Managing Cancer As a Chronic Condition

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Topics include: Treatment

For many types of cancer, aggressive chemotherapy regimens, including those with stem cell rescue, have been employed in the pursuit of a cure. These treatments often carry with them toxicities that are difficult to bear, especially by elderly patients  or those with comorbidities. In this video recorded at the 2014 International Workshop on Non-Hodgkin Lymphoma, Dr. Owen O’Connor, the chief of hematology and oncology at New York University Langone Medical Center, explains a changing paradigm where some may be able to live well with cancer well controlled on a continuous, long-term chemotherapy-lite or chemotherapy-free regimen.

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Transcript

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

Andrew Schorr:

Hello and welcome to Patient Power. I’m Andrew Schorr.

All of us patients want our cancer to be cured but what if it can be knocked back to such a low level that you can just live with it as a chronic condition?

We sat down with Dr. Owen O’Connor, a leader in the field. He joins us from the iwNHL—The International Workshop on Non-Hodgkin Lymphoma—to talk to us about that concept of how patients, young and old, might live with a chronic cancer.

Dr. O’Connor:

There are studies, as you probably are aware, looking at brentuximab [vedotin] (Adcetric) in chemo-lite combinations or brentuximab by itself in patients that are older. Of course, many of them can’t tolerate the aggressive combination chemotherapy regimens. I think that the goals of care may shift depending upon the age of your patient. If you have somebody young, you may say we’re going to take out all of the stops, we’re going to be very aggressive, we’re going to go for cure. In some diseases and in some sectors of the population like the elderly, we’re now becoming acutely aware of the prospect that maybe we don’t have to cure everybody. What if we can manage you? If you came into my office and said I wouldn’t know I had lymphoma other than that’s what you tell me and that’s what the CAT scan says, but I feel great; if I could give you a pill-a-day or treat you once a month with an IV antibody or some immunological therapy, then you would say, thank you very much, that’s a success.

I think these new drugs that are very well tolerated can be conveniently taken, implies that maybe we are in the midst of a little bit of a paradigm shift in that we don’t always need to think about aggressive therapy and an endgame of cure. But maybe we can think about good quality of life with tolerable therapy and manage the disease as a chronic disease the way you might think about managing hypertension or diabetes or COPD. I think in oncology, certainly in lymphoma, we’re there. Many of these diseases are now being turned into chronic diseases, and they’re being turned into chronic diseases—and maybe this is the most interesting take-home-message of all—with chemotherapy-free approaches. I think that’s where a lot of this is going, and I think, in my mind, this meeting is a spectacular forum to bring together the world thought leaders on how all of these breakthroughs are really going to be changing the natural history of these diseases. Within our lifetime, we’re going to be seeing dramatic changes that are going to help patients at every end of the spectrum be it young or old.

Andrew Schorr:

Now chronic cancer can be a very real description for a number of lymphomas and leukemias where we patients live a full life.

We’ll be sure to be keeping you updated so sign up for alerts if you haven’t done so already on our website, so you’ll know whenever we post something new.

I’m Andrew Schorr. Thanks for joining us. Remember, knowledge can be the best medicine of all.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

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Page last updated on September 23, 2014