CANCER SURVIVORSHIP is on the rise and expected to continue growing due to a variety of factors, including improvements in cancer screening, advances in treatment, and the general growing and aging of our population. In fact, according to David Brown, MD, of The Toledo Clinic Cancer Centers, there are currently about 17 million cancer survivors in the United States and approximately 32 million survivors worldwide. With more and more people joining the ranks of cancer survivors, the importance of appropriate post-treatment surveillance has greatly increased as well.
Dr. Brown explains that cancer survivorship begins at the time of diagnosis and continues through active treatment and beyond. With 37 years of experience under his belt, Dr. Brown knows a lot of cancer survivors who are still looking at a long life ahead. He also notes that in the population of cancer survivors, some cancer types are more commonly represented than others. Among female survivors, the most common type is breast cancer followed by endometrial cancer and then colorectal cancer. Among male survivors, the number-one type is prostate cancer followed by colorectal cancer.
Dr. Brown explains that the surveillance of patients who have transitioned beyond active treatment has several different objectives. One component is the prevention of subsequent primary cancers. “If you’ve already had one cancer, you’re at high risk of developing another, especially with head and neck cancer,” he says.
Surveillance for cancer recurrence is also an important objective, and, as Dr. Brown points out, “Different cancers have different paradigms for subsequent follow-up. For instance, with many cancers, there’s no need for imaging evaluation if the patient is asymptomatic. However, with highrisk colon cancer and testicular cancer, imaging evaluation and follow-up are essential post treatment.”
Of vital importance to oncologists is monitoring cancer survivors for long-term side effects stemming from prior chemotherapy or radiation treatments. “This is especially critical for childhood cancers. For example, female children who received radiation therapy to the chest are at high risk of developing breast cancer later in life, so we have to keep a close eye on that,” Dr. Brown states.
Yet another important element of post-treatment surveillance and follow-up in cancer patients is addressing any underlying lifestyle factors that put them at high risk of developing a new malignancy, such as obesity and smoking. Behavioral changes like quitting smoking, adopting a healthier diet, and getting regular exercise might be recommended to reduce that risk. Dr. Brown adds, “For smokers over age 50, getting a chest CT scan on a yearly basis to screen for lung cancer is incredibly important.”
The U.S. Preventative Services Task Force recommends low-dose CT screening for individuals between the ages of 50 and 80 who have at least a 20-pack-year history of smoking (the equivalent of smoking one pack of cigarettes per day for 20 years or two packs a day for 10 years) and either still smoke or quit smoking within the past 15 years.
Last, but by no means least, oncologists need to evaluate cancer survivors for any genetic associations that increase their risk of subsequent malignancy. “Most notable in this area are mutations of the BRCA1 and BRCA2 genes. It’s important to evaluate both sides of the family for these mutations because they’re connected to higher risk of breast and ovarian cancers in women and increased risk of male breast cancer and early-stage prostate cancer in men,” says Dr. Brown.
The Toledo Clinic Cancer Centers, located at 4126 N. Holland Sylvania Road, Suite 105, also provides imaging, laboratory, chemotherapy and IV services. The cancer center consists of 7 medical and 3 radiation oncologists along with 8 nurse practitioners and 4 research nurses. The cancer center also has satellite centers in Maumee, Napoleon, Bowling Green, Wauseon, and Monroe.
The Toledo Clinic Cancer Centers has earned Patient-Centered Specialty Practice level 3 recognition and Oncology Medical Home recognition from the National Committee for Quality Assurance. Oncology homes align systems and resources with coordinated care focused on cancer patients and their needs. This reduces fragmentation, supports shared decision making, and improves the patient experience. They are the first oncology practice in the state of Michigan and the second oncology practice in the state of Ohio to receive this recognition.
For more information, please call The Toledo Clinic Cancer Centers at 419-479-5605.
