Focus on how well patients live instead of how long


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Mea Culpa--I said in my first blog that there were no podium presentations on survivorship at the San Antonio Breast Cancer Symposium. Oops. I did read the program thoroughly but managed to miss the one session on survivorship on Friday morning by Lesley Fallowfield, a professor of psycho-oncology and director of Sussex Health Outcomes Research & Education in Cancer at Brighton and Sussex Medical School at the University of Sussex in England. The content of the presentation was an overview of the issues of survivors, i.e. fatigue, lymphedema, night sweats, cognitive issues, hormonal issues, economic issues, and the overall distress of coping. One slide said there is new attention paid to how well patients live in addition to how long they live. She also confirmed that integrative therapies do work, including yoga, cognitive behavior therapy, aroma therapy and massage, visualization, expressive writing, and art and music therapy. Perhaps the most pointed idea in those slides was information on mindfulness-based stress reduction. This issue has been one that I have touted for years, ever since Barbara Anderson's study with breast cancer survivors and mindfulness-based stress reduction. In her Stress and Immunity Breast Cancer Project, she showed that a psychological intervention provided to newly diagnosed breast cancer patients reduced the risk for recurrence and death from breast cancer. Fallowfield also noted that most of the changes in survivorship have been in early-stage breast cancer, not metastatic breast cancer.Fallowfield told me she was really surprised by how many physicians came to the talk and stopped her later to chat. "The hall was virtually full, but many people stopped me throughout the day to either congratulate me, ask for further contact or invite me to speak in their country." She had expected patient advocates but found it heartening to find so many interested oncologists. Let's hope they take it home and apply it to their patients. How many of you are in treatment where there is a strong survivorship program? Let me know.

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