BENGALURU: As per international statistics, with current treatment techniques, almost two out of three cancers are curable. However, being cured is often not the end of the road for most cancer survivors.
Cancer survivorship refers to the physical, psychological, and socioeconomic aspects of life for individuals diagnosed with and treated for cancer. It covers the period of time from diagnosis to the end of life and encompasses a range of issues and challenges that may arise, including long-term health conditions and side-effects of treatment, recurrence/relapse of cancer, second cancers, financial and employment difficulties, and changes in relationships and personal identity.
The number of cancer survivors has increased tremendously over the past three decades with improvements in healthcare to detect and provide therapeutic treatment. Latest studies indicate a steady increase in the 5-year relative survival rate as it currently stands at 66% for adults and 80% for children.
Among all survivors, prostate cancer accounts for the highest number of diagnoses (44%) for male cancer survivors, followed by genitourinary cancers (12%) and colorectal cancer (11%). In female survivors, the most frequently diagnosed types are breast cancer (43%), gynaecological cancers (17%), and colorectal cancer (10%).
Effects
Cancer survivors may experience common late effects such as chronic fatigue syndrome, pain, difficulty with physical function, hormonal imbalances, infertility, and radiation-induced secondary cancers. Long-term health conditions that may arise include increased incidence of chronic diseases involving the heart (heart attacks, heart failure, etc.), kidneys, blood dyscrasias, diabetes, etc.
Psychological late effects (depression, anxiety, and stress) and cognitive effects (changes in thinking, memory, and concentration) may also be evident. These effects can impact various aspects of life, such as physical, mental, and reproductive health as well as one’s social and interpersonal relationships. Hence, it is important for cancer survivors to be informed about these potential long-term effects and to have access to appropriate support and care.
Tackling the effects
The goals of cancer survivorship care include promoting physical and emotional well-being, reducing the risk of late effects, and providing ongoing monitoring for the potential recurrence of cancer or the occurrence of secondary cancers. The following can help manage the late effects of cancer:
1. Lifestyle changes: Maintaining a healthy lifestyle through regular physical activity, a balanced diet, and stress management techniques such as yoga, meditation, and counselling can help mitigate the impact of late effects and improve both physical and mental well-being.
2. Education: Learnings of the cancer survivor, family, and caregivers regarding future health risks and the need for continued surveillance is vital.
3. Rehabilitation and exercise programs: Participation in rehabilitation and exercise programmes can help to improve physical function and address late effects such as fatigue, weakness, and pain.
4. Support groups: Joining a support group of other cancer survivors can provide a source of emotional support and help cancer survivors connect with others who have similar experiences.
5. Communication with the doctor: It is very important for cancer survivors to be in touch with the treating oncology team and communicate openly about any ongoing symptoms or concerns, and discuss any questions or concerns about late effects.
6. Research: Directed towards understanding, preventing, and treating long-term adverse effects of cancer or its treatment should be followed.
7. Regular follow-ups: Having regular check-ups is the key to staying informed about one’s health. By monitoring health status as suggested, cancer survivors can keep track of their well-being, catch any issues early, and receive the right treatment and support as needed. In addition, they can read up about the possible late effects of cancer treatment and the ways to manage them and discuss them with the doctor for solutions.
8. Regulatory support /advocacy: Addressing issues related to disability/ discrimination in employment/insurance, etc., is also a vital aspect of cancer survivorship as it enables the individual to lead an active, financially viable, and productive life.
The writer is a consultant - in medical oncology at Manipal Hospital, Old Airport Road)