More than 11 million Americans have a history of cancer, and nearly 15 percent of cancer survivors alive today were diagnosed more than 20 years ago. While most of them enjoy a disease-free life, some patients experience treatment side effects that impair their physical and emotional recovery.
Addressing medical and quality-of-life issues for cancer survivors and their families has been a long-standing focus of medical oncologist Patricia A. Ganz, M.D., director of Prevention and Control Research and the UCLA-LIVESTRONG Survivorship Center of Excellence at UCLA’s Jonsson Comprehensive Cancer Center.
Dr. Ganz, who recently received the American Cancer Society’s Medal of Honor for her work in cancer prevention, control and survivorship, discusses the most important things survivors should know about life after cancer.
Why is it important for cancer patients, their families and their physicians to understand and address cancer-survivorship issues?
A cancer diagnosis can be overwhelming, and many patients only focus on the potential for recurrence of cancer, despite facing late and long-term side effects of treatment or being at risk for other diseases and chronic illnesses. These issues can negatively impact survivors’ quality of life and, in many cases, create other health problems that lead to premature death from other causes.
For example, radiation can damage coronary arteries, so we need to aggressively manage blood pressure, cholesterol and diabetes and encourage patients to manage their weight in order to prevent them from developing accelerated heart disease. We can also treat sexual dysfunction associated with treatment for cancers near the pelvis (cervical, uterine, bladder, prostate), reduce the risk for osteoporosis and address early onset menopause and infertility in female cancer survivors.
Depression and fatigue can also be problematic. Patients don’t have to just grin and bear it. There are ways to manage symptoms that persist. We want to make sure patients and their doctors are aware of that.
What is the most important thing cancer survivors can do to promote their long-term health and well-being?
They should ask for a cancer-survivorship care plan, which summarizes their treatment history and provides a recommendation for future care, such as when and by whom follow-up tests will be performed. At present, this is not a standard part of care and, as a result, there is a lot of confusion and waste. Some patients may see 10 to 15 doctors in the year after their cancer diagnosis when they really only need to see one or two. Our hope is that as electronic health records and other healthcare-reform initiatives become more widely implemented, coordinating care for cancer survivors will be easier and more efficient. For now, programs like ours are filling the gap.
How has being named a UCLA-LIVESTRONG Survivorship Center of Excellence aided your efforts to help cancer survivors?
We have a very rich research environment in the JCCC, with 20 faculty members who participate in our cancer-survivorship research program. Support from the Lance Armstrong Foundation beginning in 2006, however, enabled us to establish a formal clinical program to meet the physical and psychosocial needs of cancer survivors and to increase awareness of and access to our program through the development of community partnerships.
How do patients access the cancer-survivorship program at UCLA?
We have collaborated with the UCLA Medical Group to identify patients who have been treated for breast, colon and prostate cancers and invited those patients to our center for consultation. We also receive referrals from community oncologists and primary care physicians, and self-referrals from patients who have heard about our program. Additionally, because so many patients are survivors of childhood cancers, we have also established a clinic to transition patients from pediatric to adult care.
For more information about the UCLA-LIVESTRONG Survivorship Center of Excellence, go to: www.cancer.ucla.edu/survivorshipcenter.