The Case of the Chronic Cancer Condition
Lisa, a 32-year-old tax accountant, completed treatment for stage III triple-negative breast cancer 18 months ago. During a follow-up appointment, Lisa reported worsening headaches and difficulty concentrating at work. A magnetic resonance imaging scan and subsequent biopsy revealed a solitary brain lesion. She completed stereotactic brain radiation two months ago.
Lisa calls the oncology nurse navigator, Mindy, to report that she is having difficulty sleeping and coping with the fact that she has metastatic breast cancer. Lisa says that she and her fiancé planned to marry once her initial treatment was finished. Prior to starting treatment, she also completed fertility preservation because the couple really wanted to have a family. Now she is unsure whether she will need additional treatments or if she should start a family. She feels guilty about starting a marriage with medical debt and has cancelled her gym membership.
What Would You Do?
Nearly 17 million people in the United States are cancer survivors, and that number is on the rise with 22 million survivors projected (https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/cancer-treatment-and-survivorship-facts-and-figures/cancer-treatment-and-survivorship-facts-and-figures-2019-2021.pdf) by 2030 and 26 million survivors by 2040.
Survivors like Lisa must learn how to cope with the threat of cancer recurrence. Oncology nurses must address health promotion, sexual health, financial toxicity, and emotional well-being with all cancer survivors. Fertility preservation (https://voice.ons.org/stories/help-aya-survivors-and-patients-with-cancer-navigate-infertility) and family planning may also be (https://education.nccn.org/node/88000#group-tabs-node-course-default1) applicable.
Researchers continue to seek interventions to help alleviate the multiple challenges of cancer survivorship. One such example is the Oncology, Nutrition, and Exercise (ONE) Group at Penn State College of Medicine/Penn State Cancer Institute in State College, PA. ONE Group developed a series of exercise videos that can be done without specialized equipment and include seated exercise for people who have metastatic bone lesions.
Mindy understands the need for ongoing health and wellness in cancer survivorship and facilitates a referral to an oncology specialized social worker and a sexual health and reproductive clinic. She recommends the ONE Group program as a way to continue to exercise without paying for a gym membership as well as several national organizations that provide support and interventions for people with metastatic breast cancer.