Beyond Treatment: Anticipating the Late Effects of Cancer Treatment in Survivors

Beyond Treatment: Anticipating the Late Effects of Cancer Treatment in Survivors
Beyond Treatment: Anticipating the Late Effects of Cancer Treatment in Survivors

ORLANDO, Fla.—Side effects are experienced by many cancer survivors as a result of their cancer treatment. Some effects are defined as long-term, and some are defined as late. Although the 2 types are difficult to distinguish, their distinction is both clear and important, according to a presentation at the 2nd Annual Oncology Nurse Advisor Navigation Summit.1

Both early diagnosis and treatment advances are improving outcomes for patients with cancer, and the number of survivors is increasing. In 1971, 1.5% of the US population (approximately 3 million people) are cancer survivors; that increased to 3% (11 million people) in 2006. Furthermore, the number of people living with a cancer history is expected to continue to increase. A higher incidence of cancer treatment-related late effects is a byproduct of that increase. Navigators need to know what to expect and how to manage these effects in their patients who are cancer survivors.

Among the changes in oncology care is an evolving definition of survivorship. Traditionally, survivor was defined as 5 years after diagnosis. A more recent definition places survivorship as beginning at completion of the first phase of treatment. An even more current interpretation defines survivorship as beginning at diagnosis: A patient with cancer becomes a survivor at diagnosis, and remains so through all phases of treatment and until the end of life, explained Peter Bjerkerot, RN, OCN, an oncology nurse and nurse consultant in based in Atlanta, Georgia.

Long term refers to effects that persist for an extended period after cancer treatment is completed, up to as long as 5 years. Late refers to effects that may not be present during active treatment but instead appear months or years later.

Survivors' care needs can vary in intensity, and there are too many individual-specific effects to cover in 1 discussion, and each side effect is a discussion in and of itself. For this reason, Bjerkerot focused his talk on cardiotoxic and pulmonary effects, endocrine system effects, secondary cancers, and the more recently recognized, cognitive effects and posttraumatic stress disorder (PTSD).  

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