Surviving cancer: Going beyond medical treatment

MANILA, Philippines - Experts and the millions of cancer advocates all over the world are diligently contributing to the growing body of knowledge about cancer management and care. What’s more remarkable is that the focus now is not just on the diagnosis and treatment of cancer patients, but on the equally important continuing care for patients who have already undergone treatment. United Laboratories, Inc.’s Oncology Division Bio Onco and Unilab Medical Education and Development (UMED) forged a partnership with the Philippine Society of Medical Oncology (PMSO). They recently mounted a conference that gathered oncology experts and advocates to discuss new developments on long-term care after cancer treatment, and to develop a comprehensive and integrated approach to meet the long-term needs of survivors.

At the helm of the event were Dr. Dennis M. Tudtud, overall chairman, 11th Mid-year Convention, and immediate past president of the Philippine Society of Medical Oncology, and Dr. Felycette Gay Martinez-Lapus, president of the Philippine Society of Medical Oncology and a medical oncology practitioner at Davao Doctors Hospital.

“Survivorship care gives patients an opportunity to not only live longer but also to have better quality lives and this is because many disciplines and issues are confronted, resolved, and dealt with by different specialists,” says Dr. Tudtud.  “You tackle issues like physical health, recurrences, second malignancies, issues on emotional health, problems with sexual lives and socialization patterns, issues on spiritual care, and even economic matters that need to be addressed with patients for longer survival.”Dr. Tudtud points out, “When you have cancer and you are stressed out, not only your quality of life but your response to treatments may likewise be impaired.  With sleep issues and anxiety, you don’t get enough rest. These emotional problems will be experienced at all times.  These may affect your immune system which impacts your body’s ability to respond to treatment.”

Medical oncologists devote most of their time to active oncology care, including but not limited to giving chemotherapy, managing the side effects, diagnostics, and fine-tuning the treatment after the completion of chemotherapy. Cancer patients pass the stage where there’s less interaction with their doctors, a stage called transitioning — from being a patient to a survivor, although by definition, survivorship starts from the time of diagnosis, which is day one. The time between the transition — from very active oncology care to maintenance care — is an area where medical experts observed some patients get confused and anxious because they don’t see their doctors as often anymore, and they have no more chemotherapy. Dr. Tudtud stressed that this is the stage where a survivorship care plan should involve the rest of the physicians who are treating the patients. This is referred to as shared-care process, which includes management of pain, nutrition, utilization of complement treatment, mind-body-medicine, relaxation, and pastoral care. This is best done through cancer support and survivorship care settings.

There were three survivorship program models presented at the conference. One model uses a trained integrative oncologist who manages and refers the patient to different experts that can address various issues that are related to survivorship. This oncologist takes care of the diet, exercise, and psychosocial needs of the patients. The second model has a nurse, paired with another nurse, who acts as a navigator. The nurse oncologist is empowered to do this kind of care, as practiced in some countries now.

The third model is the shared-care model composed of physicians who do private practice. The physicians don’t necessarily need to be physically present but could be easily contacted to respond to the concerns of the survivors. As long as there’s a navigator who would bring the patients around, schedule them and get them an appointment, this could be the model to be used in places where there are no oncologist nurses or experts in integrated oncology.

Dr. Tudtud and Dr. Lapus explained that survivorship could also expand to community-based efforts to enjoin people at all levels to be more aware, sensitive, and involved in addressing the issue of cancer management.