As cancer survivorship grows, so do questions of related health issues

Treating cancer often represents a double-edged sword, as gains in survival years can be offset by other serious health problems related to the treatment, including second cancers. Lois B. Travis, M.D., of the James P Wilmot Cancer Center, was invited to chair a session on June 3, 2011, in which oncologists are to be debriefed on this topic at the American Society of Clinical Oncology (ASCO) annual meeting in Chicago.

The meeting is expected to draw 30,000 cancer specialists, and this year extensive coverage will be given to survivorship.

“The five-year survival rate for all cancers has steadily increased in the last 30 years but this rise in survivorship has come at a price, particularly for younger cancer survivors,” said Travis, a professor of Radiation Oncology and director of the Rubin Center for Cancer Survivorship at the University of Rochester Medical Center. “Going forward, research efforts must target not only the role of prevention strategies on second cancers, but the development of biomarkers that might eventually help us to identify patients who are at greater risk for subsequent malignancies.”

Doctors and patients, however, should always keep in mind that the benefits of cancer treatment usually outweigh the risks, Travis added. Her ASCO lecture will highlight many relevant facts, such as:

• More than 12 million cancer survivors exist in the United States, a number that is expected to increase greatly by 2020. Earlier diagnosis, more effective treatment, prevention of secondary disease, and reductions in other causes of death, are all pushing up the rates of survivorship.

• Many complex factors impact the development of second malignancies, including toxicity associated with chemotherapy and radiation, lifestyle choices (alcohol, tobacco, diet, exercise), environment (viruses, exposure to toxins, occupation), genetics, and age, gender, and immune function.

• The younger the age at first cancer diagnosis, the greater the relative risk of a second cancer diagnosis. Particularly for those people who have already faced Hodgkin Lymphoma, testicular cancer, and certain other childhood cancers, second solid tumors later in life have emerged as a serious risk.

• Many unresolved issues regarding the carcinogenic effects of chemotherapy and radiation must be studied further.