App for Aftercare
The article confirms the sobering reality of secondary breast cancer after curative treatment for Hodgkin’s disease/ lymphoma (1). This late complication, along with cardiovascular disorders, ranges among the most serious late sequelae of treatment for Hodgkin’s lymphoma (2).
In view of the steadily rising prevalence rates of patients as survivors of cancer, the question that arises concerns effective aftercare and prevention of secondary malignancies. In the US, this topic has already become organized and institutionalized at the highest level, with the Office of Cancer Survivorship (OCS) at the National Cancer Institute, of the National Coalition of Cancer Survivorship (NCCS) and the “Children’s Oncology Group.” As described by the authors, such lifelong risks after treatment for malignancy require clearly defined and structurally organized responsibilities for the aftercare and, equally, preventive screening of survivors (3). In order to enable a simple navigation through the many institutions that are currently involved in aftercare, Boer et al., from Groningen/Netherlands, have tapped into the zeitgeist and developed a so called survivor care app for smartphones, whose many options and advantages are obvious, especially compared with written questionnaires or aftercare reports (4): https://itunes.apple.com/us/app/survivor-care. As in Hodgkin’s lymphoma, the nodular-sclerosing type is the most common (70%), the question arises to what extent common genetic susceptibilities are present for the primary cancer and the secondary breast cancer: is there a correlation with the intrinsic subtypes of breast cancer? Finally, I wish to underline that avoidance of noxious substances—such as cigarette smoking and alcohol—is crucial for the prevention of secondary neoplasias.
Dr. med. Antonis Tsamaloukas
|1.||Schellong G, Riepenhausen M, Ehlert K, et al.: Breast cancer in young women after treatment for Hodgkin´s lymphoma during childhood or adolescence—an observational study with up to 33-year follow up. Dtsch Arztebl Int 2014; 111(1–2): 3–9. VOLLTEXT|
|2.||Travis LB, et al.: Second malignant neoplasms and cardiovascular disease following radiotherapy. Journal of the National Cancer Institute 2012; 104: 357–70. CrossRef MEDLINE PubMed Central|
|3.||Robison LL, Hudson MM: Survivors of childhood and adolescent cancer: life-long risks and responsibilities. Nat Rev Cancer 2014; 14: 61–70. CrossRef MEDLINE|
|4.||Boer H, et al.: Easy navigating through the forest of survivorship care. Journal of Clinical Oncology 2014; 32: 61–2. CrossRef MEDLINE|