Dr Niti Raizada MD DNB DM ECMO MRCP(UK)
DIRECTOR
Medical Oncology & Hemato-Oncology
Fortis Cancer Institute
Fortis Group of Hospitals
Bangalore
[email protected]
An individual is considered as a cancer survivor from the time of diagnosis, during treatment, and throughout the balance of his or her life. The patient’s family members, caregivers and friends are also affected by the cancer affecting the dear one.
The impact of diagnosis and treatment of cancer in the survivor’s is varied and deep. It starts with psychosocial issues, major economic issues and often life-long physical changes.
The survivorship spectrum encompasses the management of :
1. Lifestyle change and diet
2. Nutritional deficiencies including Anemia
3. Hormonal issues and its impact on sexual life
4. Interpersonal issues including family relationship changes
5. Cancer surveillance and persistent fear of cancer recurrence
6. Sometimes recurrent cancer and late side effects of previous treatment
7. Physical changes including cognitive impairment and dependence on certain medication
8. Genetic risk and its implications to the blood relatives
The psycho-social issues which have major impact could include:
1. Chronic fatigue syndrome
2. Anxiety, depression, trauma and distress
3. Cognitive dysfunction
4. Hormone related issues like hot flashes or vaginal dryness
5. Chronic pain
6. Sexual dysfunction/infertility
7. Sleep disorder
8. Infections and therefore change in lifestyle
9. Employment and work-related issues
10. Substance abuse, de-addiction including smoking cessation and alcohol abstinence
Every cancer type and its treatment can also pose its unique challenges. This includes Lymphedema in breast cancer patients with axilla surgeries, Chronic Graft Versus Host Disease in Haemopoietic Stem Cell Transplant patients and sometimes second cancers after treatment of pediatric cancers.
Preventive health remains the focus in survivors:
1. Healthy lifestyle including maintaining healthy body weight, regular exercise, change of dietary patterns and abstinence from tobacco and alcohol remain the main focus
2. Social support, psychological support and stress management
3. Managing pain, fatigue, emotional distress, nutritional imbalances, others medical co-morbidities
4. Regular immunization and management of infections
What is required is:
1. A good medical team including Oncologist and Physician
2. Psychologist and sometimes psychiatrist
3. Physical and occupational rehabilitation
4. Sometimes spiritual support and other support system organizations to feel connected
5. Family and caregiver harmony with intimate partner relationship
Cancer is a life-changing journey from the day one is diagnosed with cancer and remains throughout life often entailing mental and spiritual growth for all involved.
