Thanks to decades of ground-breaking research advances, 80 per cent of women diagnosed with breast cancer now survive. But its impact is still staggering: about 5,000 of the 25,000 women diagnosed in Canada each year lose their lives to the disease. Among the survivors, approximately 20 per cent (or 4,000 each year) experience long-term effects such as anxiety and depression, lymphedema, chronic pain or "chemo brain" (chemotherapy-related cognitive impairment).
With a growing population of survivors, researchers are now working to understand which patients are most likely to experience these effects, how to minimize and mitigate their impact, and how to best provide post-treatment support.
"There has been a real shift in the direction of research and clinical care to what we call the survivorship period," says Dr. Eva Grunfeld, director of Knowledge Translation Research in the Ontario Institute for Cancer Research's Health Services Research Program.
One of the critical gaps identified is a lack of integration and co-ordination between care providers, she reports. "The majority of women who have breast cancer tend to be elderly, and cancer may be just one of several chronic diseases that affect their lives. While cancer treatment is the primary focus, once it's over, it is important to properly prevent or manage other chronic conditions."
For example, her team's research also found that although survivors have a lot of interaction with the health-care system, they're not getting optimum screening for other cancers. Cancer treatment-related fatigue may get in the way of exercise, which is particularly problematic for those with diabetes (about one-third of Canadians), heart disease or obesity.
Dr. Grunfeld leads CanIMPACT, a major pan-Canadian program of research on breast cancer that will be published in October's Canadian Family Physician, a journal delivered to all family physicians in Canada. (The study was funded by the Canadian Institutes of Health Research.)
"What we've heard from patients is that they want better integration – they're shocked to find that their family doctor doesn't know the details of their cancer treatment or their oncologist may not be aware of their diabetes," she says.
|BY THE NUMBERS|
1 in 9
Canadian women during their lifetime
1 in 4
cancers diagnosed in women in Canada are breast cancer. It is the second leading cause of cancer deaths in Canadian women, after lung cancer
1 in 30
women in Canada will die from breast cancer
In Canada, the 5-year survival rate for breast cancer is
Breast cancer mortality rates have decreased by
since the peak in 1986 due to earlier detection through regular mammography screening, advances in screening technology and improved treatments
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