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
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
http://Journeyforward.org
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…