EXPERT VOICES

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The American Cancer Society

Survivorship (23 posts)  RSS

Palliative care is part of good cancer care

February 16, 2015

By Diane E. Meier, M.D., FACP

Deborah, a 36-year-old mother of two young children, was diagnosed with breast cancer 2 years ago, and the disease has metastasized (spread) to her bones. The pain is severe, making it hard to care for her children or get to work.

Like any young mother, Deborah is determined to fight her cancer and be present for her son and daughter as they grow up. Deborah's oncologists, doctors at the top of their field, are intensely focused on controlling her cancer and identifying the chemotherapy plans that are most likely to work for her. But they have been unable to manage Deborah's pain. It had become so bad that she was unable to sleep or eat, spending much of the day curled on her side in bed. She missed a course of chemotherapy because of her pain, and she had to hire outside help to get her kids to and from school.

Deborah's long-time internist finally referred her to the palliative care team at her local hospital. They prescribed a low-dose opioid medicine and within 2 days, Deborah's pain was well controlled, she was up and around, sleeping and eating, and back to normal life with her family. She has been able to complete her latest course of chemotherapy and her oncologist feels her scans are showing a good response to the treatment.

Deborah's story is not unique. She is one of many thousands of people with cancer who have benefitted from palliative care, so that she can enjoy some normal day-to-day function and quality of life while she fights cancer. 

Palliative care for any stage of disease

 

Palliative care, sometimes called "supportive care," is medical treatment for people with serious illness. It's most often begun by the cancer care team, and referrals to or visits with palliative care specialists may happen later. Teams of palliative care specialists typically include doctors, nurses, social workers, and other healthcare professionals who work together with the patient, their family, and their other doctors to provide an added layer of support. The team works with the patient to provide relief from the pain and other symptoms, as well as the distress of their illness, so that the patient can live as well as possible. More...

Chemo 101: What you need to know

January 12, 2015

By Agnes Beasley, MSN, RN, OCN

"What should I expect from chemotherapy?" 

I've heard those very words spoken by newly diagnosed cancer patients on many occasions in my extensive oncology nursing career. It's normal for a newly diagnosed patient to try to make sense of what is happening to them. Questions swirl like a tornado in a cancer patient's mind. You may feel that way right now. Some of the questions you may have are:

  • What can I expect on the day of chemotherapy (chemo)?
  • What can I expect when I go home after chemo?
  • What happens in the "chemo room?"
  • How long will it take to get my chemo?
  • Can I have someone with me during chemo to keep me company?
  • What am I allowed to bring with me to keep me busy?
  • Is it okay to sleep?
  • Will there be other people getting treatment around me or can I be in a private room?
  • I'm feeling anxious, overwhelmed, upset, and angry. Is what I'm feeling normal?
  • If I have questions, who do I call for the answers? More...

Filed Under:

Survivorship

Continuing to smoke after a cancer diagnosis

November 17, 2014

By J. Lee Westmaas, PhD


While the American Cancer Society and other organizations traditionally focus on getting smokers to quit before they develop cancer, there's a group of smokers who are especially susceptible to the negative effects of smoking. They are cancer survivors - some of whom have been diagnosed with a smoking-related cancer. It's easy to say, "If you get cancer, then you should know better and quit, and stay quit," but that's not the whole story.

Getting a cancer diagnosis does motivate some smokers to quit. Using data from the American Cancer Society Cancer Prevention Study-II, we found that about 1 out of 3 smokers quit smoking when they were diagnosed with cancer. That compares with only 1 out of 5 smokers who quit but were not diagnosed with cancer during the same time periods studied.

Even smokers whose cancer was not strongly linked to smoking (like breast cancer) quit at higher rates than undiagnosed smokers. These results were not caused by the smokers being unable to smoke due to their illness; those people were excluded from the study.

Smoking: Risky for patients and survivors

Quitting is particularly important for cancer patients and survivors because smoking can increase the likelihood of a recurrence, delay wound healing, and make cancer treatments less effective. This is true even for cancers that aren't related to smoking. 

Unfortunately, there are some cancer survivors who find it very hard to quit. We looked at data from the Study of Cancer Survivors (SCS-I), a nationwide quality-of-life study conducted by the Behavioral Research Center at the American Cancer Society. The study surveyed 2,938 survivors of 10 different kinds of cancers approximately 9 years after their initial diagnosis.

We found that 9.3% of these survivors were current smokers. Survivors of bladder, lung, and ovarian cancers had the highest smoking rates in this study. Most (83%) current smokers smoked daily, averaging almost 15 cigarettes per day. In fact, 40% percent of daily smokers smoked more than 15 cigarettes per day. More...

