cancers, there’s a risk of recurrence. Statistically, this risk is highest within a defined period of time, anywhere from 3 to 5 years for the majority of cancers. During this time, you may worry whether the cancer will return. This is also a time of rehabilitation, especially if treatment included surgical interventions that physically altered the body.
Cancer’s not going to ruin your life, and same with an amputation, it’s not going to ruin your life, and I think whenever you’re going through chemo, and you’re in the middle of all that stuff, that it’s sort of all that you can see, and you can’t really see past it and what life is going to be like past it. And I remember, I was worried about things like nobody’s going to want to take me to the prom, and you know, I’m not going to be normal. I’m always going to be the girl who had cancer. But, it’s not like that at all. It’s not like that at all. And it’s definitely what you make it. It can be a horrible experience, or it can be a bad experience that you sort of learn from and that you’re a better person from.
If the cancer has not recurred, then you enter the Living beyond cancer stage of survivorship. During this stage, you may experience long term health issues or sudden late effects resulting from earlier treatments.
All of these treatments and the cancer itself have residuals that may affect their health. For example, they may have cardiotoxicities from some of the treatments, or early coronary disease, because they were radiated to their chest. All of these aspects should be taken into consideration.
Anyone who is living with and through and after the cancer is a survivor. There are just different problems to deal with at each of these stages.
Research is ongoing to discover new ways to improve the experience of survivorship and to improve treatment strategies.
There needs to be an information loop that’s beneficial to both the survivor in terms of, if they know this information, they might do things differently in terms of screening tests, in terms of periodic medical evaluations. And secondly, the physicians who are treating new patients that come in with that type of cancer may do things differently as well in terms of getting a better outcome for everyone.
Return to Cancer Survivorship
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