NCI grant enables Case researchers to continue study of cancer after-effects
Cancer Survivors Research Program looks at quality of life issues among older cancer survivors
Advances in cancer diagnosis and treatment mean that more people than ever before are surviving the disease. While a great deal of research has been conducted on the immediate aftermath of cancer treatment, until recently little has been known about how long-term survivors are coping with the later effects of the disease.
The Cancer Survivors Research Program at Case Western Reserve University is filling that gap. Under the direction of Gary Deimling, professor of sociology, researchers are examining the quality of life among older cancer survivors. Deimling and his colleagues were recently awarded a five-year, $1.6-million continuation grant by the National Cancer Institute (NCI) to continue their work examining the quality of life of older long-term cancer survivors. Data collected over the ten-year period of the original five year, $1.4-million grant and the continuation grant will provide the researchers a unique opportunity to follow individuals age 60 and older who have survived cancer for five or more years.
“Survivorship issues have become a major thrust in cancer research,” Deimling explains. “We’re looking at the legacy of cancer and how it interacts with the general effects of aging. As people get older they naturally have a greater number of chronic health conditions. We’re looking at cancer as an overlay to these aging effects.”
The researchers presented their most recent findings at the Cancer Survivorship Conference, co-sponsored by the National Cancer Institute and the American Cancer Society, for which they received an “award of excellence”. Those findings suggest that a majority of survivors experience a good quality of life, in terms of both physical and mental health.
However, they also note that there are significant groups for whom the after-effects of cancer detract from the quality of life. For example, the research found that even decades after treatment breast cancer survivors often experience swelling, numbness and pain attributed to cancer or its treatment. For prostate cancer survivors urinary incontinence and impotence persist. For colorectal cancer survivors constipation and diarrhea are common long-term effects. Moreover, cancer survivors in general experience more health problems than non-cancer groups.
In terms of psychosocial effects, a substantial proportion of long-term survivors report continuing worries about recurrence, and fears that symptoms they experience may indicate a recurrence. Moreover, they found these worries to be significantly associated with both anxiety and depression.
Karen Bowman, senior research associate in the department of sociology and associate director of the Cancer Survivors Research Program, has focused her research on family members of long-term cancer survivors. “I wanted to look at the effects of cancer on families and effects of families on the cancer, the role that families play in their relatives’ long-term cancer survivorship,” she explains.
Bowman’s most recent work looks at families and health maintenance in long-term survivorship, including medical checkups, adequate rest, physical activity and exercise, healthy weight maintenance, and prayer. “What we’ve found is that family members are acting as what we are calling health maintenance advocates for survivors, encouraging them to do activities to keep them healthy,” she says. Family members themselves are performing a high number of health maintenance activities, but most say their activities are not necessarily related to their survivors’ cancer.
The research team is especially interested in health disparities related to race and gender. Interestingly, Deimling notes, levels of cancer-related anxiety are lower among African-Americans, even though African-Americans often are diagnosed at a more advanced stage of the disease and are thus more likely to die from it. Women who are long-term survivors experience poorer health than men, but most of that difference is due to the greater number of co-morbid health conditions that women generally experience, not a poorer response to cancer.
The Cancer Survivor Research Program will spend the next five years tracking the effects of cancer on these survivors as they continue to age, trying to identify the key factors that differentiate between those survivors who continue to have cancer-related problems and those who are able to age successfully, in spite of cancer.
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