Dawn Galloway and her children have a name for the occasional lapse of memory.
"Chemo brain, that's what she tells me," said Tyler Galloway, 15.
"I can use that," mom protests, laughing.
Having survived breast cancer and chemotherapy for nearly three years, the single mother of two is more focused on her children and her home in Clearwater than the lingering effects of her treatment. But now that long-term survival is becoming more common, some doctors are starting to focus more on what effects the treatments might have further down the road.
The American Cancer Society estimates there are 9.6 million cancer survivors nationwide, and the number is increasing. October is Breast Cancer Awareness Month, and survivors such as Ms. Galloway do their part to help educate others about the disease and the need for early detection.
But while these patients have more frequent contact with physicians who are watching for returning cancer, a study by Dana-Farber Cancer Institute in Boston found that they are often not monitored for other chronic health problems, even though their treatment might place them at greater risk.
Dana-Farber recently founded the Lance Armstrong Adult Survivorship Center with a $1 million grant from the famous testicular cancer survivor's foundation to study the issues long-term survivors face.
Chemotherapy drugs, for instance, are excreted through the kidneys and can damage them, said Karen Conley, program manager for pediatric oncology at Dana-Farber. The risk for these problems would increase as the patients got older anyway, she said.
"So we're just compounding it with the treatments we're giving them to save their lives," Mrs. Conley said. "We're creating new issues for them."
Physicians often modify treatments to cut down on future problems, such as possibly avoiding radiation therapy to the chest of a young male smoker with Hodgkin's lymphoma because of an increased risk of lung cancer later on, said Oscar Ballester, a hematologist/oncologist at the Medical College of Georgia.
"There's a whole series of problems we are appreciating now can happen in these patients even after decades that they've been cured of their cancer," Dr. Ballester said.
Patients who got radiation therapy, for instance, might receive a chest X-ray as part of their long-term follow-up because of a small risk of lung cancer or benign fibrous tumor later on, said Alice David of Medical Oncology Associates of Augusta.
"That's why close monitoring is absolutely essential," Dr. David said.
Having found a lump in her breast when she was only 23 years old, Melissa Horton was more worried about being able to have a child, which she did three years later.
Now seven years out, she puts the burden of keeping future problems at bay on herself.
"You are your own best advocate, and you always have to stay on top of it," she said.
All of that was far from her mind when Ms. Galloway found her lump in January 2002 and her surgeon was trying to lay out her treatment options.
"I thought, 'In six months, I'll be dead. What about my children? I'm a single mom. What am I going to do?'" Ms. Galloway said. "And I'd cry."
"I was a little shocked," Tyler said. "I couldn't believe it could happen to us."
"I was scared, nervous that she was going to die," said 11-year-old Taylor, her daughter.
But they rallied around her when the first chemotherapy treatment kept her in bed for three days.
"She had her own little bell," Taylor said.
Once Ms. Galloway made it back on her feet, she kept going and now tries not to dwell on what might be in her future by working with the Pink Magnolias Breast Cancer Support Group at University Hospital that helped her so much.
"(I'm) just getting the awareness out there that there is life after breast cancer," she said.
A lot of life.
Reach Tom Corwin at (706) 823-3213 or firstname.lastname@example.org.
There are a number of events and services to commemorate Breast Cancer Awareness Month. Here is a partial listing:
Medical College of Georgia Hospital and Clinics