"You have cancer."
Those three words once braced patients for a worst-case scenario. And, for some, the bad news is, it still does. But now there's positive news to report. The Centers for Disease Control and Prevention and the National Cancer Institute have released new findings saying that one in every 20 Americans is now a cancer survivor. Decreased death rates have been found in both sexes for cancers of the colon, brain, stomach, kidney and lung, as well as non-Hodgkin's lymphoma, myeloma and leukemia.
This is a watershed change in statistics on an illness with a historically devastating diagnosis. It's especially promising if you have family or friends struggling with the disease. But with this good news comes another stark reality: cancer has become more of a chronic -- rather than a fatal -- illness. Because of this, modern medicine and doctors must deliver new types of care to provide for the increased number of cancer survivors. Oncologists must shift their focus from the short-term to management of longer-term care, which potentially could last decades. Patients and their families, especially, will need to alter their lives and approach to care.
Increased Odds
Let's look at some of the health challenges for survivors and the medical community. A number of studies have shown that cancer survivors are more at risk for other types of tumors and cancers; survivors of childhood and adolescent cancer are among the higher risk populations. These secondary tumors may result from a genetic susceptibility to form cancer, continued exposure to carcinogens, the effect of treatment of the initial tumor with chemotherapy or radiation, or may be an incidental finding due to increased surveillance that occurs when imaging studies are performed to make sure the initial tumor has stayed in remission. A recent study in the Journal of the American Medical Association found that nearly one in every two adult survivors of childhood cancer reported at least one moderate to severe adverse health outcome, such as limits in activity, cancer-related pain, mental health troubles and cancer-related anxiety. Childhood cancer survivors also have an increased risk of death from cardiovascular disease and metabolic abnormalities, and women can even face an early onset of menopause.
Cancer survivors have an increased risk of osteoporosis, as well as cardiac and pulmonary dysfunction including atherosclerosis, a condition in which fatty material collects along walls of arteries. As the fatty material grows thicker and harder, it forms calcium deposits that eventually can block arteries. Survivors also are more likely to have dementia, especially those that received radiation to the brain, and a higher rate of post-traumatic stress disorder.
The Cost of Care
Besides their continued fight for health, cancer survivors also often must battle insurers. Higher insurance costs for a longer period of time mean a harder-hit pocket book. Cancer is one of the five most costly medical conditions in the United States, which often can affect health decisions during treatment. Once you're diagnosed with cancer, whether insured or not, you often will face more challenges in receiving health care that's affordable now that you have that omnipresent "preexisting condition."
As many as 10 percent of cancer patients report they have hit their insurance policy's benefit limit, forcing them to find more coverage or to pay for treatments out of pocket. Atop sky-high deductibles and copayments, many policies include annual and lifetime benefit caps, resulting in more patients hitting these ceilings and unable to afford longer-term care.
How Washington ultimately reacts to these tough health coverage cost quandaries remains up in the air, though The Affordable Care Act legislation passed by Congress in 2010, and signed by President Obama, aimed over time to begin addressing many of the issues.
Patient Patience
While all of this may be disheartening news, it's important to remember that if you are a patient in recovery from cancer, you do have some control -- by remaining knowledgeable about what type of cancer you had and any health risks associated with it. Another study published in the Journal of the American Medical Association found that 72 percent of adult survivors of childhood cancer could report their childhood diagnosis precisely; only 19 percent could report it accurately, but not precisely. This fuzzy information could hinder cancer survivors from receiving optimal long-term care. The more you know in detail about your condition, the more you can communicate good information to your doctor, resulting in better long-term care.
You also can focus on three things to ensure you're doing your part to surmount challenges that accompany surviving cancer -- maintain a regular screening schedule, work with a doctor to monitor your condition, and, finally, protect yourself with a balanced diet, exercise and healthy lifestyle changes. (Stop smoking!)
While many cancer survivors in remission may feel alone, left to deal with discomforts and the difficulties with ongoing care, there is help. It's estimated that 64 percent of cancer patients survive more than five years beyond their diagnosis. This means support and rehabilitation is becoming key in the lives of survivors. Some of the institutions that specialize in cancer have developed programs to help survivors heal, including psychological treatment and education on long-term effects of cancer-related treatments.
So, to the many and all of you who have "beat" the Big C, my congratulations -- and welcome to what I hope will be a long, healthier, albeit sometimes challenging, life.