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Cancer Survivors Need the Truth and the Whole Truth Upfront

Long-term survival can mean serious biological changes.
While most of the oncology community goes about its business with its head in the sand, pleased as punch (rightfully so) when they’ve managed to put the cancer into remission and more or less oblivious (sadly) to what else happens biologically in the long run because of that, some medical researchers have begun paying attention. 
  • A 2007 article in The Oncologist reviewed the possible biological mechanisms of long-term cancer fatigue.
  • By 2012, studies reported in the Journal of Pain and Symptom Management said that cancer-related fatigue was probably caused by a failure of the central nervous system to properly manage the functioning of the muscles.
  • The year 2013 was a banner year. There were not just one but two reports in the medical literature (Biological Research for Nursing and the Journal of Clinical Oncology) discussing long-term changes in the patient’s genetic structure or the genes’ surrounding cellular environment as causes of post-treatment fatigue, noting that increased levels of inflammatory substances could be the culprit.
  • The next year, no less a publication than the Journal of the National Cancer Institute reported that in women who had received certain types of chemotherapy for breast cancer, cellular-level markers of aging were the same as for women who were almost 15 years older! The study authors suggested that chemo had caused damage to the stem cells, which then passed the damage down to future generations of cells.
  • Keeping up the momentum, this year Ned Sharpless, formerly the director of the Lineberger Cancer Center and now the newly appointed head of the National Cancer Institute, gave Grand Rounds at UNC Hospitals on the topic of premature cellular aging in cancer survivors.
And the beat goes on…

A couple of weeks ago, my eye was caught by an article in the popular press talking about extraordinary fatigue and muscular weakness in astronauts who spend a long time on the space station. Despite their in-space exercise routine, they gradually develop the same kinds of fatigue and weakness symptoms that (I realized) cancer survivors report. I wrote to the study’s lead investigator to ask if he’d thought of testing such long-term survivors—and he already had! In fact, he and his team published these results in 2016 (PLoS ONE) and in 2017 (Journal of the American Heart Association).

Talk about this article with other patients, caregivers, and advocates in the General Discussions CURE discussion group.
Brenda Denzler is a writer and editor living in North Carolina. She received her doctorate from Duke University and worked as an editor at UNC-Chapel Hill before she was diagnosed with inflammatory breast cancer in 2009. Since then, she has devoted a great deal of her time and energy to understanding and writing about cancer, cancer treatment and the impact of pre-existing PTSD on the ability of doctors to give and patients to receive medical treatment.
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