28 November 2016

Cancer treatment takes a physical and mental toll. As patients progress from active treatment into the survivorship phase, many become frustrated that they cannot “bounce back” as quickly as they would like. Getting back to “normal” may not be realistic – many of us are doing way too much even on a good day, and ignore the warning signs telling us to slow down. Cancer is a major jolt, and all energy gets diverted for treatment. After treatment, there are new physical and mental limitations, and priorities may need to be re-set.

A study recently published in the Journal of Clinical Oncology may help explain why patients have such a difficult time getting back to their pre-treatment self. Researchers postulated that cancer treatment may trigger an accelerated aging process in some cancer survivors. They measured inflammatory cytokines (proteins that are important in cell signaling) in cancer survivors and a control group of patients without cancer. There were no differences before treatment, but after 18 months, breast cancer survivors had higher levels of these inflammatory markers compared to the control group. In addition, higher levels of inflammation correlated with increased comorbidity (other medical problems) in cancer survivors.

The authors suggested (although this was not shown in their study) that with longer follow up time, the excess inflammation may contribute to poorer health and premature mortality in the cancer survivor group.They postulated that cancer treatment may trigger an accelerating aging process in cancer survivors and they stressed the need for longer followup and more study to determine the biology behind these effects.

Many cancer patients express that they feel they have “aged beyond their years”. This study suggests that the cancer treatments themselves may indeed contribute to the aging process. The study authors noted that their results underscore the need for breast cancer survivorship care to include recommendations for exercise, diet and weight management programs, as well as screening for and treatment of other medical conditions.

11 May 2013

In May 2013, I was invited to give a talk with my colleague Dr. Carol Connor at the annual meeting of the American Society of Breast Surgeons.  Our topic was “Endocrine Therapy for Breast Cancer”, and we discussed the literature supporting the use of tamoxifen and aromatase inhibitors for breast cancer, as well as adverse effects and treatment of adverse effects. We were then invited to submit a manuscript which was published in the Annals of Surgical Oncology. The following is a summary of our talk and manuscript. I would like to express my appreciation to the #BCSM Community, who responded to my request for information about adverse effects  – it allowed me to discuss not only the literature, but also real patient experiences.

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