(Press-News.org) PHILADELPHIA – More than 60 percent of breast cancer survivors report at least one treatment-related complication even six years after their diagnosis, according to a new study led by a researcher from the Perelman School of Medicine at the University of Pennsylvania. The findings are part of a special issue of Cancer devoted to exploring the physical late effects of breast cancer treatment and creating strategies to prevent, monitor for, and treat these conditions in the nation's 2.6 million survivors of the disease.
"Our work provides the first accounting of the true magnitude of the post-treatment problems suffered by breast cancer patients, and serves as a call to action for proper monitoring and rehabilitation services to care for them," said Kathryn Schmitz, PhD, MPH, an associate professor of Biostatistics and Epidemiology who serves as a senior scientist on the committee overseeing creation of a surveillance model for breast cancer survivors. "We can no longer pretend that the side effects of breast cancer treatment end after patients finish active treatment. The scope of these complications is shocking and upsetting, but a ready solution for many of them already exists in rehabilitative exercise."
Schmitz, a member of Penn's Abramson Cancer Center, points out that previous studies to determine the prevalence of post-treatment complications typically examined just one issue. The new findings, instead, provide a full snapshot of the complications women may experience following the chemotherapy, surgery, radiation treatment and hormonal therapy to cure their disease and keep it from returning. The results reveal that these problems rarely exist in isolation: Many women with the painful limb-swelling condition lymphedema, for instance, may also struggle with fatigue and bone health challenges.
Schmitz collaborated with an Australian research team to follow 287 Australian women with invasive, unilateral breast cancer for a median of 6.6 years, prospectively assessing the women for treatment-related physical and functional complications at set points throughout the study. Areas of study included postsurgical complications, skin reactions to radiation therapy, upper-body symptoms and functional limitations, lymphedema, weight gain, and fatigue. Sixty percent of the women were still experiencing one of these problems at six years after their diagnosis, and 30 percent were still struggling with at least two issues. Most of the problems appeared within the first year patients were assessed, but the prevalence of most impairments – except lymphedema and weight gain -- decreased over the course of the study.
Writing in the lead editorial of the special issue of Cancer, Schmitz and her colleagues outline the myriad barriers that lay in the way of properly monitoring breast cancer survivors for the problems uncovered in the new study. Patients may have fragmented care, receiving different prongs of their treatment at different hospitals; patients and providers may believe certain problems are "expected" and "normal" and not appropriate for treatment; and unlike orthopedists and cardiologists who frequently send patients for physical rehabilitation to ensure their complete recovery, oncologists and surgeons are often poorly linked to physical therapy professionals, limiting the number of patients who are aware of or referred for these services.
In the face of these challenges, an expert panel laid out a model for prospectively surveying breast cancer survivors and formally incorporating rehabilitation and exercise experts into cancer survivorship programs. Research increasingly shows that post-treatment complications can be minimized – and even prevented altogether – when caught early and addressed through various rehabilitation regimens. "When early signs of impairment are noted and that impairment has a high probability of worsening if allowed to progress, which ultimately may result in a worse, permanent disability, there is an ethical obligation to treat the condition," they write.
The question of how best to implement the proposed rehabilitation and surveillance remains to be addressed. The panel plans to work through the American Cancer Society with stakeholder groups to answer questions about how to educate patients and clinicians about the plan and fully implement it. The American College of Surgeons Commission on Cancer has published guidelines that will require that all accredited cancer treatment centers provide treatment summaries and survivorship health care plans to all their patients by 2015. The proposed surveillance and rehabilitation model could serve as a framework for meeting those pending guidelines. "In the meantime," Schmitz says, "breast cancer survivors should be empowered to ask their doctor for a referral to physical therapy and exercise programs."
###
Penn Medicine is one of the world's leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania (founded in 1765 as the nation's first medical school) and the University of Pennsylvania Health System, which together form a $4.3 billion enterprise.
The Perelman School of Medicine is currently ranked #2 in U.S. News & World Report's survey of research-oriented medical schools. The School is consistently among the nation's top recipients of funding from the National Institutes of Health, with $479.3 million awarded in the 2011 fiscal year.
The University of Pennsylvania Health System's patient care facilities include: The Hospital of the University of Pennsylvania -- recognized as one of the nation's top 10 hospitals by U.S. News & World Report; Penn Presbyterian Medical Center; and Pennsylvania Hospital — the nation's first hospital, founded in 1751. Penn Medicine also includes additional patient care facilities and services throughout the Philadelphia region.
Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year 2011, Penn Medicine provided $854 million to benefit our community.
