Breast cancer patients suffer treatment-related side effects long after completing care
More than 60 percent of breast cancer survivors report at least one treatment-related complication even six years after their diagnosis, according to a new study led by a researcher from the Perelman School of Medicine at the University of Pennsylvania. The findings are part of a special issue of Cancer devoted to exploring the physical late effects of breast cancer treatment and creating strategies to prevent, monitor for, and treat these conditions in the nation's 2.6 million survivors of the disease.
"Our work provides the first accounting of the true magnitude of the post-treatment problems suffered by breast cancer patients, and serves as a call to action for proper monitoring and rehabilitation services to care for them," said Kathryn Schmitz, PhD, MPH, an associate professor of Biostatistics and Epidemiology who serves as a senior scientist on the committee overseeing creation of a surveillance model for breast cancer survivors. "We can no longer pretend that the side effects of breast cancer treatment end after patients finish active treatment. The scope of these complications is shocking and upsetting, but a ready solution for many of them already exists in rehabilitative exercise."
Schmitz, a member of Penn's Abramson Cancer Center, points out that previous studies to determine the prevalence of post-treatment complications typically examined just one issue. The new findings, instead, provide a full snapshot of the complications women may experience following the chemotherapy, surgery, radiation treatment and hormonal therapy to cure their disease and keep it from returning. The results reveal that these problems rarely exist in isolation: Many women with the painful limb-swelling condition lymphedema, for instance, may also struggle with fatigue and bone health challenges.
Schmitz collaborated with an Australian research team to follow 287 Australian women with invasive, unilateral breast cancer for a median of 6.6 years, prospectively assessing the women for treatment-related physical and functional complications at set points throughout the study. Areas of study included postsurgical complications, skin reactions to radiation therapy, upper-body symptoms and functional limitations, lymphedema, weight gain, and fatigue. Sixty percent of the women were still experiencing one of these problems at six years after their diagnosis, and 30 percent were still struggling with at least two issues. Most of the problems appeared within the first year patients were assessed, but the prevalence of most impairments except lymphedema and weight gain -- decreased over the course of the study.
Writing in the lead editorial of the special issue of Cancer, Schmitz and her colleagues outline the myriad barriers that lay in the way of properly monitoring breast cancer survivors for the problems uncovered in the new study. Patients may have fragmented care, receiving different prongs of their treatment at different hospitals; patients and providers may believe certain problems are "expected" and "normal" and not appropriate for treatment; and unlike orthopedists and cardiologists who frequently send patients for physical rehabilitation to ensure their complete recovery, oncologists and surgeons are often poorly linked to physical therapy professionals, limiting the number of patients who are aware of or referred for these services.
In the face of these challenges, an expert panel laid out a model for prospectively surveying breast cancer survivors and formally incorporating rehabilitation and exercise experts into cancer survivorship programs. Research increasingly shows that post-treatment complications can be minimized and even prevented altogether when caught early and addressed through various rehabilitation regimens. "When early signs of impairment are noted and that impairment has a high probability of worsening if allowed to progress, which ultimately may result in a worse, permanent disability, there is an ethical obligation to treat the condition," they write.
The question of how best to implement the proposed rehabilitation and surveillance remains to be addressed. The panel plans to work through the American Cancer Society with stakeholder groups to answer questions about how to educate patients and clinicians about the plan and fully implement it. The American College of Surgeons Commission on Cancer has published guidelines that will require that all accredited cancer treatment centers provide treatment summaries and survivorship health care plans to all their patients by 2015. The proposed surveillance and rehabilitation model could serve as a framework for meeting those pending guidelines. "In the meantime," Schmitz says, "breast cancer survivors should be empowered to ask their doctor for a referral to physical therapy and exercise programs."
