It is important for people with cancer to take care of themselves. Taking care of yourself includes eating well and staying as active as you can.
Surgery, chemotherapy, radiation, transplant and other cancer treatments are harsh on the body and many cancer survivors face a higher risk for medical and psychosocial effects.
Listen as Mary Reid, MSPH, PhD, Director of Cancer Screening and Survivorship at Roswell Park Comprehensive Cancer Center, discusses the brand new Survivorship and Supportive Care Center, and shares how they can help to create a plan that will be your road map to your healthiest lifestyle possible to nurture mind, body and spirit throughout your cancer journey.
Selected Podcast
Survivorship: Adjusting To Life After Cancer
Featured Speaker:
Learn more about Mary Reid, MSPH, PhD
Mary Reid, MSPH, PhD
Mary Reid, MSPH, PhD, is the Director of Cancer Screening and Survivorship at Roswell Park Cancer Institute, and is currently a Professor of Oncology in the Department of Medicine.Learn more about Mary Reid, MSPH, PhD
Transcription:
Survivorship: Adjusting To Life After Cancer
Bill Klaproth (Host): Living with, through and beyond cancer will certainly change your life and then cancer survivorship can present its own challenges, and here to talk with us about cancer survivorship is Dr. Mary Reid, director of cancer screening and survivorship at Roswell Park Cancer Institute. Dr. Reid, thank you for your time today. So, let's start with this – what’s most challenging about life after cancer?
Dr. Mary Reid (Guest): Well, there are a lot of challenges, and I think one thing that cancer patients really focus on is, you know, surviving treatment and getting to that point where they are no longer being treated, and they don't have an active cancer, but the story doesn't really end there, and I think anyone who's been through the process knows that there are often times residual effects from surgery or radiation or chemo that you have to live with, and it's a period where you really want to get back to your normal life, but you're not exactly the same, and, I think, most of the time we are not really preparing cancer patients as they go through treatment as to what effects may be ongoing, what they should plan to do during the survivorship period which, you know, really starts when treatment ends. So, some of the challenges are that you have -- your body has scars, that you may have had parts of your internal or external, you know, body parts removed. Many times the family dynamic is still stressed by the cancer diagnosis, from the financial strain of cancer treatment. You oftentimes have physical limitations, nutritional challenges. There's a lot of psychosocial aspects to surviving cancer that you want to deal with so that you can get back to whatever this normal is for you, and it's also an opportunity to change maybe some of the habits that you had before you got diagnosed so that you can help to keep the cancer from coming back or at least live a high quality of life, and I think we really -- patients need to go into the cancer treatment period understanding that when it's all over, you know, there is still some work to do, and, you know, there are lots of support services for patients and part of the challenge we find too, is really during this period to keep the conversation going and helping patients to network into those support services that they really need.
Bill: So, there's a lot going on there and getting through treatment obviously is the main goal, but then regular follow-up care is vitally important for all the reasons you just stated.
Dr. Reid: Right. It's really important. You know, when you finish treatment, your oncologist -- regardless of what specialty they're in -- really provides a roadmap to say, you will have testing at this interval for a year and then the next year, so you oftentimes do get when you need surveillance screening or imaging to detect any recurrence of your primary cancer. For instance, there are other cancer screenings that patients have put off during their treatment, so it's really important that not only do you want to keep up with the regular and regimented testing for your primary cancer, you also want to get back into routine screenings for the other cancers. There's nothing more tragic than someone surviving a cancer only to, you know, be impacted by a second advanced stage cancer that could have been prevented. So, we really want to, you know, during the survivorship period, to make sure people stay on track. There are guidelines for how often they should have surveillance imaging or testing and then to re-engage them in the other kind of screening tests for cardiovascular disease, through their primary care doctor or other cancers through the cancer center so that they get back into that kind of state of adhering to what the guidelines say for either the cancer they had or the cancers that they might go on to develop.
Bill: So, regular maintenance after cancer is so important and for normal healthcare that may be neglected, and Dr. Reid, what are some long-term effects that may not appear until well after cancer treatment?
Dr. Reid: So, there are, and I think, the best example is pediatric cancer survivors and young adults who are treated for adult cancers at a young age. We know from the literature and the experience of pediatric cancer survivors that they can be treated and survive their cancer, you know, when they're 10 years old, but around the age of 30, late 20's to 30's, some of the side effects of treatment can emerge. Sometimes, this is about their heart. They can develop things like congestive heart failure because of the toxicity that the drugs did on their hearts. They can have fertility issues; they can start to develop second cancers related to the exposure of their treatments at a young age. It's very well described in the pediatric literature and even for young adults, say who get breast cancer in their 20's, you know, by the time they get to be 30 and 40, they've lived with this, you know, post-cancer period for, you know, 10-20 years, but the drugs that they took could still do damage, and that's when it emerges. We also know that women, for instance, treated with breast cancer in their 40's could live to be 80 years old and again, whatever kind of treatment they got may pose risks. It could increase their risk of second cancers. We know that several of the treatments for bone marrow transplant, for lymphoma and leukemia really put -- pre-dispose those survivors to second cancers five, ten years after treatment is finished.
