Kenneth Miller, MD
Kenneth Miller, MD, medical oncologist, codirector, Perini Family Survivors’ Center, Dana-Farber Cancer Institute, Boston.
Cancer treatment engulfs patients in a blur of intense emotion, pain and activity as they and their medical teams attack the disease. Then, when treatment comes to a successful end (as, fortunately, it so often does) and patients are released to journey on their own back to normalcy, many quickly discover that recuperating from cancer is one thing, but recovering from its treatment and impact on your life is quite another.
Even surviving cancer affects people emotionally as well as physically. It can upend family dynamics, sometimes permanently… it can disrupt or completely change professional lives… and it virtually always creates anxiety concerning future health and care, as well as uncertainty about how to go on living a regular, daily life once again. For many survivors, what lies ahead is a long, often lonely path with lots of new challenges. Happily, there is excellent help to be had.
A number of cancer centers have developed specialized survivorship programs. Two of the most comprehensive are the Lance Armstrong Foundation Adult Survivorship Program and the Perini Family Survivors’ Center, both run by the Dana-Farber Cancer Institute in Boston. I recently spoke with the Perini program’s codirector, Kenneth Miller, MD, to discuss how cancer survivors can prepare themselves for the survivorship journey.
Dr. Miller told me that survivorship has three phases…
Transition is the period immediately after treatment ends. Accustomed to having health professionals hovering over them, many patients feel a letdown when they’re done with treatment. They may be surprised by feelings of abandonment and loss.
Extended survivorship is the second phase, covering the several years immediately following treatment. This time is characterized by active surveillance and monitoring aimed at ensuring that any recurrence is caught quickly and treated appropriately. Cancer survivors may find themselves coping with physical and cognitive limitations that they had not anticipated. Uncertainty and a sense of being adrift with no particular destination are common feelings at this point, although many patients also report a growing sense of confidence and hope.
Permanent survivorship refers to the years and even decades of life after cancer. It’s generally thought to begin at the five-year mark, which is the time when many cancer survivors are officially said to be at very low risk for recurrence. Many now dare to feel cautiously optimistic — it is the time when they travel, in Dr. Miller’s words, from “being cancer-free to being free of cancer.”
Of course, cancer patients need to remain vigilant about taking care of their physical health as well. Specifically this means…
There is more support and information available to cancer patients today than ever before, including advice on legal questions about health coverage and access to social workers who specialize in treating issues related to cancer, including family relationships, sexual discomfort, body image and changes, anxiety and other related difficulties. Helpful resources include…
All these are helpful tools to make the transition from patient to survivor a smoother and more comfortable journey.