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Inform Survivors About Possible Delayed Toxicity

Inform Survivors About Possible Delayed Toxicity

ST. PETERSBURG, Florida—As a nurse and 22-year survivor of Hodgkin’s
disease, Debra Thaler-DeMers, RN, OCN, from the National Coalition for Cancer
Survivorship (NCCS), brought her personal survivorship perspective to the Late
Effects of Normal Tissues (LENT) IV workshop on late effects criteria and
applications.

Bone Marrow Failure

With her second pregnancy, Ms. Thaler-DeMers was diagnosed with bone marrow
failure, a late effect of her Hodg-kin’s disease treatment. This complication
was not apparent, she said, until she faced the extra demands of supplying the
fetus with blood cells, when it became a crisis situation.

"We need to let survivors know what to watch out for without scaring
them. This can be done by encouraging them to maintain their health and
optimize their quality of life," Ms. Thaler-DeMers said. "Not only
oncologists but also primary care doctors who follow these patients through the
years should be educated about the long-term and late effects of cancer
treatment."

Through her work at a cancer hospital, Ms. Thaler-DeMers encountered two
other women in a support group who had received treatment for Hodgkin’s
disease and who later needed mastectomy for breast cancer.

She later saw an article in the Journal of the National Cancer Institute
(85:25-31, 1993) showing that women treated for Hodgkin’s disease had a
relative risk of breast cancer of 13.6 with follow-up equal to or exceeding 15
years. The study was based on a review of the records of 885 women who had been
treated for Hodgkin’s disease.

"This only came to light for me as a fluke because these survivors ran
into each other," Ms. Thaler-DeMers said. "With increased mobility in
today’s society, often people are not followed in the same center where they
were originally treated, so the connection between cancer treatment and late
effects may go unnoticed."

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