More surviving cancer -- and facing downside

Jim Ritter, "More surviving cancer -- and facing downside", Chicago-Sun
Times, February 20, 2006,
Link: http://www.suntimes.com/output/news/cst-nws-cancer20.html

It was front page news when the American Cancer Society recently
reported the first-ever decline in cancer deaths.

But the news was more sobering for the 10 million Americans who have
survived cancer. Many face debilitating long-term effects of their
treatments, ranging from amputation and disfigurement to sterility,
heart failure and depression.

"Mortality rates may have improved, but the way people live
post-treatment has not dramatically improved," said two-time cancer
survivor Ellen Stovall, president of the National Coalition for Cancer
Survivorship.

Ora Jordan of South Holland survived breast cancer in 2000. But while
her cancer is in remission, she continues to experience treatment
effects. For example, nerve damage in her hands and feet leaves her
less sensitive to heat and cold and more vulnerable to frostbite.

Jordan also suffers from arthritis, constipation and digestive
disorders, which she says may be related to her treatments.

"I thought once I was done with my treatment, I would be good to go,"
she said. "That's not what happened."

Jordan said her doctors made little effort to prepare her, other than
giving her a *** of paper listing possible effects of radiation and
chemotherapy.

"We're lacking in education," she said. "Your life after breast cancer
is a different life."

'Survivorship care plan' urged

There were 369 fewer cancer deaths in the United States in 2003 than in
2002, the most recent years for which statistics are available. It was
the first time since record-keeping began in 1930 that the number of
deaths decreased.

But more people are getting cancer because the population is increasing
and baby boomers are aging. The number of survivors has more than
tripled since 1974.

Defined broadly, a cancer survivor is anyone who has been diagnosed
with cancer. Three types of cancers -- breast, prostate and colorectal
-- account for about half of all survivors.

Sixty-one percent of cancer survivors are older than 65. More than a
third are of working age, and 5 percent are in their prime childbearing
years. One percent are under age 20.

Last fall, a comprehensive report from the Institute of Medicine
detailed shortfalls in survivors' care. In its key recommendation, the
institute proposed that every cancer patient receive a "survivorship
care plan."

Such a plan, for adult survivors of childhood cancers, already is in
place at Northwestern Memorial Hospital and Northwestern University.
It's called STAR (Survivors Taking Action and Responsibility). Patients
are seen at least once a year to monitor effects of past treatments and
referred to specialists when necessary. Northwestern is considering a
similar clinic for survivors of adult cancers.

Memory deficit: 'chemobrain'

Cancer survivors, of course, are grateful to be alive. Many feel proud
to have survived their disease, and they have a greater appreciation of
life. But there are many physical and emotional downsides. Consider,
for example, a few of the possible long-term effects of treating breast
cancer:

Radiation increases the risk of a secondary cancer in exposed areas
such as the thorax and shoulder. Some chemo drugs can increase the risk
of leukemia. Tamoxifen, a drug given to women with a certain type of
tumor, can increase the risk of endometrial cancer, strokes and blood
clots.

Chemotherapy also can cause premature menopause, weight gain, heart
disease, osteoporosis and fatigue lasting as long as five years. Some
women also suffer deficits in memory, concentration and executive
functioning. It's called "chemobrain."

jritter@xxxxxxxxxxxx

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