Ter­tiary pre­ven­tion: lifestyle in ovar­i­an can­cer. The Sur­vivor­ship Clin­ic concept

Ter­tiary pre­ven­tion focus­es on restor­ing health after ill­ness. The aim of ter­tiary pre­ven­tion (reha­bil­i­ta­tion) is to pre­vent or alle­vi­ate relapse, chroni­fi­ca­tion or con­se­quen­tial dam­age. In oncol­o­gy in par­tic­u­lar, ter­tiary pre­ven­tion plays an impor­tant role in improv­ing long-term sur­vival and qual­i­ty of life.

What is Long Term Survival?

Thanks to advances in med­i­cine, sur­vival rates are increas­ing, and can­cer can more and more often be viewed as a chron­ic dis­ease. In the west­ern world, more than 65% sur­vive can­cer for more than five years. In Ger­many alone there are around four mil­lion long-term sur­vivors after can­cer. Long-term sur­vivors increas­ing­ly include women with or after ovar­i­an can­cer: around a third of women become long-term sur­vivors. Despite the increas­ing num­ber of long-term sur­vivors, the top­ic of long-term sur­vival has received very lit­tle atten­tion in both the lay press and scientifically.

How is long-term sur­vival after gyne­co­log­i­cal can­cer defined?

The def­i­n­i­tion of long-term sur­vival in the lit­er­a­ture is very incon­sis­tent. For this rea­son, the fol­low­ing for­mu­la­tion was estab­lished at the 2019 spe­cial­ist con­gress in Athens of the glob­al com­mu­ni­ty of gyne­co­log­i­cal-onco­log­i­cal study groups: Long-term sur­vival is defined as sur­vival of at least five years after the ini­tial diag­no­sis of gyne­co­log­i­cal cancer.

The group of long-term ovar­i­an can­cer sur­vivors is very het­ero­ge­neous. On the one hand, there are women who have devel­oped ovar­i­an can­cer once in their life and are con­sid­ered cured and, on the oth­er hand, there are women who have had a relapse or even sev­er­al relaps­es and are cur­rent­ly receiv­ing therapy.

Are Long Term Sur­vivors Healthier?

Long-term sur­vivors are often con­sid­ered health­i­er and the lit­er­a­ture has repeat­ed­ly described that cer­tain pre-exist­ing con­di­tions, such as dia­betes mel­li­tus or pre-exist­ing car­dio­vas­cu­lar dis­ease, are asso­ci­at­ed with a poor­er prog­no­sis. As part of a Char­ité study “Car­olin meets HANNA”, long-term sur­vivors were com­pared with patients who died with­in five years of the ini­tial diag­no­sis. No dif­fer­ences in pre­vi­ous ill­ness­es or med­ica­tion intake could be determined.

For your infor­ma­tion:
For a long life — regard­less of can­cer — the fol­low­ing apply among oth­ers. the reg­u­lar con­sump­tion of cru­cif­er­ous veg­eta­bles (broc­coli, point­ed cab­bage, sweet pota­toes), berries, nuts, pome­gran­ate, avo­ca­do, green tea, flax seeds, whole grains, green leafy veg­eta­bles and toma­toes as cheap. A low-meat or veg­e­tar­i­an diet seems to reduce the risk of can­cer; for exam­ple, the risk of devel­op­ing breast can­cer is 23% high­er with reg­u­lar con­sump­tion of red meat. There is there­fore evi­dence that a healthy diet has a pos­i­tive effect on the course of the dis­ease, but so far there are no sci­en­tif­ic stud­ies on the diet of long-term sur­vivors with ovar­i­an cancer.

What role does the psy­che play?

The psy­che and relat­ed per­son­al resilience also seem to play a role in the course of the dis­ease. It is not with­out rea­son that every can­cer patient is offered psy­cho-onco­log­i­cal coun­sel­ing or sup­port. You can find more infor­ma­tion on this in the arti­cle on sup­port­ive offers.

Cured but not healthy?

52% of all long-term sur­vivors see them­selves as can­cer patients. Even among women with­out cur­rent ther­a­py, 28% still see them­selves as can­cer patients. This could include relat­ed to the fact that more than half of long-term sur­vivors still have symptoms.

After­care and then?

In Ger­many, patients with ovar­i­an can­cer usu­al­ly present for five years — after that, can­cer patients are usu­al­ly con­sid­ered cured. Although this most­ly applies to can­cer as such, it does not nec­es­sar­i­ly apply to pos­si­ble long-term side effects and fears, e.g. of a late relapse of the disease.

The Sur­vivor­ship Clin­ic — a novelty

So far there have been no spe­cial con­sul­ta­tion hours for long-term sur­vivors in Ger­many, which is why there is cur­rent­ly a con­sul­ta­tion hour for long-term sur­vivors after or with gyne­co­log­i­cal tumor dis­ease (ovar­i­an, fal­lop­i­an tube) , Peri­toneal, cer­vi­cal and uter­ine body can­cer). The aim of the con­sul­ta­tion is to improve the qual­i­ty of life and the state of health of long-term sur­vivors, the (ear­ly) detec­tion and treat­ment of long-term side effects and the cre­ation of a mul­ti­modal and inter­pro­fes­sion­al ther­a­py mod­ule. Each patient should receive an indi­vid­ual “sur­vivor­ship care plan”, as rec­om­mend­ed in the cur­rent guide­line, which also includes advice on lifestyle aspects such as diet and phys­i­cal activ­i­ty. The estab­lish­ment of this “sur­vivor­ship con­sul­ta­tion” is fund­ed by the inno­va­tion fund of the Fed­er­al Joint Com­mit­tee of Health Insur­ance Funds.

Are you a long-term sur­vivor and are you inter­est­ed in the consultation?

Then you can reg­is­ter now at survivorship-clinic@charite.de or using the con­tact form at www.survivorship-clinic.de