They say the moment of a cancer diagnosis, a patient becomes a survivor. But what does that really mean?
Across the country, there is a new effort to help people survive their often toxic therapy with a different focus — splitting physicians to tackle both the disease and the body’s overall health.
A new study reveals chemotherapy and radiation treatment are not enough.
So armed with a new plan, cancer doctors are not just prolonging life, they are extending a good life.
Kanesha Broadwater had cancer in her breast, but at a recent Northwestern Medicine’s Cancer Survivorship visit, they are looking closely at her heart.
Karen Kinahan is nurse practitioner with the program.
“It’s not just curing the patient and moving on to the next one, but kind of following them through their course and trajectory of their cancer journey,” she said.
Breast cancer survivors can have issues with bone strength as well, requiring added Vitamin D and calcium.
“They definitely help manage any long-term effects from treatment,” Broadwater said. “I like it because the practitioners here not only know you, but they know you through the lens of your cancer treatment.”
The extensive treatment for the 45-year-old’s Stage 3 ductal carcinoma included chemotherapy, surgery and radiation after a diagnosis that brought a great deal of fear — which adds stress to the body and heart.
“My first concern was I’d have to go home and tell my parents I have cancer,” Broadwater said. “They are aging …”
As she ages, Broadwater knows the value of focusing on her life beyond cancer and that includes follow up.
“They know exactly what kind of chemo I had. They know the effects that can have on your long-term health. They know how different things in your life can affect those treatment affects,” Broadwater said. “During our visit we talk a lot about cardiac health because of one of the chemos that I did receive. And so we talk at length about what kind of exercise I’m doing. Is it cardio? Is it strength training? Those sorts of things to map out a very specific logistical plan on how to deal with those side effects.”
At City of Hope the philosophy is to consider side effects even before treatment begins. Researchers launched a study with older patients, some who got standard care, the other half a bit of a boost to care.
Dr Daneng Li is an assistant professor of medical oncology and therapeutics research and oncologist at City of Hope.
“Now that we are able to potentially identify patients who are at risk for toxicity from treatment, how can we potentially minimize that risk?” Li said. “Whatever vulnerabilities were identified, we then intervened. So we had a group of various different types of specialists including an oncologist, a nurse practitioner, social worker, physical therapist, occupational therapist, pharmacist, identify some of the areas where there might be needs and then make recommendations.”
In prior studies, patients who got less chemo felt better but potentially did not get the knockout punch to their cancer. In this study patients got the full dose of drugs but they got whole body care and that made the difference. There were 10 % fewer side effects and long-term complications. They lasted longer in treatment while boosting their chance for survival.
“We are basically saying we can support you through whatever chemotherapy you are getting,” Li said. “And by doing that, we can alleviate a lot of the toxic side effects of chemo that you might get.”
In the era of precision cancer medicine targeting tumors, this approach has a different target.
“This is a more patient centric approach to precision medicine that really allows us to detect each patient’s own vulnerability and thereby allowing us to better effectively care for all of our older adults with cancer,” Li said. “Ultimately it’s helping them to not only live longer but also to live better.”
The survivorship concept is catching on across the country. At City of Hope, they know their multidisciplinary approach will work for younger patients as well. If you or someone you love is diagnosed with cancer seek out an oncolcogist and a specialist in survivorship.