15501 - Cancer Survivorship Cancer Survivorship Research:...

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Unformatted text preview: Cancer Survivorship Cancer Survivorship Research: Challenge Research: Challenge and Opportunity and Opportunity Noreen M. Aziz, MD Office of Cancer Survivorship, National Cancer Institute, Bethesda Once a virtual death sentence, cancer today is a curable insease for many and a chronic illness for most. With continued advances in strategies to detect cancer early and treat iteffectively along with the aging of the population, the number of individuals living years beyond a cancer diagnosis can be expected to continue to increase. Statistical trends show that in the absence of other competing causes of death, 62% of adults diagnosed with cancer today can expect to be alive in 5 y (1). Relative 5-y survival rates for those diagnosed as children (age 19 y) are even higher, with almost 75% of childhood cancer survivors estimated to be alive at 5 y and 70% at 10 y (2). Although survival from cancer has seen dramatic improvements over the past three decades mainly as a result of advances in early detection, therapeutic strategies and the widespread use of combined modality therapy (surgery, chemotherapy and radiotherapy) (48), the important role of the interplay between medical and sociocultural factors must also be kept in mind. Sociocultural factors include psychosocial and behavioral interventions, active screening behaviors and healthier lifestyles (9). These therapeutic modalities, however, are associated with a spectrum of late complications ranging from minor and treatable to serious or, occasionally, potentially lethal (4). One fourth of late deaths occurring among survivors of childhood cancer during the extended survivorship period, when the chances of primary disease recurrence are negligible, can be attributed to a treatment- related effect such as a second cancer or cardiac dysfunction (13). Most frequently observed medical sequelae include endocrine complications, growth hormone deficiency, primary hypothyroidism and primary ovarian failure (10,13). Thus, there is today a greater recognition of symptoms that persist after the completion of treatment and that arise years after primary therapy. Both acute organ toxicities such as radiation pneumonitis and chronic toxicities such as congestive cardiac failure, neurocognitive deficits, infertility and second malignancies are being described as the price of cure or prolonged survival (10). The study of late effects, originally within the realm of pediatric cancer, is now germane to cancer survivors at all ages because concerns may continue to surface throughout the life cycle (10,11). This paper reviews current prevalence data for cancer survivors; discusses definitional issues; examines cancer survivorship as a scientific research area; provides an overview of medical and psychosocial sequelae of cancer diagnosis and treatment experienced by survivors, gaps in knowledge and emerging research priorities; explores the role of weight, nutrition and physical activity as key variables carrying the potential to affect...
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15501 - Cancer Survivorship Cancer Survivorship Research:...

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