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Challenges in the Care of Cancer Survivors

We asked our Current Oncology Section Editors how they would define the term “life after cancer” and how that theme presents itself in their chosen fields.  Below is a response from  Dr. Thierry Alcindor, Assistant Professor, Departments of Oncology and Medicine, McGill University Faculty of Medicine.

The outcome of several cancers has improved over the past few decades, owing to advances in surgery, chemotherapy, radiotherapy and palliative care. Therefore, taking care of the surviving victim of cancer has now become an integral part of oncology.

The care of these survivors is challenging in many ways :

Patients have to cope with the uncertainty of the future. We oncologists are rarely in a situation to tell them : “You are cured, don’t come back here”.  As reassuring as a 75% cure rate can be, for health professionals in charge of some cancers like Stage III colon cancer the 25% risk of relapse (and death, usually) represents a fearsome statistical number that will haunt the thoughts of many patients. Some cancer survivors do not enjoy their lives but just survive, from the results of one scan to the results of the next one.

Late-term toxicity of anti-cancer therapy should not be overlooked. Although it is an issue best known to pediatric hematologists/oncologists, it is increasingly recognized as an important outcome in the adult population, especially after treatment for good-prognosis cancers. Late-term toxicity of chemotherapy is an incentive for discovery of safer drugs. Ideally, newer drugs should be both safe and effective.

Personalized medicine makes us hope that we will reduce both the risk for relapse and for late toxic effects, as we will choose our drugs on the basis of the genetic makeup of the disease and of the patient.

 

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