21-02-2025
‘You are always fighting the disease:' Cancer survivors face long-term health consequences years after treatment
We're in the midst of a cancer crisis. More young people being diagnosed. And while the treatments can be life-saving, years later they are life-altering.
Tina Chip is a two-time cancer survivor having fought the disease twice in her life.
Dr James Flaherty is an interventional cardiologist with Bluhm Cardiovascular Institute.
'Those that have come out of that experience often manifest cardiac problems 20, 30 years later,' he said.
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For Chip, 30-plus years later, it's the aortic valve. Its function compromised by cancer treatment she received in 1989.
'I was 16, a senior in high school and just super excited to have that fun year and I felt a lump in my neck,' she said.
That lump was Hodgkins Lymphoma.
'So I went every day for four months and received the radiation from pretty much my entire body,' she said.
Just six years later, another cancer diagnosis. Breast cancer caused by the very treatment – radiation to her chest wall — that cured her Hodgkins.
'So very advanced disease,' she said. 'I was 22, just finishing college and not in the plan of what I wanted to do for my future.'
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The future for childhood and young adult cancer survivors is the potential for what doctors call the late effects of radiation and chemotherapy.
Dr Aarati Didwania is an internal medicine physician with Northwestern Medicine.
'I can't take away the therapies they received, nor would I want to because it helped cure them, put them in remission. But I would like to try to find things before they become a problem,' Didwania said.
That's where STAR comes in – Survivors Taking Action and Responsibility. Through the program at Northwestern Medicine, doctors monitor for liver, kidney and thyroid malfunction; secondary skin and breast cancers; and blood and heart abnormalities.
Karen Kinahan is a nurse practitioner with Northwestern Medicine.
'So we end up getting a lot of patients, sometimes in their 40s even 50s, that have not been in a pediatric survivor program because there wasn't one for them and now they have had a medical consequence,' she said.
'I've survived cancer as a young adult and now I'm going to make sure I stay on top of everything else my body may give into,' Chip said.
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For the mother of three, the fight is far from over.
'My aortic valve is part of the area that would have gotten hit by the radiation and also possibly chemo long-term effects,' she said. 'And as time progresses, my valve isn't pumping blood out to the rest of my body.'
'We did what's known as an aortic valve study,' Flaherty said. 'We went across the aortic valve and measured the pressure below it and above it, in the left ventricle and the aorta to see how much narrowing or pressure drop there was across that valve.'
'Even though you are further away, and you think it was so far in the past that (you) don't have to worry about recurrence or late effects, it's actually as we get further away, age also plays a factor into that,' Didwania said.
As survivors age – thanks to effective treatments — so does their tissue that was damaged long ago. Only exacerbating potential problems.
'It means we have a bigger survivorship population. There are more people surviving,' Didwania said. 'It's bad because there are more effects we have to look out for, and we have to train providers to be aware of these things and to know when and how to look for them.'
Doctors will continue to monitor Chip's heart. Eventually, she'll likely require a valve repair.
'You have to become your own advocate and fight for yourself and know that this is now part of your life,' she said. 'You are always fighting the disease.'
Radiation has changed since her treatment, more targeted and precise, in some cases lower doses. Still, even patients diagnosed and treated today will likely be at risk 20 or 30 years from now. Knowledge is power. You can learn more about the STAR program here.
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