END
Los Angeles, CA (April 9, 2012) Does the growing number of psychiatric disorder diagnoses have an effect on people with mental illnesses? According to a new study, as definitions of mental illnesses become broader, people who show signs of depression and other common mental illnesses are less likely to evoke a supportive response from friends and family members as are people with other severe mental disorders. This new study was released in a recent issue of the Journal of Health and Social Behavior (published by SAGE).
Author Brea L. Perry studied interviews conducted ...
ATLANTA—April 10, 2012—A new report by American Cancer Society scientists says new data showing aspirin's potential role in reducing the risk of cancer death bring us considerably closer to the time when cancer prevention can be included in clinical guidelines for the use of aspirin in preventative care. The report, published early online in Nature Reviews Clinical Oncology, says even a 10% reduction in overall cancer incidence beginning during the first 10 years of treatment could tip the balance of benefits and risks favorably in average-risk populations.
Current guidelines ...
URBANA – New research from the University of Illinois sheds light on the nutritional value of whey powder and whey permeate as a lactose source for pigs.
"We wanted to determine the energy concentration and digestibility of phosphorus in whey powder, in conventional whey permeate, and in low-ash whey permeate because these values had not been determined," said Hans H. Stein, a U of I professor of animal sciences.
Skim milk powder has been used to meet the requirement for lactose by weanling pigs, but it is costly and usually uneconomical to use in commercial production. ...
ProfitKey International, a leader in ERP software for discrete manufacturing companies for over 30 years, has entered into an agreement with PowwowHR to integrate their Human Resource Management System (HRMS) with ProfitKey's Rapid Response Manufacturing ERP system.
PowwowHR is a leading provider of HRMS software and solutions delivered via a SaaS-based integrated platform which eliminates the need to manage multiple vendors.
Founded by principals with over 20 years experience providing HR solutions, they believe it takes a group of people who are HR professionals ...
Stress and anxiety among Americans is under increasing concern –in the doctor's office, in the workplace and at home. UC student researchers will be examining different facets of the crisis as they take part in a national conference aimed at bringing relief to that suffering.
UC graduate and undergraduate research posters will be presented at the 32nd annual conference of the Anxiety Disorders Association of America, which will be held April 12-15 in Arlington, Va. All of the student researchers are under the mentorship of Alison Mcleish, a UC assistant professor of psychology.
Three ...
AMES, Iowa – Christopher Karstens was on the ground studying the damage caused by the deadly April 27, 2011, tornado that hit Tuscaloosa and Birmingham, Ala.
It was just a week after the tornado. He was between the two cities, in the rough country of the southern Appalachians about 20 miles northeast of Tuscaloosa. He said it's terrain that's "beyond hilly." It's covered by dense forest and clogged by high brush that's tough to walk through. A hike of about 100 yards sometimes took as long as 45 minutes.
It was a perfect place for Karstens – a doctoral student from ...
MAYWOOD, Ill. -- Researchers have determined that bacteria are present in the bladders of some healthy women, which discredits the common belief that normal urine is sterile. These findings were published in the April issue of the Journal of Clinical Microbiology by researchers at Loyola University Chicago Stritch School of Medicine (SSOM).
"Doctors have been trained to believe that urine is germ-free," said Linda Brubaker, MD, MS, dean, SSOM. "However, these findings challenge this notion, so this research may have positive implications for how we treat patients with ...
PINC Solutions, the leading provider of advanced yard management systems (YMS) today announced that the company has been included in the list of "Cool Vendors" in the Supply Chain Management report by Gartner, Inc.
According to the March 26, 2012 report, this year's "Cool Vendors" prove once again that, although aspects of the SCM technology market are mature, innovation continues as companies look for capabilities that make them more competitive or improve their operating metrics.
Traditionally, yard management has been looked at as a means to ...
Money doesn't buy happiness. Neither does materialism: Research shows that people who place a high value on wealth, status, and stuff are more depressed and anxious and less sociable than those who do not. Now new research shows that materialism is not just a personal problem. It's also environmental. "We found that irrespective of personality, in situations that activate a consumer mindset, people show the same sorts of problematic patterns in wellbeing, including negative affect and social disengagement," says Northwestern University psychologist Galen V. Bodenhausen. ...
A new analysis provides a closer look at how much cancer patients value hope — with important implications for how insurers value treatment, particularly in end-of-life care.
The analysis led by Darius Lakdawalla, director of research at the Schaeffer Center at USC and associate professor in the USC Price School of Public Policy, surveyed 150 cancer patients currently undergoing treatment, and is part of a special issue on cancer spending from the journal Health Affairs.
Lakdawalla and his co-authors found the overwhelming majority of cancer patients prefer riskier ...
