Thriving After Cancer: Care Plans Help Map the Road to Wellness

Ed Gardella, a police officer for 31 years, thought he was pretty tough. But then the 70-year old Worcester, Mass. resident was diagnosed with esophageal cancer.

“You never forget that moment, where you were that moment you were told you have cancer,” said Gardella. “I never thought I was a particularly brave man, nor did I think I was a coward. I was a police officer, a chief of police, but this disease brings everyone to their knees — no one is tougher than cancer.”

Gardella underwent surgery, chemotherapy and radiation at Dana-Farber Cancer Institute in Boston to treat his cancer and now, five and half years later, he is cancer-free. But Gardella says that cancer remains a constant in his life. “You don’t just get cancer and get over it.”

Advances in cancer care now mean that the majority of people diagnosed with cancer will survive the disease. An estimated 12 million Americans are cancer survivors. This number is expected to nearly double by 2030. More than six out of every 10 adults newly diagnosed with cancer will meet or pass the five year survival mark.

Kenneth Miller, MD, co-director of the Perini Family Survivors’ Center at Dana-Farber, says that the transition from cancer patient to cancer survivor can pose numerous challenges.

“Finishing treatment typically is a monumental moment for many patients, but it is also an important turning point,” Miller explains. “As cancer survivors, they now have to shift their focus from figuring out how to beat the disease to learning how to adjust to everyday life again — and they often have to do so without the support network they had while on treatment.”

There are many issues confronting cancer survivors, including changes in the body after cancer treatment – emotional and physical symptom management; legal rights concerning healthcare and employment; returning to the classroom; finding support groups; maintaining, repairing, or enhancing personal relationships, and pursuing appropriate follow-up care.

Recognizing these unique challenges, Dana-Farber created the David B. Perini, Jr. Quality of Life Clinic in 1993 to provide support and services to survivors of pediatric cancers. This was one of the nation’s first such programs and it has served as the model for other institutions.

“It was clear that cancer treatments could have both a short- and long-term impact on children, and there weren’t any resources in place to address these health issues,” says Lisa Diller, MD, co-director of the Perini Family Survivors’ Center. “We knew that we needed to address this, because the survivorship landscape was rapidly changing. As recently as the 1960s childhood cancer was almost always a fatal diagnosis, but today the majority of children diagnosed with cancer can expect to be long-term survivors.”

Diller says that greater public and physician awareness about late effects from cancer treatments has resulted in Dana-Farber’s Pediatric Survivorship Clinic seeing more patients who were diagnosed 20 or 30 years ago.