Provided by University of Pennsylvania School of Medicine
- Breast cancer survivors struggle with cognitive problems several years after treatment Dec 12, 2011 | not rated yet | 0
- Prospective surveillance model emerges as standard of care for breast cancer treatment Jan 06, 2012 | not rated yet | 0
- Obesity increases lymphedema risk for breast cancer survivors Dec 18, 2008 | not rated yet | 0
- New cancer guidelines: Exercise during and after treatment is now encouraged Jun 01, 2010 | not rated yet | 0
- Breast cancer survivors often rate post-treatment breast appearance only 'fair' Nov 02, 2010 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Pressure-volume curve: Elastic Recoil Pressure don't make sense
May 18, 2013 From pressure-volume curve of the lung and chest wall (attached photo), I don't understand why would the elastic recoil pressure of the lung is...
If you became brain-dead, would you want them to pull the plug?
May 17, 2013 I'd want the rest of me to stay alive. Sure it's a lousy way to live but it beats being all-the-way dead. Maybe if I make it 20 years they'll...
MRI bill question
May 15, 2013 Dear PFers, The hospital gave us a $12k bill for one MRI (head with contrast). The people I talked to at the hospital tell me that they do not...
Ratio of Hydrogen of Oxygen in Dessicated Animal Protein
May 13, 2013 As an experiment, for the past few months I've been consuming at least one portion of Jell-O or unflavored Knox gelatin per day. I'm 64, in very...
Alcohol and acetaminophen
May 13, 2013 Edit: sorry for the typo in the title , can't edit I looked around on google quite a bit and it's very hard to find precise information on the...
Marie Curie's leukemia
May 13, 2013 Does anyone know what might be the cause of Marie Curie's cancer
- More from Physics Forums - Medical Sciences
More news stories
In a new study described in the journal Oncogene, researchers reveal how a key player in cell growth, immunity and the inflammatory response can be transformed into a primary contributor to tumor growth.
Cancer 3 hours ago | not rated yet | 0 |
A new study conducted using extensive medical records of over one million Israeli adolescents before military service shows clearly how exposure to the Israeli sun of young, light-skinned children increases substantially ...
Cancer 5 hours ago | not rated yet | 0
A new measure of the heterogeneity – the variety of genetic mutations – of cells within a tumor appears to predict treatment outcomes of patients with the most common type of head and neck cancer. In the May 20 issue ...
Cancer 9 hours ago | not rated yet | 0
Researchers at Mayo Clinic have developed a promising method to distinguish between pancreatic cancer and chronic pancreatitis—two disorders that are difficult to tell apart. A molecular marker obtained from pancreatic ...
Cancer 9 hours ago | not rated yet | 0
The use of a smartphone application significantly improves patients' preparation for a colonoscopy, according to new research presented today at Digestive Disease Week (DDW). The preparation process, which begins days in ...
Cancer May 19, 2013 | not rated yet | 0
A new study conducted by researchers at the Child Study Center at NYU Langone Medical Center found men diagnosed as children with attention-deficit/hyperactivity disorder (ADHD) were twice as likely to be obese in a 33-year ...
56 minutes ago | not rated yet | 0 |
New research from the University of Southampton has shown that blind and visually impaired people have the potential to use echolocation, similar to that used by bats and dolphins, to determine the location of an object.
12 minutes ago | not rated yet | 0 |
A novel vaccine study from South Dakota State University (SDSU) will headline the groundbreaking research that will be unveiled at the American Association of Pharmaceutical Scientists' (AAPS) National Biotechnology Conference ...
33 minutes ago | not rated yet | 0
Parkinson's disease (PD) is a degenerative neurological disorder marked by a progressive loss of motor control. Despite intensive research, there are currently no approved therapies that have been demonstrated to alter the ...
34 minutes ago | not rated yet | 0
Women are less likely than men to receive care in a trauma center after severe injury, according to a new study of almost 100,000 Canadian patients.
59 minutes ago | not rated yet | 0
Over the past few decades, neuroscientists have made much progress in mapping the brain by deciphering the functions of individual neurons that perform very specific tasks, such as recognizing the location ...
3 hours ago | 5 / 5 (3) | 0 |