Life beyond diagnosis | Understanding cancer survivorship

Written by Healthy Living News. Posted in June

With June being designated Cancer Survivorship Month, now is the perfect time to not only celebrate the positive trend in cancer survivorship, but also to heighten our awareness of what survivorship actually means—including the impact that living longer after a cancer diagnosis has on patients, their families, and the practitioners who care for them.


According to Sue Mahoney-Stombaugh, MSN, CNP, of The Toledo Clinic Cancer Centers, the general public tends to think of cancer survivorship as being cured of the disease, but oncology practitioners take a somewhat different view. “What people may not recognize is that cancer survivors may still need chemotherapy or other maintenance treatments and often require surveillance long after their active treatment ends to monitor for potential side effects and recurrence. Also, the medical community incorporates family members in the survivorship definition as well because they’re usually dealing with the ramifications of the disease as much as the patients are,” she says.

There are differing perspectives on precisely how survivorship should be defined, but according to Mahoney-Stombaugh, there seems to be a growing consensus that it begins when the cancer diagnosis is given and continues until the end of the patient’s life. Throughout that time, numerous physical, emotional, and psychosocial issues can arise as a result of either the cancer or its treatment.

Examples include persistent pain, excessive fatigue, osteoporosis, heart damage resulting from certain medications or radiation, compromised hematology (problems with the blood), neuropathy in the extremities, fear of recurrence, employment issues, and body-image issues. The high cost of cancer treatment coupled with time lost at work can also lead to serious financial difficulties—for both patients and their families. Of course, just as with the broader population, living longer means cancer survivors are at increased risk of developing chronic health problems not necessarily connected to their cancer or its treatment.

Mahoney-Stombaugh has observed an increased awareness in the medical community of the concept of cancer survivorship and the issues surrounding it. She notes that it’s becoming a more prevalent topic in nursing and medical literature and that more research is being done on the best ways to monitor cancer patients, for example determining whether an annual CAT scan would be beneficial for certain cancer patients. “The result has been the development of more research/evidence-based surveillance plans, especially for some of the major cancers,” she adds.

The ongoing improvement in the rate of cancer survivorship can be attributed in large part to earlier detection. A growing recognition of the importance of screening tests, such as mammogram and colonoscopy, as well as an increasing general awareness of the symptoms associated with certain cancers is translating into more cancer patients seeking medical care in earlier stages of their disease.

Also, the treatment options for certain forms of cancer are improving as well. “More and more state-of-the-art therapies are targeted to specific cancer types, and advanced genetic testing is helping to determine not only whether someone is at increased risk for developing certain forms of cancer, but also whether a patient’s cancer type is likely to respond to specific drugs. In breast cancer alone, better treatments, such as hormone therapy and genetic testing, are making a tremendous difference in survival rates,” Mahoney-Stombaugh states.

Changing attitudes toward lifestyle choices may be having a positive effect on cancer survivorship as well. For example, heightened awareness of the benefits of exercise and proper nutrition and the dangers of tobacco use and excessive alcohol consumption is leading some people to adopt healthier habits. Also, more research is being done on the effects of physical activity with respect to cancer prevention and survivorship. Yet the influence of lifestyle on survivorship remains a “mixed bag,” with some populations making healthier strides than others and plenty of room left for improvement.

With more and more cancer patients leading longer lives after their diagnosis and active treatment, the demand for oncology-trained physicians, physician assistants, nurse practitioners, RNs, and other practitioners who can monitor them is definitely growing. Mahoney-Stombaugh is gratified that more and more training and educational opportunities are available to oncology practitioners looking to expand their knowledge and skills related to cancer survivorship.

In fact, she and fellow Toledo Clinic Cancer Centers nurse practitioner Brenda Brien recently completed a program, developed by Memorial Sloan Kettering and City of Hope and funded by a grant from the National Institutes of Health, with the goal of educating 200 nurses in survivorship care. “This is a three-day program followed by a monitored 18-month period in which the nurses implement goals they’ve set at their home facilities. It’s a lot of work, but it has been worthwhile. What we learned has helped keep us focused and given us the tools for developing a cancer survivorship program and specific care plans here at The Toledo Clinic Cancer Centers,” says Mahoney-Stombaugh.

Asked what advice she would give Healthy Living News readers during Cancer Survivorship Month, Mahoney-Stombaugh replies, “If you’ve been diagnosed with cancer, it’s important to be diligent about follow-up care and adhere to recommendations for cancer screenings—and not just for the type of cancer you have. Also, I encourage everyone to develop or continue healthy lifestyle habits, such as eating right, staying active, avoiding tobacco use, and limiting alcohol consumption.”

Toledo Clinic Cancer Centers, now located at 4126 N. Holland Sylvania Road, Suite 105, has nine board-certified hematologists/oncologists and ten nurse practitioners on staff and can provide imaging and laboratory diagnostic services, chemotherapy services, and IV services. TCCC’s satellite centers in Maumee, Bowling Green, Oregon, Adrian, and Monroe remain open for the convenience of the patient, and many TCCC patients are enrolled in the latest cancer research and studies in our region through the Toledo Community Oncology Program (TCOP).❦

For more information, please call the Toledo Clinic Cancer Centers at 419-479-5605.

Mercy Health