A chronic condition is one that lasts for months, or even years, and typically requires ongoing management and support. Increasingly, some cancers are being managed as chronic conditions. While many cancers can be successfully treated and even cured, others may not go away completely, but long-term care can control symptoms and slow progression.
For those living with chronic cancer, managing the disease can be complex. Here’s what you need to know to effectively manage your condition and find the support you need.
What Is Chronic Cancer?
Cancer is considered chronic when it cannot be completely cured but can still be managed over time. Chronic cancers include those that have metastasized or spread beyond the original tumor site or cancers with a high risk of recurrence despite treatment.
Acute cancers, on the other hand, can be treated and potentially cured with surgery, chemotherapy, radiation therapy, or another type of treatment.
With treatment advances like targeted therapies and immunotherapy, many people with chronic cancer live years beyond their initial diagnosis.
Types of Cancer That Can Become Chronic
Cancers that affect the blood or bone marrow, like chronic lymphocytic leukemia(CLL) and multiple myeloma, have a higher likelihood of becoming chronic. Solid cancers that have spread (metastasized) to other parts of the body, such as stage IV breast cancer or stage IV prostate cancer, may also become chronic.
Myeloproliferative neoplasms (MPNs), a group of blood cancers affecting the different blood cells in the bone marrow, are also chronic. These include chronic myeloid leukemia, polycythemia vera, essential thrombocythemia, and primary myelofibrosis.
In fact, most cancers can become chronic, but certain risk factors increase the likelihood. These can include genetics, lifestyle choices like smoking or excessive alcohol consumption, and exposure to environmental toxins.
Here are a few examples of cancers that can become chronic:
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CLL
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Some other leukemias
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Multiple myeloma
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MPNs
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Certain types of breast cancer
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Some forms of metastatic cancer
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Certain neuroendocrine tumors
Living With Chronic Cancer Can Be Complex
One of the biggest challenges for those with chronic cancer is managing symptoms. While some may experience a relatively stable disease course, others have recurring or worsening symptoms that require ongoing treatment.
You may experience pain, fatigue, digestive issues, or other side effects from the cancer or its treatment. However, remission is possible and often the goal of treatment for chronic cancer.
“Remission can occur for any cancer patient when the signs and symptoms of the cancer have decreased or nearly disappeared for a long period of time,” said Snehal Smart, MD, physician and patient advocate for The Mesothelioma Center at Asbestos.com. She added that remission is often possible if:
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The cancer was caught early
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The treatment began early
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The cancer responded well to the treatment
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The patient tolerated the treatment well
“When a patient is in remission, it means the cancer may return at some point,” Dr. Smart said. “Although they may not have been completely cured from cancer, it could still mean they can take a break from treatment.”
Some other factors that may contribute to the likelihood of remission include:
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The type and stage of cancer
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The overall health and age of the patient
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Access to quality healthcare and treatment options
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Lifestyle habits, such as quitting smoking or maintaining a healthy diet
Maintenance Therapy
In some cases, doctors may recommend maintenance therapy after initial therapy to help prevent or delay the cancer from returning. This involves using lower doses of chemotherapy or immunotherapy over a long period of time.
Some cancers respond well to this approach, and it can help control the cancer and prolong remission. For example, people with multiple myeloma may be prescribed maintenance therapy with a targeted drug like lenalidomide (Revlimid). A European Journal of Haematology study found that lenalidomide significantly prolonged survival and delayed relapse following an autologous stem cell transplant.
In breast cancer, maintenance therapy with tamoxifen (a hormone therapy) reduces the risk of recurrence and death when taken for at least five years. Research published in the Journal of Clinical Oncology shows that taking tamoxifen for five years, along with yearly MRI screenings, can lower the risk of invasive breast cancer by 40% and reduce breast cancer deaths by 57% in people with estrogen receptor-positive breast cancer, compared to no tamoxifen maintenance or screenings.
If you’re a candidate for maintenance therapy, your doctor will discuss the options with you and explain any potential side effects of long-term treatment.
