Some cancer survivors have side effects
After 33 rounds of full body radiation and dangerous surgery to remove a tumor the size of a golf ball on its back brain, then 21-year-old Matthew Zachary was released from hospital on April 30, 1996, without cancer and surviving.
But his relationship with the disease had only just begun.
In the following years, he would fight his own with chronic sinuses and lung infections as a result of treatments that eliminated his own. immune system. It would be stroke At age 36, radiation damage caused by radiation rays. He would invest ten thousand dollars in fertility treatments. Her hair would not grow back. And, with coordination in his left hand difficult, he would have to put aside his dreams of becoming a professional pianist and reinvent himself.
“Account after account, they’re good problems,” says Zachary, 46, now a successful podcast host and proud father of 10-year-old twins. “But it was a great pity and loss. It took me a while to make sense of my life again. “
More Survivors – And More Challenges
Zachary is among the 17 million cancer the number of survivors currently living in the United States is projected to reach more than 22 million by 2030. In many respects, these numbers are encouraging, reflecting advances in early detection and new therapies.
But some survivors are shocked fatigue, depression, and other side effects persist long after treatment. Others live long enough to have “late effects” to endanger their lives, among others heart and bone problems, which appear a few decades later.
There has certainly been progress since 2006 when the U.S. Medical Institute issued a rigorous report calling for more long-term care for survivors.
But there is still work to be done, according to a survey conducted by the National Cancer Survival Coalition in July 2020.
About half of cancer survivors say they are concerned about ongoing side effects. However, only 60% say they were properly warned about the expectation of post-treatment, and very few say they are doing a good job of providing health care.
“We’re coming out of a system that only existed to treat tumors,” says Dr. Catherine Alfano, a surviving advocate and vice president of cancer care management at the Northwell Health Cancer Institute in New York. “It is essential now to focus on a new model of care to reduce side effects and maximize the long-term quality of life of our patients. We are not doing enough.”
When President Richard Nixon declared a “war on cancer” in 1971, the average five-year survival rate for all cancers was around 50%. Today, this rate is approximately 70% and 1 in 5 people who survived were diagnosed 20 years or more ago.
But these saved lives can have a cost.
“People have a misconception: ‘My cancer is over and I don’t have to think about it.’ But unfortunately, for a lot of people, that’s not the case,” Alfano says.
Surgeries to be removed lymph nodes, which serve to move fluids throughout the body, can cause chronic inflammation and pain in the arms and legs. Some chemotherapies can adore the extremities and others have an effect fertility, sexual function or cognition. About 1 in 3 people have it depression or anxiety.
Then there are the late effects.
Some medications, such as aromatase inhibitors, can thin bones and cause osteoporosis a few decades later.
Ironically, some treatments can cause cancer.
And adults who survive childhood cancers, which are hardest hit by late effects, appear to be aging faster, with 80% having some form of chronic health status for middle-aged people.
“The good news is that they live longer,” Dr. Julia Rowland said. He spent 18 years as director of the Office of Cancer Survival at the National Cancer Institute. “But they live long enough to see serious effects late.”
One measure does not fit all
Fortunately, treatments have changed drastically in recent years as more individualized and less invasive treatments have been introduced.
“We recognize that more isn’t always better when it comes to treating cancer,” says Jennifer Ligibel, MD, a medical oncologist At the Dana Farber Cancer Institute in Boston.
In breast cancer specifically, the radical of an era mastectomiesWhere all breast tissue, breast muscles, and lymph nodes are removed, they are rarely performed, replacing them with tissue-sparing surgeries, or no surgery at all.
Doctors are administering less chemotherapy and directed radiation rays. When it comes to prescribing drugs that can cause serious late effects, doctors have learned that they may be able to prescribe less, Ligibel says.
Meanwhile, several new drugs that act on the immune system, such as immunotherapies, have emerged, causing hair loss in patients and nausea while they bring different and sometimes less side effects.
“We first had some chemotherapy drugs and used them extensively in all types of cancer,” says Ligibel. “Now, the treatments we’re using are not only focused on individual cancers, but also on specific traits, such as genetic mutations. Two people lung cancer or breast cancer can receive very different treatments. “
For patients, all of this means more opportunities and, according to patient advocates, more support is needed.
“That day, the doctor told you what to do and what you did. If you survived treatment, ‘Congratulations, have a good life, goodbye,’ ”says Rowland, senior strategic advisor at the Smith Center for Healing and the Arts in Washington, DC. that we have, from the moment of diagnosis and treatment “.
In some areas, it’s already happening.
At the Lineberger Comprehensive Cancer Center at the University of North Carolina, each patient is assigned a navigator nurse who helps them carry out treatment as they weigh their options, and a Cancer Transition program that provides nutrition, exercise, and exercise. stress management counseling after treatment.
Memorial Sloan Kettering offers survival programs especially for those who have had treatment at a young age. Meanwhile, some medical schools offer classes for primary care physicians to help them better understand the challenges that survival entails.
“With almost all of these chronic and late effects, there are treatments that can help if we take patients to the doctor properly,” says Alfano, and physical therapy early lifelong mobility problems can be avoided and early psychotherapy it can prevent depression from getting out of control.
Patients, joined by advocacy groups like the National Cancer Survival Coalition and Stupid Cancer, created by Zachary for young adults, have begun to control their care, discussing what life will be like after starting treatment.
As Rowland recalls, Lance Armstrong was a professional cyclist testicular cancer At the age of 24 – he once refused treatment that would severely impair lung function, instead choosing another drug. And it would boost the chances of survival a little but it would have a lasting effect on the drug nerve damage in his hands, Zachary, the concert pianist, also refused.
“I thought it would be nice to rehabilitate my hand and one day find a way to play again. I didn’t want to take drugs that would cripple that opportunity. “
He’s actually playing again.
But he and others would still like the health system to be ready to prepare for the coming of patients, to advise on opportunities, and to provide them with long-term physical and psychological protection.
“We have a lot of care to survive, but it’s very reliable because survivors are defending their best care,” says Shelley Fuld Nasso, director general of the National Cancer Survival Coalition. “Still, unfortunately, we send too many people into the world and we don’t help them.”
For now, Zachary advises: actively seek out those who go through this help.
“Don’t trust Google to make your decisions,” he says. “Find your tribe.”
Cancer Survival Expert Dr. Julia Rowland Suggests Ways to Optimize Quality of Life cancer treatment.
1. Ask questions as you explore your treatment plan, especially about potential side effects and available alternative options.
2. Write a survival plan outlining the medical and psychological challenges that may arise after treatment and specifying what you and your doctors will do to address them.
3. Stay active during and after treatment. Studies show that side effects can be reduced.
4. Go quietly to yourself. If you need a year to finish treatment, you should take a year to return at full speed.
5. Establish a support network, through survival groups and online.
% 27 – The number of cancer death rates in the last 25 years.
49% – Number of cancer survivors with or without fatigue during treatment. 19% develop skin problems, 26% have neuropathy, 24% have sexual concerns and 13% have cognitive problems.
35% – Currently the number of early breast cancer patients with mastectomy.
% 41 – Number of adults surviving cancer mental health issues.
Find more articles, browse numbers, and read the current issue WebMD Magazine.