Caring for cancer survivors.
Subject: Cancer (Care and treatment)
Cancer (Patient outcomes)
Cancer survivors (Research)
Author: Cowper, Anne
Pub Date: 03/22/2007
Publication: Name: Australian Journal of Medical Herbalism Publisher: National Herbalists Association of Australia Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2007 National Herbalists Association of Australia ISSN: 1033-8330
Issue: Date: Spring, 2007 Source Volume: 19 Source Issue: 1
Topic: Event Code: 310 Science & research
Geographic: Geographic Scope: Australia Geographic Code: 8AUST Australia
Accession Number: 174818465
Full Text: Chantrill L, Tattersall M. 2006. How to care for cancer survivors. MedToday 7:4;18-23.

A cancer survivor is anyone who has completed treatment for a cancer and has no evidence of disease. Early detection and more effective treatment methods have led to increasing numbers of cancer survivors. This study looked at the medical follow up needs of survivors of breast, colorectal and prostate cancer but did not address the psychosocial needs of the survivors.

Breast cancer

The goals of follow up for breast cancer survivors are early detection of local or systemic recurrence, screening for a new primary breast cancer, detection of treatment related toxicities, provision of psychosocial support, and identification of the family history of cancer and screening recommendations for family members if appropriate.

Recurrence of breast cancer is 1-2% per annum for the first five years after treatment of localised breast cancer. A history of breast cancer doubles the risk of a second breast cancer even with no family history. Follow up history and examination should be carried out every 3 months within the first two years, every 6 months from 3 to 5 years and annually after five years. Mammograms should be carried out annually for all survivors.

Colorectal cancer

Follow up after curative resection of colorectal cancer is for both detection of second primary tumours and early detection of recurrence as well as monitoring toxicities of treatments. Persistent peripheral sensory neuropathy can be a complication after oxaliplatin. Pelvic radiation therapy can cause persistent diarrhea and episodic bleeding. There can be issues of body image and sexuality or sexual dysfunction.

Colon cancer survivors have an increased incidence of metachronous primary colorectal cancers and adenomatous polyps. Colonoscopy is recommended at 12 months and then at two and five years. Almost one in three patients who had curative surgery for colorectal cancer dies of recurrent disease. Early detection of respectable recurrence improves survival rate.

Prostate cancer

Early detection of prostate cancer by prostate specific antigen (PSA) screening has led to a large number of men with prostate cancer surviving for many years after diagnosis and/or treatment. After radical prostatectomy, erectile dysfunction and urinary incontinence are common. After pelvic radiotherapy, erectile dysfunction and urinary bleeding can occur and the incidence of bladder cancer is increased.

Follow up includes monitoring PSA, surveillance for recurrence and screening for treatment complications. PSA testing is recommended in prostate cancer survivors every six months for five years and then annually.

Anne Cowper

PO Box 45, Concord West NSW 2138

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