Regular Monitoring
According to Ammar Sukari, MD, medical oncologist and leader of the Head and Neck Oncology Multidisciplinary Team at Barbara Ann Karmanos Cancer Institute, doctors consider the following factors when deciding how to monitor your chronic cancer:
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The type of cancer
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How aggressive it is
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When you were first diagnosed
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Current disease status
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Your risk of relapse
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The availability of maintenance therapy options
Your provider may recommend several monitoring strategies, including blood tests, imaging scans, and regular physical exams. Blood tests may be used to measure specific biomarkers that indicate the presence or activity of cancer cells in your body. Imaging such as X-rays, CT scans, and PET scans can provide detailed images of your bones and soft tissues that may signify disease progression.
Be sure to attend all follow-up appointments, including any tests or imaging your provider recommends. These appointments can help identify potential cancer recurrence or progression early so additional treatment options can be explored.
Supportive Care
You will likely experience physical, emotional, and psychological symptoms after being diagnosed with chronic cancer. Supportive care involves managing your symptoms and treatment side effects, as well as addressing the emotional and mental impact of a cancer diagnosis.
Your healthcare team may include specialists such as oncology nurses, social workers, nutritionists, and counselors who can provide support and guidance throughout treatment. They can help you manage pain, fatigue, nausea, and other common side effects of cancer treatment.
In addition to managing physical symptoms, supportive care also focuses on addressing the emotional toll that comes with a cancer diagnosis. Your healthcare team can provide resources for managing stress, anxiety, and depression. They can also connect you with support groups or individual counseling to help you cope with the emotional challenges. Talking to a licensed therapist or counselor can be incredibly beneficial for managing your mental health and learning valuable coping skills.
Cancer treatments may also interfere with your appetite, digestion, and nutrient absorption. A registered dietitian can work with you to create a meal plan that meets your nutritional needs and addresses any side effects you may have, like nausea or acid reflux.
Other supportive care services may include:
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Physical therapy
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Occupational therapy
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Pain management
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Spiritual support
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Music therapy
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Integrative care
Advances in Cancer Treatments
Cancer treatment has made tremendous strides over the past few decades. Researchers are constantly developing new therapies to improve outcomes and reduce treatment-related side effects. Some of the latest advances in cancer treatment include:
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Improved screening and early detection: Modern screening techniques, such as low-dose CT scans for lung cancer or advanced imaging methods like 3D mammography for breast cancer, have improved the accuracy of detecting abnormalities at earlier stages. In addition, advances in non-invasive screening methods like liquid biopsies, which use blood samples to detect cancer, have made the screening process more accessible.
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Immunotherapy: This treatment uses the body’s own immune system to fight cancer. It can work by boosting the immune system or using specific proteins called monoclonal antibodies to target cancer cells.
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Precision medicine: Also known as personalized medicine, this approach uses genetic testing to identify specific mutations in your cancer cells.
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Targeted therapy: This involves using drugs that target specific proteins or other molecules directly involved in the growth and spread of cancer cells.
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Clinical trials: Participating in clinical trials can give you access to new and innovative treatments that are not yet FDA-approved. These trials also help researchers gather data and improve treatment options for others in the future.
Takeaway
While many chronic cancers can’t be cured, treatments can control disease progression and extend survival by years or even decades. Talk to your doctor about your treatment and maintenance options, as well as any available resources and supportive care services.
Lindsay Modglin, Medical Writer
Lindsay Modglin is a professional medical writer and editor with 9+ years of clinical healthcare knowledge. She graduated from Ivy Tech in Indiana for nursing and has since received a professional certificate in scientific writing from Stanford. She also holds a handful of professional certifications in writing, SEO, and content marketing. Her byline has appeared in Forbes, Insider, Verywell, Parents, and Healthline—along with many other digital and print publications.
Sangeetha Venugopal, MD, MS, Assistant Professor of Medicine, Leukemia Program, Division of Hematology
Dr.Venugopal has presented several abstracts at the annual American Society of Hematology, American Society of Clinical Oncology meeting and the European Hematology Association meeting. Dr.Venugopal was awarded the 2021 ASCO merit award from the conquer cancer foundation for high ranking abstracts and 2021 ASH award for outstanding abstract.
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