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Lesson4:ImpactofCancer

LearningObjectives
x Describethepotentialphysical,psychological,socialandspiritualimpactsofcancer

KeyTakeaways
x Cancerpatientsfacemanyphysical,psychological,socialandspiritualimpactsfrom
canceranditstreatment.
x Adolescentsandyoungadults,aged1540,faceuniquechallengesfromolderadults
duringandaftertreatment.
x Peoplelivingwithadvancedcanceralsofaceuniquechallenges.
x Cancercanimpactpeopleevenaftertreatmentendsinthesurvivorshipphaseofthe
cancercontinuum.
x SurvivorshipCarePlansaretoolstohelpcancersurvivorsaftertheyaredonewith
treatment.Theyincludeatreatmentsummaryandaplanforfollowupcare.
x Manypatientswillhaveendoflifeneeds,whichvaryfrompatienttopatient.



 

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LESSON4:IMPACTOFCANCER

Physical,Psychosocial,PracticalandSpiritualImpacts
IssuesUniquetoAdolescentsandYoungAdults(aged
1540)
IssuesUniquetoThoseLivingwithAdvancedCancer
PostTreatmentSurvivorship
ResourcesforPatientNavigatorsandPatients

Physical,Psychosocial,PracticalandSpiritualImpacts

Cancercanimpactpatientsinmanyways.Eachpatientisdifferentandwillexperience
treatmentdifferently,eveniftheyhavethesametreatmentregimen.

PhysicalImpacts
Pain
Fatigue
Anemia
Weightgain/loss
Nausea/vomiting
Selfcareandmobilityissues
Othertreatmentsideeffects
Lifethreateningmedicalemergencies
PsychosocialImpacts
Bodyimageissues
Anxietyanddepression
Changesinrelationshipsandrolesinfamily
Caregiverburdenandsupportneeds
Stigma,fear,socialisolation
Mentalhealth
PracticalImpacts
Financial
Abilitytowork
Food,housing,utilities
Legal
SpiritualImpacts
Findingmeaninginillness
Changesinbelief
Endoflife

Source:Cancer.Net.SideEffects.2014.

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IssuesUniquetoAdolescentsandYoungAdults(aged1540)

Disruptionto Managing
Familydynamics Isolation
school/work/career distress/emotions

Sexual
Peergroups Fertility
relationships/dating


Source:U.S.DepartmentofHealthandHumanServices.ClosingtheGap.2006.

IssuesUniquetoThoseLivingwithAdvancedCancer

Psychosocialdistress

Emotionalsupport

Information

Decisionmakingandcommunication

Reliefofsymptoms

Practicalconcerns

Sources:MetastaticBreastCancerAlliance.ChangingtheLandscape.2014;PfizerOncology.
BreastCancer:AStoryHalfTold.2014.

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PostTreatmentSurvivorship

LongtermandLateEffects

Cancersurvivorsareatriskforlongtermandlateeffects.Alongtermeffectissomethingthat
startedduringtreatmentandlastsevenaftertreatmentisover.Forexample,ifapatienthas
lymphedemaaftersurgery,thismightcontinueevenaftertheyaredonewithalloftheir
treatment.Alateeffectissomethingthatstartsaftertreatment.Lateeffectscanhappen
monthsorevenyearsaftertreatment.

Treatment Longtermsideeffects Latesideeffects

Chemotherapy Fatigue Vision/cataracts

Prematuremenopause
Sexualdysfunction
Neuropathy(tinglinginhands/feet)
Chemobrain
Kidneyfailure
Infertility
Liverproblems
Lungdisease
Osteoporosis(boneweakness)
Reducedlungcapacity
Secondprimarycancers

Radiationtherapy Fatigue Cataracts

Skinsensitivity Cavitiesandtoothdecay
Cardiovasculardisease
Lymphedema
Hypothyroidism
Infertility
Lungdisease
Intestinalproblems
Secondprimarycancers

Surgery Sexualdysfunction Functionaldisability

Incontinence Infertility
Pain

Sources:Hewittetal.FromCancerPatienttoCancerSurvivor:LostinTransition.2005;Mayo
Clinic.CancerSurvivors:LateEffectsofCancerTreatment.2014.

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ComponentsofSurvivorshipCare

AccordingtotheLostinTransitionReport,survivorshipcareshouldincludethese4
components:

x Preventionanddetectionofnewcancersandrecurrentcancer
x Surveillanceforrecurrenceornewprimarycancers
x Interventionsforlongtermandlateeffects
x Coordinationbetweenspecialistsandprimarycareproviders


SurvivorshipCarePlans

SurvivorshipCarePlansaretoolstohelpcancersurvivorsaftertheyaredonewithtreatment.