So, it's really important, I think as people emerge into this survivorship period that not only do they understand what tests are ongoing, but they really need to be educated in terms of what risks they have for other diseases and other cancers. Again, because, you know, you educate people, they can proactively address some of these risks. They can make sure that they have the kind of testing they need when they're in the highest risk period, and they can educate their families because again, you know, cancer isn't just impacting one person. So, you really need your support system to be on top of things to get you into, you know, the best kind of proactive mode, so that you aren't, you know, suffering from the effects of cancer treatment.
Bill: Right. Proactive mode. I like how you put that, and can you talk to us about Chapter 2 and tell us what that is?
Dr. Reid: So, we, you know, decided to name our survivorship workshop -- this is the first one that we have going at Roswell. It's called "Chapter 2" because it really kind of demarcates that period after you have gotten through the cancer and, you know, people are courageous during the cancer treatment period, and, you know, you see that all the time. In Chapter 2, it's really, this new lease on life. You know, you've made it through treatment, and we want people to know what the options are, so that they can take advantage of say, other ways of living, get nutrition support, get physical therapy support, and so we've organized this conference both to educate people who are survivors on what the issues are and their caregivers. We're really encouraging the family members or the caregivers to attend the conference because we know they're also impacted by being with someone who's survived cancer, but we also want people to have options; like, they may have thought, "you know, maybe yoga will help me stretch and, you know, kind of get past some of the physical side effects of treatment, but I don't want to -- I don't know who to contact," so we're providing a series of 45-minute workshops on a variety of support services: spirituality, physical therapy, nutrition. They can pick three workshops to go to so that they can get sort of the beginning education and find out, you know, will this help me? Is this something that I've always wanted to try, but I don't really know what it's about, and you know, again, it's really about education and giving people access to services that they can personalize and really be in control of how they regain their normalcy -- whatever that is -- that they can find some peace of mind, that they can address some of the, you know, having cancer is a shock to the system, and it takes a while to sort of get past the impact that it has on your psychology, and so we really want to provide people with the time to have the conversation to ask experts and to experience some of the things that may have always wanted to try to see if those will help them to live better lives because, you know, we all know, it's about quality of life. You know, you can survive cancer, but what's really meaningful about that is you have to get to a quality of life that makes life rich -- leads people to lead their best lives after cancer because, you know, you can, you know, be a survivor for 10, 20, 30 years, and you really want to pack in the best life you can during that period.
Bill: So, Chapter 2 -- it sounds like it's very beneficial in turning the page on a new chapter in life after cancer, and lastly, Dr. Reid, can you tell us about survivorship and the Supportive Care Center at Roswell Park Cancer Institute?
Dr. Reid: Well, I'd love to. It's a new service. Our clinic is in the new building -- the clinical science center attached to the Roswell Park Hospital. It's on the third floor. It opened just this winter. We have a full staff in the survivorship clinic, and it sort of has two functions. One is that long-term survivors, when they no longer need to see their oncology team can come to this clinic. We'll perform all the surveillance and screening tests that the oncology team has asked for, but we will also network people into support services that are either available at Roswell or in the community because again, we want to empower people to make choices about how they lead this next part of their life.
We also want to support the generation of care plans so that when you finish treatment, you're actually given the plan by your oncology team that outlines both the schedule of tests, what issues they think you might have, and it encourages people to get some other referrals to some of those support services. It's formatted to communicate back to their primary care doctor so that there's the understanding of what tests can be done in the community versus what tests we want to have done at Roswell, and then from beyond that, if someone wants to come up to the clinic and see our practitioner, get networked into support services, have an assessment, we have a psychologist in the clinic. We're hiring our own nutritionist. Social work is there. We're closely linked with PT and OT and lymphedema treatments, so we have a very nice network based in that clinic, and patients can come in. It doesn't mean they have to leave their oncologist because, you know, you've developed a relationship. Oftentimes that person saved your life, but we want to provide this service because we really know that the sooner someone who is a survivor gets into, you know, gets back to their normal -- gets back to their physical sense of well-being and their quality of life, we know they do better. We know they survive longer, and we'll do whatever we can to facilitate that, so I think this is really a great addition to how we care for our patients at Roswell. It's very patient-focused, and it really puts the power and control and the kind of the control over their destiny back in the patient's court so that they can make decisions about how they're going to lead their lives going forward.
