A Look at the Challenges of Life After Cancer
SAN DIEGO (KUSI) – For many of the 14 million people in the United States alive today who have overcome cancer, the battle with the disease itself may be over, but the challenges of cancer survivorship can go on for years.
By 2022, the United States will have 18 million cancer survivors and during the next 25 years the number of cancer survivors is expected to continue to significantly increase.
A 2005 study of cancer survivors by the Institute of Medicine (IOM) found that both cancer and its successful treatment can take a substantial physical and psychological toll.
More than 30 percent of cancer survivors typically rated their health as either fair or poor, compared to just 18 percent of patients in the general population who rated the same. This significant difference illustrates the need for improved care and services for survivors.
For many, cancer has become a chronic condition that is managed, rather than a terminal illness. In addition, through support groups, social media and other networks, cancer survivors have become a cohesive group that is helping to drive the movement for improved care.
“While survivors may feel fortunate to have won the cancer battle, moving on with their lives can be challenging,” said David C. Leopold M.D., who specializes in integrative medicine at Scripps Health. “As might be expected, one of the most common concerns among cancer survivors is recurrence.”
Along with fear that the cancer may return, survivors may experience anxiety, depression, uncertainty and changes in the way they approach their families, relationships, jobs and lifestyles. For some, the possibility of recurrence is incorporated into every decision they make.
Twenty-five percent of cancer survivors report problems with interpersonal relationships. They may feel disconnected from their partners, friends, and family, who usually have not had the same experiences of cancer diagnosis and treatment.
Survivors may find themselves re-examining personal relationships and professional goals. Sexual dysfunction, often due to physical changes resulting from surgery or treatment, can cause additional strain.
At least half of survivors complain of fatigue, which may persist for months and often years after treatment. Much more than simply feeling tired, this extreme fatigue permeates every area of their lives.
It can affect personal relationships, interfere with caring for their families or themselves, impede work or school and prevent people from enjoying their lives the way they did before cancer.
Unlike fatigue that can be traced to a physical cause such as anemia, post-cancer fatigue can be very difficult to address. Similarly, some patients describe a feeling of lasting malaise or “just not feeling well” that is challenging to quantify or treat.
Recent studies are beginning to shed light on why so many cancer survivors have fatigue, but optimal treatment options are still not entirely clear.
One-third of cancer survivors complain of lingering pain, such as nerve pain possibly associated with chemotherapy, pain after surgery, or pain from unknown causes. As with fatigue, this can be difficult to treat if the cause is unknown.
The good news is we are beginning to understand more of how and why these symptoms occur, though adequate treatments still may be difficult. Exercise has been shown to be beneficial in relieving post-treatment fatigue and many patients find some relief for fatigue and pain with interventions such as acupuncture, meditation, tai chi and yoga.
All of these issues call for more research into how these patients can be helped, especially as their numbers increase. It is clear that a multifaceted, highly targeted approach is needed to effectively deal with the residual effects from cancer treatment.
This strategy should not only include standard and integrative medical care, but address psychological care, lifestyle mediation, stress management, relationships and spirituality. Cancer survivors who experience medical or emotional issues should consult with a physician or therapist to explore what options may be available.
For more information, visit scripps.org/KUSI or call 858-240-5075.