Cancer: what happens after the therapy?

Tumors: Many cancer therapies have massive late effects

Radiology in Rostock: MRI can detect tumors. But what happens next after the successful treatment? (archive image)

Photo: Bernd Wustneck / dpa

Surviving cancer does not mean feeling healthy. Many patients suffer from the long-term consequences of the treatments.

Berlin/Mainz. Blogger Jules (26) has adopted an unusual way of using social media: His videos on Youtube are all about cancer. How the disease started? What do you eat as a patient? Does cannabis help against cancer? When will the hair grow back? These are the titles of the videos on his Youtube channel "Chemoblog," which is aimed especially at those affected and their relatives.

The blogger from Mainz is now cancer-free and wonders what happens next – a topic that concerns many people. According to figures from the Center for Cancer Registry Data, there are more than one million people living in the Federal Republic of Germany who have survived their cancer diagnosis by at least ten years.

Surviving cancer does not mean being healthy

Former cancer patients do not feel healthy after their experience, says the spokeswoman for the Women’s Self-Help After Cancer organization, Caroline Mohr, ahead of World Cancer Day on 4. February. The group was founded 40 years ago.

The organization brings together women cancer patients – and, for some years now, male patients as well – in more than 300 groups across Germany to talk about their disease.

Even if a quarter of the members are considered cancer-free, many report late effects: They are less able to perform, complain of dizziness, exhaustion and sensory disturbances in the arms and legs, Mohr relates.

Oncologist is optimistic about progress

Oncologist Georgia Schilling knows enough of these symptoms in cancer patients. The senior physician, who also works at the Tumor Center at the Asklepios Klinik Altona in Hamburg, is optimistic about the progress being made in cancer therapy. Still, they say, they’re a double-edged sword. "We buy our success with side effects," she says.

When chemotherapy, immunotherapy and radiation are combined, the patients end up with a cocktail of side effects that they cannot get rid of even after the cancer has gone.

Many are not resilient enough for the job

For example, in everyday working life: 60 percent of cancer patients are back at work after an average of 150 days off therapy. "But we know that very many patients give up their jobs again because they just can’t cope," says Schilling.

Blogger Jules has taken it slow. He had his last chemotherapy at the end of 2018. The self-employed cameraman is working regularly again, although much less than before cancer. According to his own statements, he feels nothing of late effects – except the fear that they could come.

Children are hit particularly hard

Side effects hit children particularly hard. "The younger the person, the more sensitive they are to radiation, for example," says Peter Kaatsch, head of the German Childhood Cancer Registry at the University Medical Center Mainz.

At first glance, the registry’s figures are positive: the majority of children with cancer are now cured; ten years after treatment, 83 percent of children are still alive.

Girls who receive radiation are more likely to get breast cancer later

"At the German Childhood Cancer Registry, about 30.000 of these children are known," says Kaatsch. The registry has been recording cases since 1980 in western Germany and since 1991 also for the eastern German states.

Many of the patients covered have late effects from the therapy: Kaatsch reports heart-damaging leukemia drugs that sometimes even necessitated heart transplants in cured patients in young adulthood.

Another example: doctors used to treat girls suffering from lymphatic cancer with radiation therapy in the breast area – these girls would then often become breast cancer patients as adult women, Kaatsch explains.

In the case of childhood cancer, radiation therapy is now avoided wherever possible – but awareness of the long-term consequences has only existed since the 2000s.

The disease does not simply end

"One thing is for sure: everyone is afraid to start again with everyday life," says Youtuber Jules. For him, the first thing in the coming months is follow-up care. Examinations every three to six months. "The disease does not end."

Whether he also wants to share this with the public, he does not yet know. He does not plan long into the future. "Because I never know what’s coming." (dpa/aba)

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