Treatment
summary

SurvivorshipCare
Plan

Followup
plan




ThefollowingarefreeSurvivorshipCarePlantemplates:

x ASCOCancerTreatmentSummariesandSurvivorshipCarePlans
x JourneyForward
x LIVESTRONGCarePlan


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ResourcesforPatientNavigatorsandPatients

x AmericanCancerSocietysTreatmentandSideEffectsSection
Thiswebpagehaslinkstoinformationontypesofcancertreatment,clinicaltrials,
dealingwithsideeffects,copingwithcancerandcomplementaryandalternative
medicine.
x NationalCancerInstitutesAdolescentsandYoungAdultswithCancer
Thissectionofthewebsiteincludesavarietyofinformationrelatedtoadolescentand
youngadultcancers,includingorganizationsandresourcesspecifictothisgroup.
x NationalCancerInstitutesCopingwithAdvancedCancer
Thisbookletisforpeoplewhohavebeentoldtheyhavelatestagecancer,orthattheir
cancerisnotrespondingtotreatment.Familyandfriendsmayalsowanttoreadthis
booklet.
x Cancer.netsSurvivorshipSection
Thiswebpagehaslinkstoavarietyofinformationaboutlifeaftercancertreatment.
x CenterforAdvancingHealthsMakingPlansForYourEndOfLifeCare
Thiswebpageincludesinformationonadvancedirectives.
 

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Module3,Lesson4:ImpactofCancer

References:Presentation

AmericanCancerSociety.CancerTreatment&SurvivorshipFacts&Figures20142015.2014.
Retrievedfrom:
http://www.cancer.org/acs/groups/content/@research/documents/document/acspc
042801.pdf.
AstrowAB,WexlerA,TexeiraK,HeMK,SulmasyDP.Isfailuretomeetspiritualneeds
associatedwithcancerpatients'perceptionsofqualityofcareandtheirsatisfactionwithcare?J
ClinOncol.2007;25(36):57537.doi:10.1200/JCO.2007.12.4362.
Cancer.Net.ASCOCancerTreatmentSummariesandSurvivorshipCarePlans.2015.Retrieved
from:http://www.cancer.net/survivorship/followcareaftercancertreatment/ascocancer
treatmentsummariesandsurvivorshipcareplans.
Cancer.Net.SideEffects.2015.Retrievedfrom:http://www.cancer.net/navigatingcancer
care/sideeffects.
ChochinovWBandBreitbartHM.2009.HandbookofPsychiatryinPalliativeMedicine.Oxford
UniversityPress.ISBN10:0199862869.
HewittM,GreenfieldS,StovallE.2005.FromCancerPatienttoCancerSurvivor:Lostin
Transition.TheNationalAcademiesPress.ISBN10:0309095956.
HollandJC,etal.Distressmanagement.JNCCN.2010;8(4):448485.

InstituteofMedicine.IdentifyingandAddressingtheNeedsofAdolescentsandYoungAdults
withCancerWorkshopSummary.2013.Retrievedfrom:
http://iom.edu/Reports/2013/IdentifyingandAddressingtheNeedsofAdolescentsand
YoungAdultswithCancer.aspx.
JohnsHopkinsMedicine.2013.TheOnlyMetastaticCancerSurvivorRetreatofitsKind[Video
file].Retrievedfrom:https://www.youtube.com/watch?v=Bg02G2a7uHo#t=419.
LIVESTRONGFoundation.[livestrongarmy].2013.DatingandSex:AVideoSeriesforYoung
AdultswithCancer[Videofile].Retrievedfrom:
https://www.youtube.com/watch?v=IkUIXLQRcoM&index=25&list=PL88EAB22E9D8ACD85.
MayoClinic.CancerSurvivors:LateEffectsofCancerTreatment.2014.Retrievedfrom:
http://www.mayoclinic.org/diseasesconditions/cancer/indepth/cancersurvivor/art
20045524.

