1 University of Melbourne Department of Nursing/Centre for Cancer Research
This paper will present a brief overview of the changing face of cancer as a chronic disease focusing on two very different cancers: multiple myeloma and melanoma. Data from patient experience studies will be discussed and opportunities for the development of feasible and efficient multidisciplinary models of care considered.
People living with multiple myeloma (MM) have to manage numerous, often intractable disease symptoms and treatment side effects, in the context of a largely incurable disease. Fatigue, pain, pathological fractures and cognitive impairment are common problems that patients and their families have to find ways of managing, often for many years when away from acute, specialist centres. Acute exacerbations of symptoms and side effects can require repeated hospitalisations that impact individuals’ quality of life as well as adding to health service costs. The beginnings of a research proposal to develop and test a model of care for people living with MM will be outlined. With the advent of immune and personalised therapies over the past decade outcomes for patients with stage 3 or 4 melanoma, who have targetable genetic mutations, have been revolutionised. Patients with these mutations can now expect to live years after diagnosis, rather than the few short months previously associated with a diagnosis of advanced melanoma. But improvements in outcomes are associated with side-effects such as pyrexia, flu-like symptoms, fatigue and emotional consequences, such as fear of recurrence that may have considerable quality of life impacts. Insights from a study currently underway with patients with melanoma will be presented and consideration given to how we best meet the needs of this growing group of cancer survivors into the future.