July 31, 2012 | by Shawn Le
Cancer used to be the elephant in the room that people would whisper about, but not discuss openly. Over the years, society and science have come such a long way that openly acknowledging a cancer diagnosis is almost expected. Raise the flags and let them fly.
Cancer survivorship, though, can sometimes pull the flags down. Once done with cancer, patients may want to forget about it.
Melanie Palomares, M.D., M.S., assistant professor and director of City of Hope’s High Risk Breast Program, urges cancer survivors to come to terms with the health issues they may face after winning the biggest fight of their lives and take action.
“We need more education,” says Palomares. “Many patients can feel that they have already overcome their cancer and don’t want to think about it returning. But we’ve also seen that many patients, once they understand their risks, are highly motivated to take preventive steps to actively lower their risk for a second cancer.”
Some of those preventive steps may already be in your refrigerator, or they could be medications easily accessible through the local pharmacy. Wherever they are, Palomares wants to find them.
She’s conducting clinical trials to identify interventions like diet, exercise or medication that could help prevent a second cancer. One clinical trial, coordinated by City of Hope, investigates the use of low-dose tamoxifen to prevent breast cancer among women previously treated with radiation for other cancers, for example.
“Right now, there are no proven interventions for cancer survivors except screenings,” says Palomares. “We’re enrolling women who were 40 years old or younger when they received chest radiation to treat any type of cancer, except breast cancer. Radiation therapy is used to treat cancers, but the higher a dose that is required, the higher a survivor’s risk of developing a second cancer.”
Originally the researchers were testing the prevention strategy only among survivors of childhood Hodgkin lymphoma, who face a high risk of breast cancer as adults. But studies that made news at the 2012 annual meeting of the American Society of Clinical Oncology showed that other patients had an elevated risk of breast cancer after radiation therapy to the chest, too. Now the trial is open to women treated for a variety of cancers as children, teens or young adults, including those who received total body irradiation as part of a bone marrow transplant. She hopes more trials are coming.
“We have really done a great job with identifying and addressing the health issues pediatric cancer affecting survivors, but there are many more adults diagnosed with cancer,” says Palomares. “We need to find out practical interventions and make sure that information gets to everyone.”