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MetastaticBreastCancerAlliance.ChangingtheLandscapeforPeopleLivingwithMetastatic
BreastCancer.2014.Retrievedfrom:
http://www.mbcalliance.org/docs/MBCA_Full_Report_Landscape_Analysis.pdf.
NassSJ,PatlakM.IdentifyingandAddressingtheNeedsofAdolescentsandYoungAdultswith
Cancer:AWorkshopSummary.2013.Retrievedfrom:
http://www.nap.edu/catalog/18547/identifyingandaddressingtheneedsofadolescentsand
youngadultswithcancer.
NationalCancerInstituteOfficeofCancerSurvivorship.SurvivorshipRelatedGraphs.2014.
Retrievedfrom:http://cancercontrol.cancer.gov/ocs/statistics/graphs.html.
NationalCancerInstitute.EndofLifeCareforPeopleWhoHaveCancer.2015.Retrievedfrom:
http://www.cancer.gov/cancertopics/advancedcancer/carechoices/carefactsheet.
PfizerOncology.BreastCancer:AStoryHalfTold:ACalltoActiontoExpandtheConversation
toIncludeMetastaticBreastCancer.2014.Retrievedfrom:
http://www.pfizer.com/files/news/Statement_ofNeed.pdf.
PuchalskiCM,FerrellB,ViraniR,etal.Improvingthequalityofspiritualcareasadimensionof
palliativecare:Thereportoftheconsensusconference.JPalliatMed.2009;12(10):885904.
doi:10.1089/jpm.2009.0142.
U.S.DepartmentofHealthandHumanServices.ClosingtheGap:ResearchandCare
ImperativesforAdolescentsandYoungAdultswithCancer.ReportoftheAdolescentandYoung
AdultOncologyProgressReviewGroup.2006.Retrievedfrom:
http://planning.cancer.gov/library/AYAO_PRG_Report_2006_FINAL.pdf.
References:BriefQuiz

AstrowAB,WexlerA,TexeiraK,HeMK,SulmasyDP.Isfailuretomeetspiritualneeds
associatedwithcancerpatients'perceptionsofqualityofcareandtheirsatisfactionwithcare?J
ClinOncol.2007;25(36):57537.doi:10.1200/JCO.2007.12.4362.
Cancer.Net.ASCOCancerTreatmentSummariesandSurvivorshipCarePlans.2015.Retrieved
from:http://www.cancer.net/survivorship/followcareaftercancertreatment/ascocancer
treatmentsummariesandsurvivorshipcareplans.
Cancer.Net.SideEffects.2015.Retrievedfromhttp://www.cancer.net/navigatingcancer
care/sideeffects.
ChochinovWB,BreitbartHM.2009.HandbookofPsychiatryinPalliativeMedicine.NewYork
(NY):OxfordUniversityPress.ISBN10:0199862869.

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GWCancerInstituteCancerSurvivorshipELearningSeriesforPrimaryCareProviders.Module
3:LateEffectsofCancerandItsTreatment:MeetingthePsychosocialHealthCareNeedsof
Survivors.2013.Retrievedfrom:https://cancersurvivorshipcentereducation.org/.
HewittM,GreenfieldS,StovallE.2005.FromCancerPatienttoCancerSurvivor:Lostin
Transition.Washington(DC):TheNationalAcademiesPress.ISBN10:0309095956.
HollandJC,etal.Distressmanagement.JNCCN.2010;8(4):448485.

InstituteofMedicine.IdentifyingandAddressingtheNeedsofAdolescentsandYoungAdults
withCancerWorkshopSummary.2013.Retrievedfrom:
http://iom.edu/Reports/2013/IdentifyingandAddressingtheNeedsofAdolescentsand
YoungAdultswithCancer.aspx.
LIVESTRONGFoundation.[livestrongarmy].2013.DatingandSex:AVideoSeriesforYoung
AdultswithCancer[Videofile].Retrievedfrom:
https://www.youtube.com/watch?v=IkUIXLQRcoM&index=25&list=PL88EAB22E9D8ACD85.
MayoClinic.CancerSurvivors:LateEffectsofCancerTreatment.2014.Retrievedfrom:
http://www.mayoclinic.org/diseasesconditions/cancer/indepth/cancersurvivor/art
20045524.
MetastaticBreastCancerAlliance.MetastaticBreastCancerLandscapeAnalysis:Changingthe
LandscapeforPeopleLivingwithMetastaticBreastCancer:ResearchReport.2014.Retrieved
from:http://www.mbcalliance.org/docs/MBCA_Full_Report_Landscape_Analysis.pdf.
PuchalskiCM,FerrellB,ViraniR,etal.Improvingthequalityofspiritualcareasadimensionof
palliativecare:Thereportoftheconsensusconference.JPalliatMed.2009;12(10):885904.
doi:10.1089/jpm.2009.0142.
SmithAW,ReeveBB,BellizziKM,etal.Cancer,comorbidities,andhealthrelatedqualityoflife
ofolderadults.HealthCareFinanceReview.2008;29(4):4156.

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