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Thyroid Cancer Survival Rate

An article in US News & World Report (5 April 2004) looks at the challenges faced by cancer survivors who have undergone conventional treatments. As the cancer survival rate for children treated with chemotherapy, radiation, and surgery has increased over the years, doctors have learned that these treatments can create other problems years later. Consequently, follow-up care for children who survive cancer is quite extensive. The medical establishment is just beginning to recognize that adult survivors also need follow-up care. The National Institutes of Health is funding more studies on cancer survivors. Some cancer centers, such as Memorial Sloan-Kettering (New York City, New York) and M.D. Anderson (Houston, Texas), now have 'survivorship' programs. In April 2004, the Centers for Disease Control and the Lance Armstrong Foundation was scheduled to release "a public-health blueprint for addressing the needs of cancer survivors."

The US News article says that radiation therapy is a major source of problems. The brain's white matter, responsible for much of our higher cognitive abilities, is easily damaged by radiation. Children with leukemia often received head irradiation until a 1981 study found that it caused a significant drop in IQ. Mark Keran, director of pediatric neuro-oncology at Dana-Farber (Boston, Massachusetts), remembers a 5-year-old patient treated for pediatric brain cancer in the late 1970s. Treatment, which included radiation, cured the boy of cancer; but at age 20, "[he] was rocking back and forth in a chair, sucking his thumb." Today, doctors have more awareness of radiation's effect on a child's developing brain. But researchers are still learning about radiation's long-term effects. A recent study found that children diagnosed with Hodgkin's disease between 1955 and 1986 and treated with radiation have 18 times the risk of developing another cancer (usually breast or thyroid) as the general population. Adults who receive radiation therapy may develop cardiac arrhythmias, bone weakness, premature aging of organs, sexual dysfunction, and lymphedema. In addition, radiation therapy pushes women into premature menopause.

Like radiation, chemotherapy can cause infertility, but it also has other after-effects. Cisplatin, which is one ingredient in therapy for testicular cancer, damages the kidneys and, possibly, the heart. Some of the chemicals also cross the blood-brain barrier, resulting in memory loss, impaired concentration, and decreased organizational skills. Impaired mental function can last for years after treatment.

Fatigue, depression, and pain can also trouble cancer survivors long after treatment ends. Bone-marrow-transplant patients often suffer severe fatigue, which Pam Massey and colleagues at M.D. Anderson says can be reduced with exercise. Depression is a serious problem in cancer patients and survivors. William Breitbart, the chief of psychiatry at Sloan-Kettering, says about 15 to 25% of cancer patients and survivors suffer clinical depression that can be helped with medication. Depression also contributes to pain. Research shows that people with a history of depression are more likely to develop chronic pain. "You can have symptoms that go on for years, whether from the tumor itself, chemo, radiation, or surgery," says Ada Jacox, professor of nursing at the University of Virginia and director of clinical practice guidelines for the American Pain Society.

Many cancer survivors turn to the web for support and information about the challenges they face. One of the web sites that some find helpful is the one sponsored by the Lance Armstrong Foundation, www.livestrong.org. This site includes personal stories of survivors with different kinds of cancers as well as "straight-forward advice from experts broken into three categories: physical, emotional, and practical."

Silver, Marc. E-Comfort, Online Help. US News & World Report. April 5, 2004.

Szegedy-Maszak, Marianne & Hobson, Katherine. Beating a Killer. US News & World Report. April 5, 2004.

COPYRIGHT 2004 The Townsend Letter Group
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