284. Survivorship

Question 1

Epidemiology of Cancer Survivorship

Define Cancer Survivor

Answer 1

Survivorship is GROWING due to aging population, high prevalence of cancer and improving tx of cancer (lower mortality)
Childhood Cancer Survivors: 95.5% will have >1 chronic health condition, 80.5% will have serious/disabling or life-threatening chronic health condition

Cancer Survivor: any person who has been DIAGNOSED, from time of diagnosis to end of life
- survivorship stage: occurs after curative/noncurative tx ends

Question 2

Chronic and Late effects of cancer and txs (5)

Answer 2

Higher risk of late mortality than population controls

1. Abnormal Growth/Development
2. Abnormal Organ Fx
   - Heart: Anthracycline and dose-dependent CHF beginning 5 YEARS LATER, Trastuzumab causing CHF, Anti-VEGF tx causing HTN leading to CHF/Coronary syndrome due to VC, Platinum increasing risk of premature atherosclerosis due to endothelial damage
   - Lung: Bleomycin, Mediastinal RT
   - Nerve: Peripheral Neuropathy (deep numbness) due to platinums, hearing loss from cisplatin
3. Abnormal Fertility and Reproduction
4. Subsequent Cancers
5. Psycho-social effects (rollercoaster of emotions, follow ups)