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Susan Hong MD MPH Associate Professor of Medicine University of Chicago LIVING BEYOND BREAST CANCER Susan Hong, MD MPH Associate Professor of Medicine Associate Program Director, Cancer Survivorship Center for Clinical Cancer Genetics University of Chicago

Living beyond breast cancer Treatment 9.11.12.pdf · LIVING BEYOND BREAST CANCER Susan Hong, ... SEER Cancer Statistics Review. 1975-2008, National Cancer Institute. Bethesda, MD

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Susan Hong MD MPH Associate Professor of Medicine University of Chicago

LIVING BEYOND

BREAST CANCER Susan Hong, MD MPH

Associate Professor of Medicine

Associate Program Director, Cancer Survivorship

Center for Clinical Cancer Genetics

University of Chicago

Susan Hong MD MPH Associate Professor of Medicine University of Chicago

SEER CANCER STATISTICS

Susan Hong MD MPH Associate Professor of Medicine University of Chicago

Estimate numbers of cancer survivors in US by site

of primary cancer

Howlader N, Noone AM, Krapcho M and Colleagues. SEER Cancer Statistics Review. 1975-2008, National

Cancer Institute. Bethesda, MD. http://seer.cancer.gov/csr/1975 2008/

Susan Hong MD MPH Associate Professor of Medicine University of Chicago

Site of primary cancer among adult cancer survivors in

US

Susan Hong MD MPH Associate Professor of Medicine University of Chicago

Survivorship Defined: NCI

“An individual is considered a cancer

survivor from the time of diagnosis, through

the balance of his or her life. Family

members, friends and caregivers are also

impacted by the survivorship experience and

are therefore included in the definition.”

Susan Hong MD MPH Associate Professor of Medicine University of Chicago

Survivorship Defined

• Definition of Survivorship takes into

consideration the physical, emotional,

psychological, financial, and other impacts

of cancer and cancer treatment

Susan Hong MD MPH Associate Professor of Medicine University of Chicago

Breast Cancer

• Impacts Everyone

• Does not impact everyone the same way

• Age of the affected individual impacts-

treatment and consequences of treatment

• Age, social support, health condition of the

individual affected-must be considered in

comprehensive survivorship care

Susan Hong MD MPH Associate Professor of Medicine University of Chicago

Issues faced by cancer survivors

• Increased risk for second cancers

•Treatment related effects (known and

unknown)

• latent-persists for months to

years

• delayed-present years later

Susan Hong MD MPH Associate Professor of Medicine University of Chicago

Consequences of treatment

•Higher rates of other chronic health

conditions

•1:30 Adults in US considered Cancer

Survivors

•2/3 have at least one chronic health

condition

Susan Hong MD MPH Associate Professor of Medicine University of Chicago

Self reported information National Health Information Survey

Susan Hong MD MPH Associate Professor of Medicine University of Chicago

One or more functional limitations: NHANES II

Susan Hong MD MPH Associate Professor of Medicine University of Chicago

Issues faced by cancer survivors

Richard Westwall’s Sword of

Damocles. 1812

Susan Hong MD MPH Associate Professor of Medicine University of Chicago

Challenges of recovery

• Important to recognize (and accept) that

there is a new normal

• May actually be a healthier state than

before

• Physical Recovery takes as long as it

takes---

• Just because your hair as grown back

does not mean the side effects of

treatment are over….

Susan Hong MD MPH Associate Professor of Medicine University of Chicago

Challenges of recover

•Emotional recovery-

• In some cases is more difficult than

the physical recovery

•For many women recognizing this

needs to happen is most of the battle

Susan Hong MD MPH Associate Professor of Medicine University of Chicago

Challenges of recovery

•Triggers of stress

• Going to the doctor

• Anniversary of breast cancer diagnosis

• Month of October

• Any physical symptom-e.g. headache,

joint aches, etc.

• Internet/Media

Susan Hong MD MPH Associate Professor of Medicine University of Chicago

Challenges of recovery

•Accepting that there are no

guarantees….

•No blood test, imaging, or medical

evaluation can ever guarantee against

cancer…..

Susan Hong MD MPH Associate Professor of Medicine University of Chicago

Survivorship care plan

•Treatment summary and care plan

• Included should be cancer diagnosis,

stage, pathology information, testing

received and treatments received

•List of your providers and how to

reach them

Susan Hong MD MPH Associate Professor of Medicine University of Chicago

Survivorship care plan

•Recommendations for follow-up care

• How often you should see your doctor

• How often you should undergo testing

• Additional surveillance test needed (if

any)

•Resources –where to get additional

information

Susan Hong MD MPH Associate Professor of Medicine University of Chicago

Sample care plans

Susan Hong MD MPH Associate Professor of Medicine University of Chicago

http://Journeyforward.org

Susan Hong MD MPH Associate Professor of Medicine University of Chicago

Susan Hong MD MPH Associate Professor of Medicine University of Chicago

Susan Hong MD MPH Associate Professor of Medicine University of Chicago

http://livestrongcareplan.org

Susan Hong MD MPH Associate Professor of Medicine University of Chicago

http://www.mncanceralliance.org/scp.html

Susan Hong MD MPH Associate Professor of Medicine University of Chicago

Navigating the new normal

•Join support groups-it’s not just for the

newly diagnosed

•Prioritize your health-for many women

this is a new way of thinking

•Make sure you follow-up regularly with

your cancer doctors

Susan Hong MD MPH Associate Professor of Medicine University of Chicago

Navigating the new normal

•Use common sense-ways to decrease

risk for cancer recurrence will also

decrease your risk of other adverse

health outcomes…

• Keeping fit-maintaining a healthy body

weight and exercising

• Eating well balanced diet

• Reducing stress

Susan Hong MD MPH Associate Professor of Medicine University of Chicago

Navigating the new normal

•Remember – your health is more than your cancer history

• Don’t forget about the non-cancer aspects of your health

• Get regular check-ups

• Keep up to date with ALL your health needs

•Allow yourself some emotional setbacks…

Susan Hong MD MPH Associate Professor of Medicine University of Chicago

Cancerecho.com