Survivorship

ADDRESSING THE AFTEREFFECTS

Improving Life After Cancer

Cancer and its treatment can result in long-lasting or late-onset effects, including pain, infertility, neuropathy, sexual dysfunction, depression, graft-vs.-host disease, memory issues, financial strain, subsequent malignancies and fear of recurrence of the original cancer. At Fred Hutch, we conduct research on cancer survivorship to help guide care for cancer survivors and learn more about the challenges they face after their treatment ends. Research topics range from the cardiovascular effects of chemotherapy and radiation to the factors that affect emotional adjustment and quality of life for survivors.

Our survivorship research takes place across all Fred Hutch divisions, through the Survivorship Clinic located within Seattle Cancer Care Alliance’s Wellness Center and through our Long-Term Follow-Up Program for blood stem-cell transplant patients. As part of these efforts, patients who obtain survivorship care through SCCA are asked to complete an annual questionnaire about their physical, emotional and medical experiences. 

Addressing Physical and Emotional Issues

Many cancer survivors experience decreased quality of life due to physical problems brought on by their cancer treatment as well as emotional issues such as anxiety, depression and fear of recurrence. Researchers in the Public Health Sciences Division, the Biobehavioral Sciences program within the Clinical Research Division, and other groups at Fred Hutch and SCCA study factors associated with cancer survival and the effects of cancer and cancer treatment on quality of life. Study topics include physiological issues such as lymphedema, a condition that can present years after treatment; sexual dysfunction and body image issues; stress that can endure long after diagnosis, treatment and follow-up; and culturally appropriate methods of providing psychosocial support.

Jesse Fanna psychiatrist and the director of the Psychiatry and Psychology Service at SCCA.
Dr. Jesse Fann, a psychiatrist and the director of the Psychiatry and Psychology Service at SCCA. Photo by Robert Hood / Fred Hutch

Improving Follow-up Care 

Fred Hutch teams are conducting research on long-term health outcomes for cancer survivors and ways to improve follow-up care. For example, the Fred Hutch Survivorship Program is leading a nationwide study that aims to improve long-term health outcomes for cancer survivors aged 18 to 39. The study, which involves six other comprehensive cancer centers, tests the effectiveness of using treatment summaries and survivorship care plans and collects evidence to support long-term follow-up recommendations.

After treatment, many cancer survivors transition back to their primary care physician, who may not understand the potential long-term or late-onset effects of the treatment or how to manage them. Researchers at Fred Hutch have helped to develop national guidelines for caring for survivors of various cancers, including head and neck and breast cancer.

Dr. Fred Appelbaum during the Fred Hutch's Bone Marrow Transplant Survivor Reunion in 2015

Long-Term Follow-Up Program

Kelly Lipscomb speaks about Returning to Work After Cancer during the 12th annual Moving Beyond Cancer to Wellness event in 2018

Survivorship Program

Long-Term Follow-Up Program

The Long-Term Follow-Up program at Fred Hutch and SCCA provides lifelong consultation services to recipients of a bone marrow or stem cell transplant. LTFU also sends yearly surveys to transplant recipients, gathering information that can help inform strategies for preventing and treating long-term effects of transplantation and for educating patients about potential post-transplant problems.

Understanding Complications After Treatment

Numerous Fred Hutch investigators are researching a common and potentially deadly complication of bone marrow transplant known as graft-vs.-host disease, in which donor cells mount an immune response against the recipient’s healthy tissues. The condition can be acute or chronic, affecting the skin, mouth, eyes, joints, lungs, liver and other organs. Our research ranges from preventive strategies to clinical trials and targeted therapies.

A cancer survivor on his laptop at home
Greg Grappone, who developed graft-vs.-host disease, which proved fatal, after a blood stem cell transplant that cured his cancer. Photo by Robert Hood / Fred Hutch