Getting 'Smart' About Survivorship

NEW ADVANCES IN CANCER treatment have brought the welcome challenge of living beyond cancer — survivorship. Although these advances in therapy have lengthened the life span of many individuals with cancer, the financial, physical and psychological burdens of a diagnosis can be daunting. But there are reputable, user-friendly and costeffective websites and mobile apps that can enhance a cancer survivor’s quality of life.

The financial costs of cancer treatment cannot be underestimated. Data from the National Cancer Institute in 2015 list the average cost of breast cancer in women 65 and older as $23,078 and $2,207 for continuing treatment. Regardless of insurance status, this price tag is daunting. Fortunately, the National Comprehensive Cancer Network (NCCN) has a free app, NCCN Reimbursement Resource App, for patients and caregivers dedicated exclusively to assisting with reimbursement. The app helps individuals search for resources and payment assistance programs to cover the cost of care. Users can search by cancer type, drug name and assistance program.

The many other facets of survivorship — medical appointments, side effect and symptom monitoring, drug schedules and dosages, record keeping and engaging with members of the treatment team — can now be managed with the touch of a button on a cell phone thanks to modern technology. Survivorship apps and sites such as My Care Plan by Journey Forward and Cancer.Net from the American Society of Clinical Oncology allow individuals to track symptoms, medications, and follow-up appointments and maintain contact information.

Resources like Cancer.Net as well as Breast360.org offer patients information written by reputable sources, including oncologists and breast surgeons. Both sites are updated regularly with news sections that digest the latest research and provide helpful videos and links to additional resources. Breast360.org also offers a list of active clinical trials that are researching new treatments for breast cancer and guidance specifically for survivorship.

The psychological impact of a cancer diagnosis, coming face-to-face with one’s own mortality, is one of the biggest effects of the disease. Apps can help survivors face this challenge through mind-body techniques such as mindfulness meditation, contemplative prayer and simple, coherent breathing exercises. Popular ones include Headspace and Insight Timer. Both offer guided and unguided meditation options, secular and religious (all types) practices and educational podcasts.

The last but perhaps most important aspect of survivorship is staying active and involved. Cancer treatment and the accompanying psychological burden can often leave individuals with debilitating fatigue, unwanted weight gain, new physical pain and limitations. Studies show that physical activity of nearly any type and at any point in the cancer care continuum benefits individuals in all these areas as well as many others. Once again, technology comes to the rescue. Apps offer modalities for every form of physical movement imaginable, with options to join social networks to stay inspired and set personal goals plus anonymity features for those unable or unwilling to venture into public exercise venues. Top apps such as MyFitnessPal offer everything from calorie and macronutrient targets to recipes, step trackers, reminders and links to other fitness apps. Others such as Strava can even map an individual’s course while he or she is walking or running.

Prevention of a recurrence or a new cancer is often at the forefront of survivors’ minds. While many cancers are sporadic, growing data support the role of environmental factors in the development of disease. Although individuals cannot change their genetic makeup, they can follow essential guides for making healthy choices going forward. The Environmental Working Group provides a user-friendly, unbiased one called Healthy Living. Available as a website and an app that can scan listed products at a store, this program guides consumers to better choices for everything from water filters to cosmetics to cleaning products and, of course, food.

A cancer diagnosis is undeniably a life-altering event. As with all such moments that cause paradigm shifts in an individual’s world, taking on the challenge with knowledge creates empowerment and resilience — keys to moving beyond the initial fear and shock. Taking advantage of technology and the tools available today is one way to move beyond just being a cancer survivor and truly thrive.

Lauri Medina, M.D., FACS, is a board-certified general surgeon at Southwest Medical Group in Cortez, Colorado. Medina also serves on the board of directors of The American Society of Breast Surgeons Foundation.