Cancer survival rates force major treatment rethink

Posted by on 17 May 2012

Cancer is the single largest cause of death in Australia, but early detection and advances in treatment mean death rates are falling.

Almost two-thirds of those with the disease will live for at least five years after diagnosis, so a growing number of Australians are having to learn to live with cancer.

As cancer survivorship grows, patients are by necessity having more treatment over a longer period of time, and are less tolerant of outdated systems of treatment that are based around stand-alone specialists.

Bogda Koczwara, an oncologist, says specialists need to rethink how cancer is treated.

"Cancer care needs to be integrated and consolidated in one location, so that we will not deliver one good care just by one provider in one area and then send the person down the corridor to the next treatment. We really want to do much better than that," she said.

"Even though we will celebrate completion of treatment, the process of finishing your treatment and leaving a very intensive period of therapy and monitoring and scans ... that can be quite frightening and quite stressful.

"Suddenly you are left to your own devices."

Dr Koczwara has been practising for 20 years, and says the accepted mantra in the beginning was: "Kill the cancer at any cost".

Now advances, particularly in medicine, mean more than 60 per cent of her patients live past the five-year mark. With that development comes a greater emphasis on long-term management.

"There might be fatigue, there might be some bone loss as a result of cancer treatment and we need to recognise that we might eradicate the cancer," she said.

"But the patient might be left with osteoporosis, for example. So we as oncologists need to learn how to manage osteoporosis and recognise that that's a risk and factor."

Facing his demons

Ashleigh Moore is one of a growing number of Australians who survived cancer, and he now uses his experience to help others in similar circumstances.

His life took a turn for the worse after a tumour spread from his tonsils into his neck and head.

Almost six years after beating the disease it returned in a different form. He endured surgery that removed almost half his lungs.

"It was hard dealing with it with all of that knowledge as well. You knew that the statistics weren't very good, you knew all of that, because you'd been there before," he said.

"I thought all that was behind me, and I was looking forward to a rosy future and then all of a sudden [the relapse] happened. But then you've just got to get on with it and suck it in and get on with the treatment."

The physical rollercoaster of surviving cancer was matched by a wild emotional and psychological ride. Mr Moore left his work as an executive with the South Australian Government as restoring his health consumed vast amounts of his time.

He then returned at a much lower position, in part as a diversion from his illness.

Mr Moore addressed the anxieties about cancer by gathering together cancer survivors in a cycling team that now numbers more than 450. Collectively they share experiences and advocate for patients.

'A game-changer'

Mr Moore was guest of honour recently when a $28 million facility was opened at the Flinders Medical Centre in Adelaide's south.

Mr Moore, along with survivor Julie Marker, had acted as consultants, giving a patient's perspective for the layout of the treatment areas.

"I'm really optimistic that with the new building as well and the opportunities for putting in new technologies, that this will be a game-changer, I hope," Ms Marker said.

The centre's emphasis on survival means prevention strategies, research, treatment, counselling, nutrition and case management are all under one roof for the first time.

This trend toward broader treatment is reflected in a similar facility being built at Melbourne's Austin Hospital and a cancer survivors' centre being created in Sydney.

Within days of the euphoria of the new centre being opened, Mr Moore was back in hospital. Even after 19 months free of cancer, there remains the nagging fear of a relapse?

"I've had most of the things that are currently available for my type of cancer. I was told that if it does return, there's not a lot left," he said.

He agreed to allow 7.30 to film a pioneering procedure call narrow band imaging, where doctors search his lungs for potential cancer cells.

However, during the procedure, a sample of tissue was examined with the worst news. A 10 millimetre tumour was discovered in his lung.

The 53-year-old now faces surgery and an unknown future, but his story is not unusual.

More than 300 people are diagnosed with some form of cancer in Australia each day.

Article originally posted on ABC website