The doctor's successful treatment of us cancer people with chemotherapy and radiation is now our problem. Only now are doctors beginning to talk about the long term issues for people treated with chemotherapy. Well oncologists were more aware but other doctors not so much.
A recent study (because we needed another study) found that 6% of non cancer doctors knew about the long term side effects of chemotherapy drugs.
"While advances in cancer care have successfully kept more cancer
patients alive, this new study finds there's room for improvement in
their follow-up care. Primary care physicians and even cancer
specialists need to be aware of the long-term effects of the drugs
patients have taken to beat cancer.
Researchers at Harvard University, the National Institute of Nursing Research and the American Cancer Society
surveyed nearly 1,100 primary care physicians and 1,100 oncologists or
cancer specialists. They asked these doctors to identify the long-term
side effects of four of the most widely used chemotherapy drugs used to
treat breast and colorectal cancer, two of the most common cancers.
Overall, only 6% of primary care physicians and 65% of oncologists
were aware of all the long-term side effects that the four drugs could
When asked about the drug Doxorubicin, 55% of primary care physicians
knew patients are at risk for cardiac dysfunction, compared to 95% of
In the case of Cyclophosphamide, only 14% of primary care physicians
knew women are likely to suffer premature menopause, compared to 71% of
Doxorubicin is also know n as Adriamycin and Cyclophosphamide is known as Cytoxan. I was treated with these drugs during chemo. A friend of mine has impaired cardiac function as a result of chemo. All women are told that chemo was likely to put them into early menopause. But I do have another friend who was in her 20's when introduced. When she gets through hormonal treatment next year, they are going to start working on a baby.
I just checked on chemocare.com for details on side effects and Adriamycin is listed as having two long term side effects. It can interfere with the pumping of the heart and this can show up 7 or 8 years after treatment. And there is also a risk of developing leukemia years after treatment - I know two women who have had this. Cyclophosphamide is only listed as possibly causing leukemia as well, nothing about premature menopause.
that, in the past, medical training has not been focused on making sure
physicians taking care of cancer survivors are adequately prepared to
deal with long-term side effects.
In addition to chemotherapy drugs and radiation treatments affecting
organs and tissues, ... also spoke about psychosocial problems
patients can face, like fear of cancer recurrence. Problems with
relationships also occur because patients are no longer functioning in
crisis mode and reentry into a normal pattern is sometimes very
Experts agree that in the past, the emphasis has been to keep cancer
patients alive, and that entire field of cancer survivorship is a pretty
new one. But with the success of cancer care, more attention must be
given to this area. ... points out that it's now recommended by professional
societies for doctors to provide a survivorship care and treatment plan
when patients complete their cancer therapy. Such a plan will inform the
patient of issues they may face and they can share this information
with their physician.
Not recognizing how a cancer survivor can develop treatment-related
health problems is a concern. Link calls it a doctor-education problem
and a patient-education problem, which he believes could be helped by
better use of electronic medical records."
This means I need to educate my doctors. I do like my new primary
care doctor but she is young and I will need to have a discussion with
her about long term side effects. What didn't kill us may not have made us stronger in this case.