Health Journalism 2008: Life after cancer – Survivorship planning

By Shatto Light
ASIA, the Journal of Culture and Commerce

Medical journalists continue covering cancer – in any form – from research, to personal stories, to prevention, but this year's conference allotted a session on survivorship that can be easily overlooked as one of the important segments on the life of cancer patients and their families.

Panelists Aziza Shad, M.D., Georgetown University Hospital; Kenneth Miller, M.D., Yale Comprehensive Cancer Center; Priscilla A. Furth, M.D., Lombardi Comprehensive Cancer Center; and Rana Kahl, a cancer survivor advocate with Susan G. Komen for the Cure, talked about survivorship planning as an essential way of combating the disease.

Shad, an expert on childhood cancer survivors and their families, emphasized the need for follow-up care for pediatric cancer survivors.

"The mission of the long-term follow-up program," Shad said, "is to follow survivors carefully for the late effects, to educate the patients about their cancer and its treatment, to provide education on risk taking behaviors, healthy lifestyle, fertility, employment and health insurance issues and to transition them to adult programs as they grow older."

Shad collaborated with colleagues from Georgetown University Hospital and published a book, "The Next Step, Crossing the Bridge to Survivorship." The book tells stories of children and their families, how to survive and face their biggest challenges and cross the bridge towards a brighter tomorrow.

Miller, a medical oncologist, is a survivor himself. His wife, Joan, was diagnosed with acute leukemia and recovered. He shared pictures of his patients and summarized his talk with quotes from them about decision making:

"Making decisions about my own treatment helped me to maintain my self-identity, individuality and sense of self worth," he read. Another patient's experience: "The process of healing, during the after illness, is physically emotional, social and spiritual. My life turned upside down after the diagnosis. The decision-making process helped me which transforms a sense of disorder into one of order." Miller ended with another quote, "Some of the choices that I made have less to do with medical science or to do with my personal preferences. I did not choose to get cancer but I did help choose how to recover." Miller recently published a book, "Choices in Breast Cancer Treatment," a compilation of stories of women and the choices they made.

Furth, professor of oncology at Lombardi Comprehensive Cancer Center, on the other hand, concentrated her talk on one aspect of survivorship, which is yet to be widely acknowledged as part of treatment of cancer: the role of physical fitness.

"Breast cancer, the post-menopausal breast, and colon cancer are two cancers in which there has been some progress with drugs and it has been shown that physical exercise or fitness can actually prevent the cancers," Furth said. Each patient can have recommendations based on his or her needs which can be beneficial and can involve the family.

"What I would I finish with?" asked Furth. "I want to increase the recognition that physical fitness and activity should be part of normal cancer survivor practice. We need to do some research to look at the cause and effectiveness. We would like to know more mechanism, as evidence of stage medicine. We would like to work out some optimal program and most importantly is the cost coverage." This then, Furth said, can convince insurance companies that the program is part of the coverage.

Finally, panelist Kahl, is a cancer survivor advocate. Diagnosed with breast cancer on her 33rd birthday, the young mother's experience was not a traditional breast cancer experience. After chemotherapy, she was able to have children, was able to breast feed and is constantly being monitored for early menopause. For Kahl, information should always be available for patients with unusual situations.

"From a cancer survivor's perspective," Kahl said, "the journey is very overwhelming. I think it is absolutely imperative that there is some type of road map that is available for cancer survivors as newly diagnosed to navigate different options. Finally, when you are in the business of saving your life, the last think you worry about is ‘can I return to my normal physical fitness regiment?' Even though after you get through that part, that becomes the most important thing you go to, to become 'normal.'"