Saving a life, paying the price?

One of the things that remains an important issue for my mom after all these years in treatment is the long term effects the very treatment that is saving her has caused. In the medical field this issue is often referred to as “survivorship side effects”. It’s a bit ironic, isn’t it? The chemo has side effects, the surgery has side effects, the radiation, hormone therapy, immunotherapy, whatever else they may have thrown at you had side effects… And then they give you medicine to counter the side effects, and that medicine has side effects!  So you take all this and do what you’re told and finally feel like you are coming out of the tunnel and then suddenly you find out you have survivorship side effects!

My grandmother, on my mom’s side, lived almost to age 97. She was healthy and independent till a very advanced age. I remember once a truck had the nerve to cut her off as she was crossing the street downtown Ottawa, and she hit back… with her cane. I pity the driver.

My mom fully intends to follow in her footsteps (age-wise, not cane-and-truck-driver-aggression-wise), perhaps even break 100. And why not? Her cancer is in check, she is active and lives a healthy life.  Age has never slowed her down, and in my opinion, never will.

So, one day, after browsing her medical records (like you do), she noticed the phrase “moderate kidney disease”. When she asked her oncologist about it, he dismissed her concerns about the chronic kidney damage that was probably the result of years of cancer treatment saying it was not of concern because at her age this could happen anyway. The unspoken insinuation was that it wasn’t “worth” looking into, because of her age.

Now let me tell you about my mom. She doesn’t get angry, until she gets angry, and then, well, she gets angry.

The oncologist died a slow, painful death.

But seriously, she got herself another opinion, another oncologist. The issue is not yet resolved, but the fact is, cancer treatment naturally focusses on the immediate, and issues of future and long term health are secondary. This makes sense. Why check the coffee supply if the plane’s engines have just died (you’ll notice I use a lot of aviation analogies… Occupational hazard). But as survivorship rates are increasing every year, this is becoming an important issue, one that could impact not just our own health, but the economic future of our country. Health insurance is already expensive enough, we don’t need to be paying for long term kidney dialysis, for example, for someone who inconveniently decided to live for another 30 years. Why not treat the problem now instead of waiting till it becomes critical? (What if the engines are out because the pilot is tired and… and… ok I’ll stop).

Survivorship side effects? Of course these exist, and we have no choice but to accept that fact. My son is only 5 years old and coming out of 10 months of treatment which included surgery, radiotherapy and 24 rounds (so far) of chemotherapy. He has an excellent prognosis but the long term effects all these treatments will have on him in say, 20, 30 or even 60 years, are still being studied.

No matter what your age or prognosis is, you should request to be treated as someone who will live to be 100.

And if any truck cuts you off, hit it with whatever you’ve holding.

How do you feel about long term side effects? Do you have any survivorship issues or concerns? I would love to hear from you about these issues, and what you think the solutions are.