Tips for your first oncologist's appointment

October 13, 2014

By Francisca Alvarado, BSN, RN, OCN


The cancer journey brings about many overwhelming feelings. Many thoughts may go through your mind when you hear, "You have cancer and you need to be seen by an oncologist." You may wonder how this will impact you, your family, and your friends. The possible anxiety caused by wondering what the oncologist will tell you at the appointment and which decisions you will have to make may take over your thinking. You may have trouble listening, understanding, or remembering what anyone is telling you during this time due to the very normal distress, uncertainty, fear, and anger you may be feeling.

Having a better understanding of what to expect, what to take with you, and which questions to ask at your first oncologist's appointment may help you better prepare and lessen the anxiety. 

Get the logistics clear


Before your first appointment, make sure you know the answers to these questions. Although they seem obvious, it can be easy to overlook these details when you're worried about your diagnosis:

  • What is the full name of the oncologist I will be seeing?
  • Does the oncologist take my insurance? What will I be expected to pay on the first visit?
  • How will the oncologist get my medical records? Will the referring physician send them, or do I need a copy to take to the first appointment? If I need a copy, how can I get it?
  • How do I get to the oncology office?
  • Where do I park, and how much will I have to pay for parking?
  • How long will the first appointment take?

More...

Filed Under:

General | Survivorship

Adults Need Vaccines, Too

September 22, 2014

By William Schaffner, MD


As I like to tell my patients, the best approach to everyday health is a proactive one, and that means staying up-to-date on recommended vaccinations in addition to annual checkups.

Many adults don't visit a doctor unless they feel ill, nor do they think about vaccination as part of their routine, preventive healthcare. This leaves them needlessly vulnerable to diseases that can cause severe health complications or even death. 

Vaccines are a safe, effective way to help prevent a number of diseases at any age-from 6 months to 60 years, and beyond. In fact, there are several vaccines recommended specifically for adults because of their risk for certain infections.

It's important for all adults to check with a healthcare professional about which vaccines are recommended for them, as we all need some vaccinations as we age. For example, the chance of having complications from the flu, or getting shingles or pneumococcal disease (see below for more information) increases with age. In other cases, a weakened immune system or the presence of underlying illnesses like cancer, heart disease, or diabetes can make us more susceptible to diseases.

Many adult vaccines are readily available at primary care medical offices and in pharmacies, and the cost of vaccination is usually covered by Medicare and most private insurers. So, there are no excuses for not staying up-to-date!

Vaccines and the immune system


If you have a weakened immune system due to cancer or related treatment, there are vaccines you should receive - and some that you should not receive.

Vaccines come in two forms: inactivated or live. Inactivated vaccines only contain killed viruses or bacteria and can be used for those with compromised immune systems. Live vaccines, such as the flu nasal spray (but not the shot, which has inactivated virus) or shingles, contain weakened but live components. While this does not pose a risk for people with a healthy immune system, live vaccines are not recommended for people whose immune system is weakened by certain cancers, cancer treatment, or other factors. 

Cancers like leukemia, lymphoma, and Hodgkin disease interfere directly with the immune system. In most cases, however, it's not the cancer itself, but the cancer treatment, that changes the immune system. Some cancer treatments, such as radiation, certain chemotherapies, and transplantations, prevent your immune system from responding the way it should to infections. If you aren't sure whether your immune system is being affected, talk to your doctor or other healthcare professional before you or anyone you spend a lot of time with gets any vaccines. More...

Filed Under:

General | Survivorship

After Prostate Cancer Treatment Ends

September 11, 2014

By Rebecca Cowens-Alvarado, MPH


According to the American Cancer Society, there are nearly 3 million prostate cancer survivors in the United States today and this number is expected to increase to almost 4.2 million by 2024.  Most prostate cancers (93%) are diagnosed at the local or regional stage, before the cancer has spread to surrounding organs. Treatment at these early stages is often very successful, and the 5-year relative survival rate approaches 100%.

Treatments for prostate cancer patients vary based on age and stage of diagnosis, but the majority of prostate cancer patients younger than aged 65 are more likely to be treated with radiation, radical prostatectomy, or a combination of both. Some patients may also be treated with androgen deprivation therapy (ADT), while others may simply undergo active surveillance, or "watchful waiting," to see how the prostate cancer progresses before choosing a treatment option. While the survival rate for prostate cancer is high, being diagnosed and treated for prostate cancer may cause a number of physical, psychological, and social side effects that can last (or develop) long after treatment ends.

