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Cancer survivorship brings its own set of issues

While more Americans are being diagnosed with cancer now, more patients are being cured or living chronically with the disease. This week on WRVO's health and wellness show "Take care,” hosts Lorraine Rapp and Linda Lowen speak with Dr. Patricia Ganz, an oncologist and co-founder of the national coalition for cancer survivorship. Dr. Ganz discusses the many health issues that cancer survivors face, and how the medical community is working to address them.

Lorraine Rapp: When we use the term survivor, who are we talking about? Who is included in that group?

Dr. Patricia Ganz: Well, it’s very complicated. The definition that the National Coalition for Cancer Survivorship came up with was that one is a cancer survivor going on the journey of survivorship from the time of diagnosis until death, that it wasn’t just focused on the post-treatment survivor. And it was also supposed to include the families. Historically if you think about the diagnosis of cancer, survivors were the ones that were left behind. As Harold Benjamin would say, “we’re not victims, we’re victors.” So this war language isn’t the best, but we have a war on cancer and survivors are people who have come out the other end.

Lorraine Rapp: What are some of the most prominent issues facing survivors? I’m talking about the people who just finished treatment and their next appointment is in six months or a year.

Dr. Ganz: You know, about 80 to 90 percent of people going through chemotherapy-radiation combination treatments have very significant fatigue during the treatment. For many people, it gets gradually better over the year following the treatment, but for some people it persists, and it’s very debilitating. It interferes with their ability to do their everyday activities, whether it’s around the house or going back to work. There are other individuals who may have a depressed mood. They’re dealing with the reality of the fact that they’re always going to have to worry about the cancer coming back. Another issue is cognitive dysfunction, sometimes called chemo brain. It’s not just associated with chemo, but it can be associated with other treatments as well. There can be sexual dysfunction. Individuals, men or women, may have treatments that directly affect the pelvic organs and may lead to sexual difficulties such as prostate cancer or cervical or uterine cancer. But even just having chemotherapy and radiation and other treatments may be causing difficulty with resuming a normal sex life.

Linda Lowen: Now for the person that is a long term survivor, maybe this discussion prompts a few feelings that they haven’t dealt with. How do you find help with these issues?

Dr. Ganz: The system is going to be bursting at the seams with new cancer diagnoses. And I think we’re going to be going into a new transitional period, where once patients, particularly those with low risk diseases, they’re not going to be able to be followed forever in the cancer care system—there’s not going to be room for everyone. And so we’re looking for ways to coordinate and collaborate with primary care practices to ensure that cancer patients have long term follow up by physicians, who are actually quite skilled at taking care of depression, fatigue and a lot of other symptoms because they see it in their primary care practices. So we’re going through that transition not because we’re trying to save money, but because it’s the right thing to do. Otherwise we ignore the diabetes and the heart disease and other things that people are ultimately going to die from because they’re not going to die from the cancer.

More of this interview can be heard on "Take Care,” WRVO’s health and wellness show
Sunday evening at 6:30 p.m.  Support for this story comes from the Health Foundation for Western and Central New York.