Over 30,000 people in the state of Rhode Island are surviving after having had treatment for cancer. These men and women, young and old have steered a course through surgery, chemotherapy, radiation, hormonal therapy and are now living to tell the tale. Now, as they look forward to years of quality life they need to be aware that constant surveillance is essential for their continued good health. A woman who has been successfully treated for breast cancer must be aware that after the age of 50 she needs to be screened for colorectal cancer, no different than anybody else after the age of 50. A man treated for prostate cancer cannot neglect colorectal screening either.

Besides the standard cancer detection programs that everyone should be aware of and have performed regularly, survivors of cancer must also be aware of second cancers associated with their first cancer. For instance, a woman who has been treated for breast cancer is at a higher risk of ovarian cancer and must have regular checkups from her gynecologist for this disease. In addition, there are some late effects of cancer treatment, which can occur 20 or 30 years after the initial treatment. The key to continue good health is careful surveillance.

Successful survivorship really means being integrated back into the mainstream of society. This can be difficult particularly if health insurance, life insurance, and employment opportunities are not available. Under the Americans with Disability Act, survivors of cancer cannot be discriminated against in the work place, transportation and housing. If a cancer survivor finds that they are experiencing discrimination because of their past illness they have recourse through The Rhode Island Commission on Human Rights so that these barriers can be removed.

Successful survivorship may entail rehabilitation, including reconstructive surgery. In Rhode Island, a woman is entitled to Breast prosthesis after breast surgery if necessary. Prior to receiving a chemotherapy or radiation, a young man may wish to discuss with his oncologist sperm banking so that he can have a family later on. There are also egg banks available for women who wish to preserve the prospect of motherhood after successful treatment for cancer. Many cancer survivors find comfort from participating in support groups where people can exchange ideas and learn about activities and opportunities they can use in the future.

Consideration of genetic counseling in appropriate situations may be important in regard to family and offspring. Confidentiality of the results of genetic testing is imperative. It must always be the cancer survivor's choice as to who should share that information. This can be a critical factor in obtaining genetic testing and a good counselor is necessary to make sure that the information is handled appropriately. The confidentiality of the results of the test should not be available to health insurers, life insurers or employers without the explicit consent of the individual. Legislation is now being drafted in Rhode Island, to guarantee this kind of confidentiality, so that those who wish to know about their genetic propensity can obtain that information and then be in charge of who gets to see it as well.

These are a whole new set of problems for the cancer survivor and the medical profession. Thirty, 40 years ago most patients didn't survive. Now over 50% of all cancer patients will survive and in some situations like Hodgkins disease or childhood leukemia, 90% of the patients survive their disease. More than half of the women with breast cancer can expect to be cured. So there is an ever-growing large population of cancer survivors who can look forward to as normal a life as their neighbor who never was afflicted with this disease and this should be a successful experience for them.

For more information and answers to specific questions contact the Rhode Island Cancer Council at info@ricancercouncil.org or call us at (401) 728-4800 or toll free 866-879-4100.

IT IS EASIER TO PREVENT CANCER THAN TO TREAT IT.

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