Case Western Reserve University

Cancer worries continue long after treatment ends
Case researchers find in long-term cancer survivors

CLEVELAND -- The doctor may give the cancer patient a clean
bill of
health, but worries about recurrences, lingering effects
from
treatment, a second cancer and a shortened life plague the
thoughts of
approximately one-third of long-term, older-adult cancer
survivors,
according to researchers from Case Western Reserve
University's Cancer
Survivor Research Project. This is one of the first studies
to look at
the worries experienced by long-term survivors.

It may be that these long-term survivors of five or more
years after
the end of their treatments may be worriers in general,
said Gary
Deimling, Case professor of sociology and lead investigator
on the
"Cancer-Related Health Worries and Psychology Distress
among Older
Adult, Long-Term Cancer Survivor" article in the journal,
Psycho-Oncology.

But he adds that it raises concerns that cancer continues
to impact
survivors' lives.

Overall most survivors are not letting these worries
compromise the
quality of their lives either physically or
psychologically, report
Deimling and co-investigators Karen Bowman, Samantha Stern,
Louis
Wagner from Case's sociology department and Boaz Kahana
from Cleveland
State University, but these worries are linked to both
depression and
anxiety.

The researchers' concerns led to the study of 321 long-term
survivors
of breast, colorectal or prostate cancer in National Cancer
Institute-funded Cancer Survivors Research Project at Case.

While much research focuses on cancer during and
immediately after,
this study looked at the survivors who average slightly
more than 10
years after their last treatment and are over the age of
60. They felt
that years after treatment the survivors might have
different worries
about cancer than those experienced during the disease.

While the five-year point is often considered a milestone
in surviving
cancer, Deimling points out that most survivors recognize
that it as
no guarantee of a cancer-free future. "Many cancers can
recur long
after five years, and the possibility exists that another
cancer will
result from the carcinogenic effects of treatment," added
Deimling.

In general, survivors who have an optimistic outlook also
have less
worries, and lower depression and anxiety.

They did find an association between having chemotherapy
and
functional difficulties which in turn may result in
depression.

At diagnosis, the cancer patient worries about surviving,
during
treatment about the side effects from the therapies or
surgery, and at
the end of treatment, a recurrence.

With the passage of time, the cancer survivor thinks about
second
cancers from radiation or chemotherapy or a new primary
cancer.

Also continued testing and monitoring for cancers raises
distress in
the survivor, the researcher report.

The researchers reported some of their findings were:

* Between 27% to nearly 40% of survivors continue to
have concerns
about a recurrence, with male colorectal and prostate
survivor having
the greatest concerns.
* Depending on the type of cancer, between 34-41% worry
that
current symptom might indicate that cancer has returned.
* Depending on the type of cancer, some 26-36% of the
survivors
expressed concerns about getting a second cancer, with
prostate cancer
survivors having the highest concerns.
* Depending on the type of cancer, follow-up testing
continued to
bother 36-44% of the survivors, again with colorectal
cancer survivors
with the most concerns.

The researchers also said that while men reported more
cancer-related
health worries, women had higher anxiety scores. Women
survivors of
breast cancer and cancer in general also had more
depression than male
survivors of prostate cancer.

"The cancer-related health worries reported by survivors
should be an
important consideration for oncologists, primary care
practitioners
and mental health professionals treating older adult
long-term
survivors," said the researchers, who pointed out they may
be linked
to depression which is suffered by as much as 17% of the
older population.