Bill: Well, that's great information, and it sounds very comprehensive as you would expect at Roswell Park Cancer Institute. Dr. Reid, thank you so much for your time today. For more information, visit roswellpark.org. That's roswellpark.org. You're listening to Cancer Talk with Roswell Park Cancer Institute. I'm Bill Klaproth. Thanks for listening.
Survivorship: Adjusting To Life After Cancer
Bill Klaproth (Host): Living with, through and beyond cancer will certainly change your life and then cancer survivorship can present its own challenges, and here to talk with us about cancer survivorship is Dr. Mary Reid, director of cancer screening and survivorship at Roswell Park Cancer Institute. Dr. Reid, thank you for your time today. So, let's start with this – what’s most challenging about life after cancer?
Dr. Mary Reid (Guest): Well, there are a lot of challenges, and I think one thing that cancer patients really focus on is, you know, surviving treatment and getting to that point where they are no longer being treated, and they don't have an active cancer, but the story doesn't really end there, and I think anyone who's been through the process knows that there are often times residual effects from surgery or radiation or chemo that you have to live with, and it's a period where you really want to get back to your normal life, but you're not exactly the same, and, I think, most of the time we are not really preparing cancer patients as they go through treatment as to what effects may be ongoing, what they should plan to do during the survivorship period which, you know, really starts when treatment ends. So, some of the challenges are that you have -- your body has scars, that you may have had parts of your internal or external, you know, body parts removed. Many times the family dynamic is still stressed by the cancer diagnosis, from the financial strain of cancer treatment. You oftentimes have physical limitations, nutritional challenges. There's a lot of psychosocial aspects to surviving cancer that you want to deal with so that you can get back to whatever this normal is for you, and it's also an opportunity to change maybe some of the habits that you had before you got diagnosed so that you can help to keep the cancer from coming back or at least live a high quality of life, and I think we really -- patients need to go into the cancer treatment period understanding that when it's all over, you know, there is still some work to do, and, you know, there are lots of support services for patients and part of the challenge we find too, is really during this period to keep the conversation going and helping patients to network into those support services that they really need.
Bill: So, there's a lot going on there and getting through treatment obviously is the main goal, but then regular follow-up care is vitally important for all the reasons you just stated.
Dr. Reid: Right. It's really important. You know, when you finish treatment, your oncologist -- regardless of what specialty they're in -- really provides a roadmap to say, you will have testing at this interval for a year and then the next year, so you oftentimes do get when you need surveillance screening or imaging to detect any recurrence of your primary cancer. For instance, there are other cancer screenings that patients have put off during their treatment, so it's really important that not only do you want to keep up with the regular and regimented testing for your primary cancer, you also want to get back into routine screenings for the other cancers. There's nothing more tragic than someone surviving a cancer only to, you know, be impacted by a second advanced stage cancer that could have been prevented. So, we really want to, you know, during the survivorship period, to make sure people stay on track. There are guidelines for how often they should have surveillance imaging or testing and then to re-engage them in the other kind of screening tests for cardiovascular disease, through their primary care doctor or other cancers through the cancer center so that they get back into that kind of state of adhering to what the guidelines say for either the cancer they had or the cancers that they might go on to develop.
Bill: So, regular maintenance after cancer is so important and for normal healthcare that may be neglected, and Dr. Reid, what are some long-term effects that may not appear until well after cancer treatment?
Dr. Reid: So, there are, and I think, the best example is pediatric cancer survivors and young adults who are treated for adult cancers at a young age. We know from the literature and the experience of pediatric cancer survivors that they can be treated and survive their cancer, you know, when they're 10 years old, but around the age of 30, late 20's to 30's, some of the side effects of treatment can emerge. Sometimes, this is about their heart. They can develop things like congestive heart failure because of the toxicity that the drugs did on their hearts. They can have fertility issues; they can start to develop second cancers related to the exposure of their treatments at a young age. It's very well described in the pediatric literature and even for young adults, say who get breast cancer in their 20's, you know, by the time they get to be 30 and 40, they've lived with this, you know, post-cancer period for, you know, 10-20 years, but the drugs that they took could still do damage, and that's when it emerges. We also know that women, for instance, treated with breast cancer in their 40's could live to be 80 years old and again, whatever kind of treatment they got may pose risks. It could increase their risk of second cancers. We know that several of the treatments for bone marrow transplant, for lymphoma and leukemia really put -- pre-dispose those survivors to second cancers five, ten years after treatment is finished.
