Life Ater Treatment
Those of you who know me are aware that this is my most favorite topic. I am very interested in what happens to women after adjuvant treatment concludes. I have written several articles and even a book (After Breast Cancer: A Commonsense Guide to Life After Treatment) about this topic and continue to learn new things from my patients. The fortunate summary is that most women, after a period of physical and psychological challenge and adjustment, do fine. I would never subscribe to the "blessings of cancer" theories, but I do believe that many of us have improved our lives after our diagnosis and treatment. For all of us, cancer was a major wake-up call, and we are given an opportunity to consider our choices and priorities and, if we choose, make some changes.
This is an editorial from JCO about a couple of new studies that support my brief comments. Here is an excerpt and then a link to read more:
Life After Adjuvant Chemotherapy for Breast Cancer:
The News Is Mostly Good
Belinda E. Kiely, National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia
Nicholas R.C. Wilcken, Westmead Hospital, University of Sydney, Sydney, New South Wales, Australia Martin R. Stockler, National Health and Medical Research Council Clinical Trials Centre, University of Sydney; and Sydney
Cancer Centre, Royal Prince Alfred and Concord Hospitals, Sydney, New South Wales, Australia
There comes a time with all cancers when thoughts turn from the initial successes and costs of treatment to the containment of long- term toxicity. So it is for breast cancer now. Although we have yet to cure everyone with this disease, overall recurrence rates are low, in large part because of systemic treatments that can result in long-term adverse effects.
Most survivors of breast cancer report good quality of life, but impairments of role, emotional, cognitive, and social functioning per- sist for years in some.1 Fatigue, cognitive dysfunction, sleep, pain, and menopausal symptoms are more subtle than the acute toxicities of chemotherapy, but they can be chronic and debilitating. Information on the likelihood, severity, and duration of long-term problems is needed to help women make informed decisions about adjuvant sys- temic therapy.
In this issue of Journal of Clinical Oncology, Ganz et al2,3 report two studies on symptoms and quality of life within 1 to 2 years of primary treatment for early breast cancer. The overall findings are reassuring: post-treatment symptoms are generally mild, and quality of life recovers to baseline levels within 12 months of completing primary treatment.