Cancer Worries Continue Long After Treatment Ends
Cancer survivors and treatment
The doctor may give the cancer patient a clean bill of health, but worries about recurrences, lingering effects from treatment, a second cancer and a shortened life plague the thoughts of approximately one-third of long-term, older-adult cancer survivors, according to researchers from Case Western Reserve University's Cancer Survivor Research Project. This is one of the first studies to look at the worries experienced by long-term survivors.
It may be that these long-term survivors of five or more years after the end of their treatments may be worriers in general, said Gary Deimling, Case professor of sociology and lead investigator on the "Cancer-Related Health Worries and Psychology Distress among Older Adult, Long-Term Cancer Survivor" article in the journal, Psycho-Oncology.
But he adds that it raises concerns that cancer continues to impact survivors' lives.
Overall most survivors are not letting these worries compromise the quality of their lives either physically or psychologically, report Deimling and co-investigators Karen Bowman, Samantha Stern, Louis Wagner from Case's sociology department and Boaz Kahana from Cleveland State University, but these worries are linked to both depression and anxiety.
The researchers' concerns led to the study of 321 long-term survivors of breast, colorectal or prostate cancer in National Cancer Institute-funded Cancer Survivors Research Project at Case.
While much research focuses on cancer during and immediately after, this study looked at the survivors who average slightly more than 10 years after their last treatment and are over the age of 60. They felt that years after treatment the survivors might have different worries about cancer than those experienced during the disease.
While the five-year point is often considered a milestone in surviving cancer, Deimling points out that most survivors recognize that it as no guarantee of a cancer-free future. "Many cancers can recur long after five years, and the possibility exists that another cancer will result from the carcinogenic effects of treatment," added Deimling.
In general, survivors who have an optimistic outlook also have less worries, and lower depression and anxiety.
They did find an association between having chemotherapy and functional difficulties which in turn may result in depression.
At diagnosis, the cancer patient worries about surviving, during treatment about the side effects from the therapies or surgery, and at the end of treatment, a recurrence.
With the passage of time, the cancer survivor thinks about second cancers from radiation or chemotherapy or a new primary cancer.
Also continued testing and monitoring for cancers raises distress in the survivor, the researcher report.
The researchers reported some of their findings were:
- Between 27% to nearly 40% of survivors continue to have concerns about a recurrence, with male colorectal and prostate survivor having the greatest concerns.
- Depending on the type of cancer, between 34-41% worry that current symptom might indicate that cancer has returned.
- Depending on the type of cancer, some 26-36% of the survivors expressed concerns about getting a second cancer, with prostate cancer survivors having the highest concerns.
- Depending on the type of cancer, follow-up testing continued to bother 36-44% of the survivors, again with colorectal cancer survivors with the most concerns.
The researchers also said that while men reported more cancer-related health worries, women had higher anxiety scores. Women survivors of breast cancer and cancer in general also had more depression than male survivors of prostate cancer.
"The cancer-related health worries reported by survivors should be an important consideration for oncologists, primary care practitioners and mental health professionals treating older adult long-term survivors," said the researchers, who pointed out they may be linked to depression which is suffered by as much as 17% of the older population.