During active treatment, a person’s focus is often completely on the cancer: getting rid of it, managing side effects, getting better. The future may feel uncertain, and it can be hard to think about the next step. And, many people may be looking forward to leaving the cancer behind, regaining a sense of normality in their lives, and getting a break from the challenges associated with treatment. Transitioning into survivorship, the period after treatment, can bring new, unexpected challenges, such as long-term side effects and continued medical care.
Doctors and researchers are examining the challenges patients experience after treatment to find ways to prepare for and manage them. Some of these issues are highlighted in 3 studies to be presented at this week’s Cancer Survivorship Symposium.
The importance of follow-up care
An important way for patients to manage challenges, such as long-term side effects, is to have continued follow-up care after cancer treatment. In one study, researchers found gaps in care for 354 adolescents and young adults who received treatment for Hodgkin lymphoma. Although, nearly all (96%) had the recommended oncology visits and 70% received the recommended lab tests within the first 5 years, about half did not receive all the recommended care within the first year after treatment.
“Patients treated for Hodgkin lymphoma are at high risk for recurrence and relapse, as well as serious long-term and late effects,” said lead study author Erin E. Hahn, PhD, MPH, a research scientist at Kaiser Permanente Southern California, Department of Research and Evaluation. “We need a systematic way to deliver post-treatment care, including screening for late effects of treatment.”
The cost of follow-up care
The second study addressed the challenges associated with the cost of follow-up care. Researchers found that breast cancer survivors with a low income were more likely to receive recommended survivorship care when they received personalized survivorship counseling and care plans.
“Cancer care does not end when treatment stops. Survivorship care plans are an important tool for keeping patients healthy in the long run, in terms of screening for second cancers and long-term side effects. Low-income patients face unique challenges in accessing this care,” said Merry-Jennifer Markham, MD, ASCO Spokesperson. “This study is an important step forward, demonstrating that personalized care plans in conjunction with one-on-one counseling on survivorship care planning can make a real difference for patients.”
Managing long-term side effects
In the final study to be highlighted at this week’s meeting, researchers found that 45% of women have symptoms of chemotherapy-induced peripheral neuropathy (CIPN) years after treatment ends. CIPN is a type of nerve damage caused by chemotherapy. It is linked with worse physical functioning, including changing patients’ walking patterns and causing more falls. According to study author Kerri M. Winters-Stone, PhD, a research professor at Oregon Health and Science University in Portland, there are currently no effective treatments, but “rehabilitative exercise programs may preserve physical functioning and mobility in the presence of neuropathy to help prevent falls and resulting injuries.”