The American Society of Clinical Oncology together with the American Cancer Society has issued new guidelines for breast cancer survivors. It aims to provide guidance to clinicians and other health care providers in caring for the more than 3 million breast cancer survivors in the United States.
The new guideline addresses the short and long-time effects of cancer and of the treatment at both physical and psychosocial level. It also provides guidance for post-treatment care.
This is the third guideline issued by ACS for cancer survivors. The first two were aimed at prostate and colorectal cancer survivors.
The breast cancer guideline recommends patients to constantly visit their clinicians and take regular screenings to prevent recurrence. Breast cancer survivors should be carefully evaluated on the basis of their cancer history and given physical examination, besides the screenings. Although, according to the new guidelines routine laboratory tests are not necessary for asymptomatic patients. Mammography remains the best tool of observation and it should be taken whenever recommended.
Primary care clinicians are advised to counsel their patients about the importance of a healthy lifestyle. They should also monitor for symptoms of treatment-related adverse effects and advice patients to undertake endocrine therapy.
Besides recommendations of screenings and lifestyle factors, the guideline contains recommendations on many issues, such as cognitive impairment, body image, fatigue and coordination of care.
Authors of the guideline claim that each patient should be treated according to their preferences and their risk profile should be evaluated, addressing physical and psychosocial factors. Survivors still face impacts of both cancer and its treatment and they all need coordinated, comprehensive and high-quality follow-up care.
A recent study revealed that cancer survivors are at greater risk of developing secondary cancer related to the previous treatment. Treatments targeting tumors, such as chemotherapy, affect healthy cells in the proximity. The new study found evidence that this increases the risk of leukemia.
Scientists have analyzed 88 breast cancer survivors’ medical records, finding that 22 percent had an additional primary cancer. They also discovered that 57 percent of the patients had a history of cancer in their family and 21 percent carried an inherited gene mutation that increases the possibility of breast cancer occurrence.
These findings are important since they show the possible negative impact of cancer therapy for women with a greater risk of developing therapy-related leukemia but also other types of secondary cancer.
Researchers argue that future research should focus on the genetics’ role in cancer development and on the effects of breast cancer therapy on patients with both gene mutations and family history of cancer.
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