Cancer control and survivorship
October 25, 2013
I recently attended the Southwest Oncology Group (SWOG) meeting, a consortium of research institutions doing clinical trials on cancer. The conference highlighted how new research will remarkably affect cancer survivorship, quality of life (QOL), integrative care and our ability to predict and provide needed services more accurately and with greater cost effectiveness for cancer survivors. The tools for implementing cancer control are evolving quickly.
Here are some highlights from the meeting:
- Biomarkers, which are any human characteristics that are measurable including everything from gene expression (or over-expression) to pain surveys, can potentially predict long term survival as well as the specific services that will most benefit patients.
- Symptoms that are increasingly predictable by biomarker assays include fatigue, insomnia, pain, anorexia, nausea, depression and others. This means that we will soon be able to better predict the patients who will be affected by these problems and deliver interventions much earlier and more effectively.
- Patient satisfaction is frequently not related to treatment outcome. Factors such as QOL and survivorship are important.
- Lung cancer patients suffer inordinately high, long-term QOL deficits. Many of these respond well to interventions but interventions are frequently not provided to patients with lung cancer.
- Symptom clusters (i.e. combination of symptoms such as insomnia plus constipation plus night sweats) may provide information beyond what is available from individual symptoms.
- Gene variations, many of which are inherited, coincide with a number of responses and behaviors including susceptibility to chemotherapy adverse effects, bone pain from metastases, neuropathy, joint pain and estrogen depletion with certain drugs to name just a few. Once again, we can increasingly focus interventions on the patients most likely to run into these problems before they reach devastating levels.
- Psychosocial issues are closely associated with other symptoms including QOL with treatment.
- Acupuncture helps alleviate joint pain secondary to anti-estrogen treatments.
There is much more information but this gives you a sampling of the progress being made. The bottom line is that we can get patients through cancer treatment with better outcomes and less discomfort. From a regulatory and advocacy perspective we must now find ways to educate patients and providers about the availability of this support.