Life after cancer

As patients become survivors, a new focus

As treatments for cancers improve and more patients become survivors, hospitals across the country are rethinking strategies to help them readjust to a new normal life.

The comprehensive attention, including psychological, financial and nutritional counseling, has been a long time coming, said Dr. Christina Pozo-Kaderman, of Mount Sinai Medical Center in Miami Beach.

“You finish treatment and it’s like, ‘OK, go live your life. We’ll see you in three months,’ ” said Pozo-Kaderman, a psychologist and sex therapist who works with cancer patients and survivors. “They’re thrilled to be finished with treatment and not have to get chemo any more, but then starts the ‘what ifs,’ the fear, the anxiety.”

In many cases, these side effects include sexual dysfunction, fatigue and memory problems known as chemo brain. Pozo-Kaderman said it can be difficult for survivors to talk about some of these side effects, especially the sexual ones, with their oncologists.

“You survive and you live but you’re a changed person, and depending on the age, the concerns are very different.”

For that reason, the medical staff at Mount Sinai tell survivors about the possible side effects during their first check-up three months after cancer treatment is over, and offer referrals if they need them at that time.

This sort of attention will soon become a standard at cancer treatment centers in the U.S., where the number of survivors is expected to increase to 18 million by 2022, according to the American Association for Cancer Research. Under a mandate by the country’s leading medical governing bodies to improve life for cancer survivors, accredited centers are now working to create so-called “survivor care plans” by 2015.

At the Memorial Cancer Institute at Memorial Healthcare Systems in Broward, disease-specific teams are developing these plans for breast, colon, lung, and blood cancer survivors. The plans will be given to patients during a check-up three months after completing therapy and include a detailed physical and electronic document that explains the diagnosis, medical treatment, past surgeries and risk factors.

“When a patient completes her treatment, she will have a tool that she can take with her wherever she goes. It will describe everything that happened to her,” said Cynthia Frankel, director of the institute’s survivorship program.

Dr. Eugene Ahn, an oncologist at the University of Miami’s Sylvester Comprehensive Cancer Center, said one of his biggest frustrations has been that cancer patients don’t get enough time with their doctors after their treatment is over.

“When most patients complete their therapy, they see their oncologist with 15 to 30 minutes allotted to their follow-up appointment,” Ahn said. “It’s not long enough.”

That’s why he supports a new breast cancer survivorship program launched at Sylvester earlier this month. It takes a holistic approach to treatment after the disease has gone into remission.

The program focuses on the most common physical and psychological problems that breast cancer survivors face, including depression, fatigue, weight gain and menopausal symptoms.

Melinda Rodriguez, 45, had her first session with the UM program last week. Rodriguez, who lives in Key West and drives to Miami for sessions, finished chemotherapy in early May. She went from seeing her doctors on a weekly basis, to not seeing them at all.

“All of a sudden you stop seeing a doctor,’’ she said. “It kind of makes you feel like, what do you do? You’re lost.’’

Rodriguez met with specialists who gave her personalized advice and directions for sleeping and eating better, and how to exercise.

“It was just a very good feeling to know that I still had somebody I can talk to,’’ she said.

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