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Treatment-Related Side Effects Trouble Breast Cancer Patients Long After Completing Care

At least 1 treatment-related complication is reported by more than 60% of breast cancer survivors as late as 6 years after their diagnosis, according to a new study published in a special issue of Cancer. Devoted to exploring, preventing, and monitoring the physical late effects of breast cancer treatment, the special issue focuses on the nation’s 2.6 million survivors of the disease.

“Our work provides the first accounting of the true magnitude of the post-treatment problems suffered by breast cancer patients, and serves as a call to action for proper monitoring and rehabilitation services to care for them,” said Kathryn Schmitz, PhD, MPH, an associate professor of biostatistics and epidemiology at the Perelman School of Medicine at the University of Pennsylvania. Schmitz serves as a senior scientist on the committee overseeing the design of a monitor system for breast cancer survivors.

According to Schmitz, a member of Penn’s Abramson Cancer Center, the study results show that these late effects seldom occur in isolation. For instance, many women with lymphedema may also experience fatigue and bone health issues.

Through collaboration with an Australian research team, Schmitz and colleagues followed 287 Australian women with invasive, unilateral breast cancer for a median of 6.6 years. Assessments for treatment-related physical and functional complications were conducted at set points throughout the study. The treatment-related side effects studied included postsurgical complications, skin reactions to radiation therapy, upper-body symptoms and functional limitations, lymphedema, weight gain, and fatigue. Of the 287 study participants, 60% were still experiencing 1 of these problems at 6 years after their diagnosis, and 30% were suffering with at least 2 issues.

Unfortunately, many obstacles inhibit proper monitoring of breast cancer survivors for these problems. According to Schmitz and her colleagues, patients may have disjointed care; patients and providers may believe certain problems are “expected” and “normal”; and oncologists and surgeons are often poorly linked to physical therapy professionals, thus limiting the number of patients who are referred to the services for complete recovery.

In the face of these challenges, a prospective model for following breast cancer survivors and formally integrating rehabilitation and exercise specialists into cancer survivorship programs has been formed. However, until a surveillance and rehabilitation model is in effect, “breast cancer survivors should be empowered to ask their doctor for a referral to physical therapy and exercise programs,” Schmitz said.

Source: Penn Medicine.

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Last modified: September 8, 2015