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Changes needed in cancer care system to take care of survivors

Spectrum Health

While someone may successfully fight off a cancer diagnosis, the battle usually doesn’t end there. Cancer survivorship brings with it a number of different issues that may inhibit a person’s ability to return back to a normal life.

This week on Take Care, Dr. Patricia Ganz discusses issues surrounding cancer survivorship. Dr. Ganz is a medical oncologist and director of the UCLA Livestrong Cancer Survivorship Center of Excellence, is on the faculty at the UCLA School of Medicine, and was a co-founder of the National Coalition for Cancer Survivorship.

Click 'Read More' to hear our interview with Dr. Ganz.

While the definition of a cancer survivor may vary, Ganz says, “that one is a cancer survivor going on the journey of survivorship from the time of diagnosis until death.”

With cancer treatment getting better and better, fewer people are dying from cancer, meaning the number of survivors has increased significantly in recent years. While survivors often pride themselves in winning the fight against cancer, a number of issues can still plague them. Some of the most common include:

  • Fatigue: Ganz says between 80 and 90 percent of patients going through chemotherapy and radiation suffer from significant fatigue. While this fatigue usually gets better with time, it persists in some survivors. “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,” says Ganz.
  • Depression: This may occur for a number of reasons, the most common being that patients are “dealing with the reality of the fact that they’re always going to have to worry about the cancer coming back,” says Dr. Ganz. Issues such as death and mortality become a bigger deal for survivors, and they may not have a support system to talk to about it.
  • Chemo brain: This is a type of cognitive impairment that can occur after chemotherapy treatment. Symptoms include impairment of memory, attention and motor coordination.
  • Sexual dysfunction: An issue not commonly addressed with doctors, says Ganz. “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.”
  • Guilt: Some survivors report feeling guilt that they survived their cancer while friends and peers may have not.

With a significant number of baby boomers soon turning 65, Ganz believes cancer diagnoses are going to spikein the next couple of years. With more people dealing with cancer, she believes a change needs to be made to the cancer care system in order to make sure survivors are still getting the care they need post-cancer treatment.

“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,” says Ganz.

Educating primary care physicians on the symptoms affecting cancer survivors may help ensure that not only is everyone getting a sufficient amount of care, but that certain issues are not being overlooked.

“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,” says Ganz.

Additional online resources for survivors:

-- Livestrong Centers for Excellence & Livestrong Care Plan

-- Journey Forward

-- cancer.net