Cancer's lifetime commitment

By now the cancer community has heard about ABC news reporter Robin Roberts' diagnosis of myelodysplastic syndrome, a pre-leukemia condition that will require a bone marrow transplant -- and is most probably a late effect of her treatment for breast cancer five years ago. It is a reminder to all of us that finishing treatment does not mean cancer is over. What it means is that we have to shift our thinking about the way we view our health care to add treatment for cancer as a possible risk factor for other health concerns for our future. When we have cancer we have to watch for second cancers, cardiac issues, fertility concerns, and many other late effects of the drugs and other treatments we undergo. And part of the challenge is that we will each face physical concerns that may or may not be connected. After breast cancer at 30, my friend Diane battled hormonal issues for more than a decade until she finally had a complete hysterectomy. She was the first in her family to have such problems. Were they connected to her treatment?I developed bilateral neuropathy in my feet more than a decade after treatment ended. Was treatment related when I didn't have any of the taxanes? I am in the middle of doing a feature on the late effects of treatment for the adolescent and young adult population, which is ages 15 to 39. This age group is in a particularly difficult place because they are mobile and often don't have health insurance. They are also trying to become adults, and a cancer diagnosis may be emotionally as well as physically crippling. We all want to leave cancer behind when treatment is over. We want to get on with our lives and forget those awful months of treatment. But the reality is, as we have begun to live longer, the late effects of the drugs they have developed to keep us alive have come to light, and some are serious. If your oncologist didn't tell you what those late effects could be, find out. Do your own survivorship care plan. There are a number listed at the ACS site. Tell your primary care physician and, together, research your risk for cardiac issues, second cancers or other concerns from treatment you may have had. Know what kind of monitoring you need and don't put it off. Trying to leave cancer behind and pretending it never happened can have some serious consequences.