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Physical and Emotional Impairments Often Untreated in Cancer Patients

Review calls rehabilitation critical, cost-effective (May 17)

A new review finds that cancer survivors suffer a diverse and complex set of impairments affecting virtually every organ system. Writing in CA: A Cancer Journal for Clinicians, Julie Silver, MD, and colleagues say a majority of cancer survivors will have significant physical and psychological impairments as a result of treatments, and that these often go undetected and/or untreated, resulting in disability.

The American Cancer Society (ACS) estimates that the number of cancer survivors in the U.S. will increase from 13.6 million to 18.0 million by 2022. However, increased survival brings with it a growing need to address the long-term effects of cancer and its treatment. Cancer survivors report a much worse health-related quality of life for both physical and emotional health compared with population norms.

The new review outlines data showing that poor physical health is reported by 25% of cancer survivors, compared with about 10% of those without a history of cancer. Meanwhile, poor mental health is reported by 10% of cancer survivors compared with 6% of adults without a cancer diagnosis. Those numbers suggest that 3.3 million cancer survivors in the U.S. may have poor physical health and that 1.4 million may have poor mental health.

According to the authors, it is critical that cancer survivors be screened for both psychological and physical impairments and then referred appropriately to trained health care professionals, including rehabilitation specialists, for evaluation and treatment. To ensure that all cancer patients have their rehabilitation needs met, everyone involved throughout their care — oncologists, mental health professionals, nurses, and primary care physicians — should have knowledge of the proper screening questions, tools, and procedures, the authors say. Impairment-driven cancer rehabilitation appears to be cost-effective and may reduce both direct and indirect health care costs, as well as the substantial financial burden of cancer.

The authors conclude: “Delivering quality, patient-centered care requires that all cancer patients and survivors be screened for psychological and physical impairments throughout the care continuum in order to preserve and/or improve their functioning and quality of life.”

Source: ACS; May 17, 2013.

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