Survivorship and Men’s Health
National Cancer Survivor Day is celebrated on the first Sunday of June; this year, it is recognized on June 2, 2024. It's a day to celebrate and recognize people who have had a previous cancer diagnosis or who are currently living with the disease. It is also a day to raise awareness of cancer and commemorate the growing number of people who are surviving it.
The official website for National Cancer Survivors Day states that it is a CELEBRATION for those who have survived, an INSPIRATION for those recently diagnosed, a gathering of SUPPORT for families, and an OUTREACH to the community (https://ncsd.org/). In recognition of this special day, it is essential to bring awareness to survivorship and the importance of offering this to our patient population. Because it is also Men’s Health Month, I wanted to focus on Survivorship in Men as this is a time to focus on the health issues they may face and the importance of being proactive for early detection of many diseases.
People are living longer with cancer than ever before due both to earlier detection and the many available new treatment modalities. Cancer survivorship emphasizes the health, well-being, and quality of life of people who are living with cancer. In cancer survivorship, providers monitor and guide the patients from the initial cancer diagnosis through treatment and even to the end of life.
We often think of breast cancer when thinking of survivorship, and typically, it does represent the largest group of patients who seek this program. However, men with prostate cancer are the next largest group. Patients with both breast and prostate cancer also represent the highest survival rates ten years after diagnosis. It is also important to mention that men are significantly less likely than women to seek out medical care or report symptoms to their health care provider until they feel something is wrong.
There are many issues that prostate cancer patients may face long after they finish treatment, both physical and psychological in nature. Long-term side effects, including fatigue, neuropathy, weight changes, sexual dysfunction, sleep dysfunction, body image changes, anxiety, and depression, are just some of the possible things. Financial considerations and the costs of cancer care are also real issues that patients face both while undergoing treatment and thereafter. Men who are living with prostate cancer can benefit from the guidance of a survivorship provider for symptom management, guidance in making healthy life choices/changes, and long-term active cancer surveillance.
A focus on routine health maintenance is important in the overall care past active treatment. Discussion may be related to lifestyle modifications involving diet, exercise, smoking, and immunizations. Considerations for genetic counseling regarding how their diagnosis distinguishes risk for other family members is also included. Patients receiving androgen deprivation therapy (ADT) may be at risk for various systemic effects. Accordingly, the American Society of Clinical Oncology (ASCO) recommends an annual complete blood count for the evaluation of anemia. Data also demonstrated that ADT is associated with a greater incidence of cardiovascular disease after five years of follow-up.
An advisory panel from the American Heart Association, American Cancer Society, and the American Urological Association recommended assessment of blood pressure, lipid profile, and blood glucose level prior to initiation of therapy, 3 to 6 months after first treatment, and annually thereafter (Rasper AM, & Terlecki RP. 2016).
Cancer survivorship is receiving greater recognition overall as part of oncology and supportive care, and these programs also offer support in coping or finding resources. Survivorship models in practice create a more supportive environment for patients and can foster increased collaboration with other providers across specialties. Successfully treating only cancer is not sufficient. The cancer survivor represents an individual in need of continuous monitoring and proactiveness against future potential problems. A well-implemented and well-supported survivorship program not only meets a mandate for accreditation in practice but also logically translates into better patient care.
References:
https://ncsd.org
Rasper AM, Terlecki RP. Prostate cancer survivorship: Implementation of survivorship care plans to meet the mandate and enhance urologic practice through collaborative care. Rev Urol. 2016;18(4):214-220. doi: 10.3909/riu0733. PMID: 28127263; PMCID: PMC5260951.