So, it's really important, I think as people emerge into this survivorship period that not only do they understand what tests are ongoing, but they really need to be educated in terms of what risks they have for other diseases and other cancers. Again, because, you know, you educate people, they can proactively address some of these risks. They can make sure that they have the kind of testing they need when they're in the highest risk period, and they can educate their families because again, you know, cancer isn't just impacting one person. So, you really need your support system to be on top of things to get you into, you know, the best kind of proactive mode, so that you aren't, you know, suffering from the effects of cancer treatment.
Bill: Right. Proactive mode. I like how you put that, and can you talk to us about Chapter 2 and tell us what that is?
Dr. Reid: So, we, you know, decided to name our survivorship workshop -- this is the first one that we have going at Roswell. It's called "Chapter 2" because it really kind of demarcates that period after you have gotten through the cancer and, you know, people are courageous during the cancer treatment period, and, you know, you see that all the time. In Chapter 2, it's really, this new lease on life. You know, you've made it through treatment, and we want people to know what the options are, so that they can take advantage of say, other ways of living, get nutrition support, get physical therapy support, and so we've organized this conference both to educate people who are survivors on what the issues are and their caregivers. We're really encouraging the family members or the caregivers to attend the conference because we know they're also impacted by being with someone who's survived cancer, but we also want people to have options; like, they may have thought, "you know, maybe yoga will help me stretch and, you know, kind of get past some of the physical side effects of treatment, but I don't want to -- I don't know who to contact," so we're providing a series of 45-minute workshops on a variety of support services: spirituality, physical therapy, nutrition. They can pick three workshops to go to so that they can get sort of the beginning education and find out, you know, will this help me? Is this something that I've always wanted to try, but I don't really know what it's about, and you know, again, it's really about education and giving people access to services that they can personalize and really be in control of how they regain their normalcy -- whatever that is -- that they can find some peace of mind, that they can address some of the, you know, having cancer is a shock to the system, and it takes a while to sort of get past the impact that it has on your psychology, and so we really want to provide people with the time to have the conversation to ask experts and to experience some of the things that may have always wanted to try to see if those will help them to live better lives because, you know, we all know, it's about quality of life. You know, you can survive cancer, but what's really meaningful about that is you have to get to a quality of life that makes life rich -- leads people to lead their best lives after cancer because, you know, you can, you know, be a survivor for 10, 20, 30 years, and you really want to pack in the best life you can during that period.
Bill: So, Chapter 2 -- it sounds like it's very beneficial in turning the page on a new chapter in life after cancer, and lastly, Dr. Reid, can you tell us about survivorship and the Supportive Care Center at Roswell Park Cancer Institute?
Dr. Reid: Well, I'd love to. It's a new service. Our clinic is in the new building -- the clinical science center attached to the Roswell Park Hospital. It's on the third floor. It opened just this winter. We have a full staff in the survivorship clinic, and it sort of has two functions. One is that long-term survivors, when they no longer need to see their oncology team can come to this clinic. We'll perform all the surveillance and screening tests that the oncology team has asked for, but we will also network people into support services that are either available at Roswell or in the community because again, we want to empower people to make choices about how they lead this next part of their life.
We also want to support the generation of care plans so that when you finish treatment, you're actually given the plan by your oncology team that outlines both the schedule of tests, what issues they think you might have, and it encourages people to get some other referrals to some of those support services. It's formatted to communicate back to their primary care doctor so that there's the understanding of what tests can be done in the community versus what tests we want to have done at Roswell, and then from beyond that, if someone wants to come up to the clinic and see our practitioner, get networked into support services, have an assessment, we have a psychologist in the clinic. We're hiring our own nutritionist. Social work is there. We're closely linked with PT and OT and lymphedema treatments, so we have a very nice network based in that clinic, and patients can come in. It doesn't mean they have to leave their oncologist because, you know, you've developed a relationship. Oftentimes that person saved your life, but we want to provide this service because we really know that the sooner someone who is a survivor gets into, you know, gets back to their normal -- gets back to their physical sense of well-being and their quality of life, we know they do better. We know they survive longer, and we'll do whatever we can to facilitate that, so I think this is really a great addition to how we care for our patients at Roswell. It's very patient-focused, and it really puts the power and control and the kind of the control over their destiny back in the patient's court so that they can make decisions about how they're going to lead their lives going forward.
Bill: Well, that's great information, and it sounds very comprehensive as you would expect at Roswell Park Cancer Institute. Dr. Reid, thank you so much for your time today. For more information, visit roswellpark.org. That's roswellpark.org. You're listening to Cancer Talk with Roswell Park Cancer Institute. I'm Bill Klaproth. Thanks for listening.