Cancer Survivorship

Key people: Prof Martha Hickey, Dr Michelle Peate, Dr Yasmin Jayasinghe, Dr Jennifer Marino

Overview

More than a million people in Australia live with cancer or have survived a diagnosis (Cancer Council Australia, 2016). With improvements in treatment and an ageing population, this number will continue to rise. The needs and experiences of patients in active treatment have been well-characterised, but those of people who have completed treatment are under-studied. Cancer and its treatment may have long-term effects on physical, mental, and family health, and as the word ‘cancer’ is used to describe more than 200 different diseases, survivor needs are diverse. At the Women’s, we aim to provide quality evidence to inform the ongoing care of women who have survived cancer

Many research issues overlap in Cancer Survivorship and Infertility / Fertility Preservation. Please also refer to the section on Infertility / Fertility Preservation.

Research projects

Paediatric and Adolescent. Please refer to Infertility / Fertility Preservation

Research projects: Adults

Managing menopause after breast cancer

Many cancer survivors experience menopausal symptoms, sexual dysfunction, and mood or sleep disturbance which may impair quality of life and relationships. Survivors of breast cancer treated with endocrine therapy to prevent recurrence (such as tamoxifen or aromatase inhibitors) may discontinue therapy because of severe menopausal symptoms, thus increasing their risk of a second cancer.

Although there are now safe and effective treatments for menopausal symptoms and sexual problems after cancer, some of which also improve mood and sleep, most survivors do not have access to them. Cancer survivors may also be at greater risk of long-term health problems such as depression, osteoporosis and fracture, but prevention and treatment of these is also often overlooked.

In response to surveys of unmet need in breast cancer survivors, we have developed a new model of care, implemented in Victoria and Western Australia, called MSAC – managing Menopause Symptoms After Cancer. This multidisciplinary service provides evidence-based treatments for menopausal symptoms, sexual difficulties, and mood and sleep problems. This service also offers personalised advice on maintaining mental health, bone and heart health. The approach is patient-centred, aiming to address the particular needs of each woman. These clinics also provide high-quality patient-reported outcome data critical to patient care worldwide, work which has been recognised by awards at national meetings.


Priorities and needs of women living with advanced cancer

Although the survival of patients with cancer has improved greatly over the past 30 years, between 2008 and 2012, a third of all patients with cancer survived less than five years. Generally, cancer research tends to focus on curative therapy, but many patients die of their cancer. These patients not only have to cope with facing an incurable condition, but are often ‘forgotten’ or become ‘invisible’ in the context of this focus on survivorship outcomes. Many people who live with advanced cancer report a feeling of being seen negatively by society, and that they suffer from psychological, physical or financial problems for which they receive little support. Despite this, we know very little about the needs and priorities of people living with advanced cancer. This information is essential to inform clinical decision-making to maximise the quality of the life these patients have left – for some this is only a short time yet others will live with their cancer for many years. The aim of this project is to gather qualitative and quantitative data from advanced cancer patients, their families, and their providers to identify their needs, with the eventual goal of establishing clinical tools, including patient-reported outcome measures and useful tools that can improve the end-of-life experience of these patients and their families.

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