Long-Term and Late Effects
Over the past several years the Institute of Medicine has published several reports on the status of survivorship research. These reports include: Childhood Cancer Survivorship: Improving Care and Quality of Life (2003); From Cancer Patient to Cancer Survivor: Lost in Transition (2005); and Cancer Care For the Whole Patient: Meeting Psychosocial Health Needs (2007).
These reports demonstrate that after a diagnosis of cancer there is an increased risk of a recurrence (reappearance of disease) or metastases (transmission to other sites in the body), or of a second primary tumor. There are also other increased risks that vary based on a particular diagnosis and treatment. Since its inception, NCCS has advocated for research and long-term follow-up for adult cancer survivors. As early as 1987, a leading oncologist in survivorship research, Dr. Patricia A. Ganz, wrote:
- Familiarize yourself with the specifics of your treatment
- Remain alert to the possibility of secondary medical effects
- Plan to have regular follow-up visits for the rest of your life
These suggestions are as true today. There is now evidence that treatment may cause or contribute to long-term or subsequent physiologic changes as long as 5, 10, or 20 plus years later. This is not intended to frighten you, but rather to alert you to the potential problems so that you can be vigilant about your care.
Simply by aging, many of us experience these health problems. Organ damage, organ failure, premature infertility, premature aging, compromised immune system and a damaged endocrine system have been identified as some of the potential immediate, mid-range and long-term effects. These effects may contribute to chronic illness, incontinence, swelling, reproductive problems and psychological conditions.