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A new analysis of a large survey showed that many primary care providers (PCPs) are not familiar with the long-term side effects of four types of chemotherapy commonly used to treat breast and colorectal cancers. It is important for cancer survivors to have lifelong follow-up care to watch for long-term side effects (also called late effects), and survivors often visit PCPs for ongoing follow-up care after cancer treatment ends. This study highlights the importance of communication between oncologists, PCPs, and cancer survivors to make sure survivors receive appropriate follow-up care and treatment for any long-term side effects.
Previous results from this survey, called the Survey of Physician Attitudes Regarding the Care of Cancer Survivors (SPARCCS), showed that many PCPs feel that they do not have the general knowledge and confidence to care for cancer survivors. In the new analysis of this survey, researchers focused on the PCPs awareness of common late effects of treatment, including heart problems, peripheral neuropathy (nerve problems), early menopause, and second cancers, for four commonly used breast and colorectal cancer drugs.
Researchers found that among the PCPs surveyed, 55% knew that heart problems are a late effect of doxorubicin (Adriamycin). Furthermore, about 27% knew that peripheral neuropathy is a late effect of paclitaxel (Taxol), and about 22% knew that peripheral neuropathy is a long-term side effect of oxaliplatin (Eloxatin). For cyclophosphamide (Cytoxan, Neosar), about 15% of PCPs knew that early menopause is a late effect, and about 17% knew that second cancers are a risk. For the oncologists surveyed, knowledge of the late effects ranged from 62% to 97% for the four drugs.
What this means for patients
"While we strongly encourage patients to be aware of the treatments they receive and their side effects, it is vitally important that oncologists relay this information to patients' primary care providers so their risks can be appropriately managed throughout their lives," said lead author Larissa Nekhlyudov, MD, MPH, Assistant Professor of Population Medicine at Harvard Medical School and internist at Harvard Vanguard Medical Associates in Boston, Massachusetts. “At the same time, our findings highlight the need for ongoing education among all physicians who care for cancer survivors, including oncologists, about the potential late effects of treatment.” Talk with your doctor during and after treatment about creating a summary of the treatment you received, the possible long-term side effects, and the recommendations for follow-up care.
What to ask the doctor
- What type and stage of cancer did I have?
- What treatments did I receive?
- What are the long-term side effects from treatment?
- Who will be coordinating and managing my follow-up care?
- Could you provide a written treatment summary?
- How can any late effects be managed?
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