As a cancer survivor, “Good Morning America” co-anchor Robin Roberts is in good company: An estimated 17 million cancer survivors are living in the United States today. That large and growing number is a testament to just how successful today’s cancer treatments can be.
Yet Roberts’ story is also emblematic of a more troubling trend. Five years after her breast cancer diagnosis, Roberts learned she had myelodysplastic syndrome, a rare blood cancer. It wasn’t just bad luck: Doctors told her it was likely a long-term side effect of the chemotherapy that had saved her from breast cancer.
When facing a cancer diagnosis, everyone’s focus is on getting rid of the cancer, and getting rid of it fast. But what happens after? Unfortunately, many cancer treatments have serious side effects that can crop up years or decades later.
As more people are living longer after cancer, doctors and researchers have begun scrutinizing these effects — and looking for ways to prevent them.
Motivated to act
Roberts partnered with the V Foundation for Cancer Research to create the Robin Roberts Thrivership Fund, which supports research aimed at improving the outlook for cancer survivors. As a colleague of celebrated coach and ESPN broadcaster Jim Valvano, who launched the V Foundation as he was dying from cancer, Roberts had long been a friend and supporter of the foundation. She has served on its board since 2012.
After the ups and downs of her own cancer experience, Roberts wanted to make sure there was enough support for science focused on giving survivors the best chance for a long and healthy life.
“Cancer survivorship is finally coming to the forefront. While cancer prevention and treatment are critical, helping survivors thrive is equally important,” Roberts said at the fund’s launch event in 2017. “I’m thrilled to be part of the V Foundation team in making this happen.”
Just over two years in, the fund has awarded $5.4 million to date in support of nine promising research projects.
No more double-whammies
Researchers are using this funding to pursue two main avenues. The first is to develop new or improved therapies with fewer side effects. A second avenue, called personalized medicine, focuses on giving doctors tools to identify which therapies are most likely to work for each patient’s specific cancer, thus minimizing their exposure to unnecessary treatments and side effects.
Dr. Smita Bhatia of the University of Alabama, Birmingham, is pursuing both goals with her V Foundation funded research on heart failure, a debilitating and deadly side effect of chemotherapy drugs in the anthracycline family. In a study involving more than 140 hospitals, her team is gathering blood samples from hundreds of children to find out what makes one child more likely to develop heart failure than another.
“If you expose 100 people to anthracyclines, 10 will develop heart failure and 90 won’t. The question is, why do these 90 people escape? To find out, we’re systematically looking at the DNA to see if a certain gene increases or decreases the risk of toxicity from anthracyclines,” Bhatia explains. “I’m extremely grateful to the V Foundation for giving us these funds to advance our goal of truly understanding the mechanisms for how an anthracycline causes these heart problems.”
Bhatia hopes the research will help doctors identify the patients facing the highest risk of heart failure so they can adjust anthracycline treatment accordingly in these patients. The findings could also help researchers find new treatments that counteract the activity of anthracyclines in the heart.
Taking the long view
Survivorship research often focuses on survivors of childhood cancer, who potentially have decades of healthy life ahead of them. Ewelina Bolcun-Filas, assistant professor at the Jackson Laboratory in Bar Harbor, Maine, is studying ways to preserve the eggs and ovaries of young girls during cancer treatment. Up to 20 percent of girls have reduced egg supplies after undergoing chemotherapy, and many suffer infertility and hormonal problems later in life.
Among other leads, Bolcun-Filas is using her Thrivership grant to explore how drugs targeting a protein known as CHK2 could be given alongside chemotherapy to help to protect eggs from damage.Other Thrivership grants are supporting research on immunotherapy, which uses the body’s immune system to seek and destroy cancer cells. Immunotherapies can have fewer side effects than other treatments, though they do not work well for everyone. Researchers are working to better understand their long-term effects and make them work better for more patients.
As the research moves forward, there is one thing all cancer survivors can do to stay on top of their health: Visit a doctor regularly. After spending so much time in the hospital, some survivors just want to enjoy the freedom of living cancer-free without thinking about doctors and tests. This is especially true of survivors of childhood cancer, who, like young adults everywhere, can have a tendency to feel invincible and overlook potential health problems.
“Their biggest desire is to be cured and put the cancer behind them, and indeed, that should be the topmost priority,” says Bhatia. “But when that happens, it is important to sit down with a survivorship counselor to take a look forward and make sure they are living a healthy and productive life. Often, that second part doesn’t happen, and it’s a missed opportunity.”
Keeping up with regular check-ups is vital to catching any issues early on, when there are often more opportunities to intervene. And that can make all the difference between surviving — and thriving.