Cancer Survivorship: Treatment-Related Effects Part One
Presented by Michelle Kirschner
This course introduces students to the concept of cancer-treatment-related effects and reviews the identification, evaluation, and treatment of four common adverse effects, with a goal toward improving the overall health for long-term cancer survivors. Cancer-treatment-related effects are reviewed based on temporal occurrence and modalities of treatment. This course focuses on four of the most common general cancer-treatment-related effects including fatigue, psychosocial distress, cognitive dysfunction, and pain. A brief overview of each treatment-related effect will give the prevalence, causes, symptoms, evaluation, and treatment. Participants will learn to distinguish appropriate pharmacologic and non-pharmacologic treatment modalities based on current guidelines. Special attention is given to the role of cancer rehabilitation in the treatment of cancer survivors. This course content is directed at health care providers such as nurses, physical therapists, occupational therapists, and social workers who provide care for cancer survivors. Midlevel providers, such as nurse practitioners and physician assistants, along with primary care physicians, will also benefit from specific medical treatment recommendations provided in this course. Last Reviewed: September 2024
Meet your instructor
Michelle Kirschner
Michelle Kirschner is the Clinical Coordinator for Cancer Survivorship at the UC Health Barrett Cancer Center in Cincinnati, Ohio. With more than 20 years of previous clinical experience as a Nurse Practitioner specializing in Cardiology, Pulmonology, and Internal Medicine, Michelle brings a unique and practical perspective…
Chapters & learning objectives
1. Overview of Cancer Treatment-Related Effects
Health care providers need to understand the definition of a treatment-related effect. These effects can be broken down according to temporal relationship to the treatment including acute, subacute/delayed, and late effects. Specific cancer treatment such as surgery, radiation, and chemotherapy present individualized side effect risk profiles. Understanding these concepts will assist in creating the most effective method of addressing the health issues of cancer survivors.
2. Addressing Fatigue in Cancer Survivors
Cancer-related fatigue is the most frequent treatment-related effect reported by cancer survivors. This symptom frequently persists after the completion of treatment and impacts overall quality of life. Fatigue in cancer patients is multifactorial, and comprehensive assessment is essential in development of a successful treatment plan. Symptoms most often respond to exercise, which is considered first-line treatment for this condition.
3. Addressing Psychosocial Distress in Cancer Survivors
Long-term assessment of psychosocial distress is a fundamental aspect of survivorship care. Depression and anxiety may decrease long-term survival and overall quality of life. Care centers now focus on the impact of mind-body interaction on treatment success. Practitioners are expected to conduct ongoing assessments for distress and psychosocial symptoms that may impede the treatment plan. Developing treatment resources and collaborative relationships is an important component in the care of these treatment-related effects.
4. Addressing Pain and Neuropathy in Cancer Survivors
Cancer rehabilitation plays a pivotal role in the treatment of cancer-related pain. Common causes of pain in cancer patients include musculoskeletal and neuropathic etiologies. Addressing and eliminating pain is the first step in correcting functional limitations found in this patient population. Neuropathy is a significant treatment effect that can worsen pain issues and create functional limitations. Chemotherapy-induced peripheral neuropathy and radiation-induced plexopathy are well-known syndromes that health care providers need to understand how to appropriately diagnose and treat when providing care to cancer survivors. Ongoing research shows that limited research supports pharmacologic agents; therefore, other modalities of treatment and addressing secondary consequences, such as gait issues are core concepts in improving an individual’s health. Pharmacologic treatment of pain and neuropathy has significant risks and limitations, so it is essential to determine non-pharmacologic interventions to restore the patient to a higher level of health.
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