Common issues faced by prostate cancer survivors who underwent surgery or radiation include: difficulty having an erection and decreased interest in sex, which may impact sexual intimacy; needing to urinate quickly or not being able to control when they urinate; bowel problems such as not being able to control or having diarrhea; and distress or depression. Prostate cancer survivors who are on ADT may also experience lack of interest in sex, hot flushes, weakening of the bones (osteoporosis) and increased risk of heart attack or diabetes. And for those undergoing active surveillance or watchful waiting, the anxiety and distress from waiting for the results of frequent prostate-specific antigen (PSA) tests are very real. More...

Filed Under:

Prostate Cancer | Survivorship

How electronic health records can help on your cancer journey

August 20, 2014

By Simone Myrie

Ed. note: This guest post by Simone Myrie of the Office of Consumer eHealth, Office of the National Coordinator (ONC) for Health Information technology, US Department of Health and Human Services. In it, she explains how electronic health records and Blue Button can help cancer patients, survivors, and caregivers as they navigate their cancer journey.


No two experiences with cancer are alike, but there are certain things that almost all cancer patients and their loved ones share in common. From getting a diagnosis, to coordinating care among doctors and at home, and on to long-term survivorship plans, the cancer experience is one centered around information. Some of the information we seek is mostly objective: What can I expect this disease to do? What are my treatment options? How can I improve my odds of beating cancer?

But some of the most important information you can gather, keep track of and share is information unique to you: Your own health records. The visit summaries, clinical notes, test results, medication lists, treatment histories, and other documents represent a critical picture of your individual cancer experience. This information has implications for your individual choices, your professional care, and the care you receive from loved ones. More...

Filed Under:

General | Survivorship

Cancer Survivors: Make Changes for Long-term Health Gains

May 28, 2013

By Corinne Leach, MPH, MS, PhD

If you are a cancer survivor, whether you're currently in treatment or completed treatment long ago, you are far from alone. The estimated number of cancer survivors in the United States is currently 13.7 million and will continue to grow as our population gets older. By 2022, we expect there to be 18 million cancer survivors.

Cancer researchers are working hard to find cancers earlier, improve treatment, and decrease the negative side effects commonly associated with treatment, like fatigue, pain, lymphedema, and chemo brain. Many people come into the cancer experience with other chronic health conditions (e.g., diabetes, hypertension, arthritis), and many more develop additional conditions after their cancer treatment ends.

An important question is:  what can I do to stay as healthy as possible and feel as good as I can after cancer? The good news is that making changes in your lifestyle can make a difference in your long-term health. Here at the American Cancer Society we recently developed physical activity and healthy eating recommendations specifically for cancer survivors. But what do they mean for you? More...

Filed Under:

Survivorship

Holiday Eating Tips If You're in Cancer Treatment

December 03, 2012

By Michele Szafranski, MS, RD, CSO, LDN

 

We all have wonderful food memories associated with the holidays. Maybe it is a favorite dish made by a loved one or a special memory of decorating cookies with your grandchildren. But during cancer treatment, visions of sugar plums may bring anxiety. When you are having trouble eating or keeping food down, the thought of holiday gatherings and meals can fill you with dread. There are a few things to keep in mind that might be help you get through these occasions with reduced stress.


Celebrating doesn't have to be stressful

What can you do to make a holiday gathering less stressful? First, don't be afraid to tell people you aren't up to your usual celebration. Delegate if you are hosting the party. People always want to know what they can do, so give them specific dishes or tasks to take some of the pressure off.  If you have a dish you are known for, focus your energy on that one dish and let others take care of the rest. If you aren't up to cooking, pass the beloved recipe to a friend or loved one for them to try.  Offer to bring drinks, paper goods, or the centerpiece for the holiday table. To avoid the hassle of a big entrance, arrive early and find a quiet spot to sit if you need to escape from the hustle and bustle of the kitchen.

When it comes to the food, here are tips to help you find what and how much you can eat: More...

Filed Under:

Caregiving | Survivorship

Weight Gain during Cancer Treatment

July 05, 2012

By Michele Szfranski, MS, RD, CSO, LDN

 

When I talk with people who have gained weight during their cancer treatment, they are often shocked. For people who lost considerable weight before their diagnosis and then felt better once their treatment started, weight gain can be a welcome change. But more often I speak with people who were at a healthy weight or overweight before treatment and did not realize that their treatment might cause some weight gain. More...

Filed Under:

Survivorship

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