Articles by G van Londen, MD

Dr. van Londen is a cancer provider/medical oncologist and a cancer survivor. Born and raised in The Netherlands, she has migrated to the USA where she completed a medical residency, as well as fellowships in medical oncology and geriatric medicine. She has practiced medicine in the USA for nearly 20 years at a large health care system in Pittsburgh, PA, USA. Her background has prepared her to handle diverse and complicated cases. She specializes in: 1) Treating newly diagnosed, older breast cancer patients by performing a geriatric assessment and creating a personalized, multidisciplinary treatment plan that aims to respect patient’s preferences and desire for independence. 2) Cancer survivorship care to prevent/support the late/long-term post-treatment needs of cancer survivors of any gender and tumor type (and their caregivers). Together with a village of various supportive care providers, she performs clinical, research, and educational activities to empower cancer survivors (and their caregivers and providers) to support the post-treatment emotional, physical, and functional needs of cancer survivors. The content of this domain is protected. Entries and replies are not endorsements. Views are mine. No COI.
Who is a Cancer Survivor?

Who is a Cancer Survivor?

The definition of a cancer survivor remains debated. The National Coalition for Cancer Survivorship (NCCS) defines a cancer survivor as “An individual from the time of diagnosis, through the balance of his or her life”, and in their most recent version of their definition they include “impacted family members, friends, and caregivers”. Dr. Feuerstein (Editor of The Journal of Cancer Survivorship) proposed a working definition “From completion of primary treatment up to end-of-life”. Calls have been made to make the definition more transparent and be more respectful of persons who have lived past cancer.

Regardless of the definition you relate to, there is some good news! Medical advancements in cancer detection and treatment have made huge advancements in the last few decades, as described in the Pulitzer Prize winning book and documentary “Emperor of all Maladies”. These medical advancements have resulted in improved cancer outcomes and an ongoing increase in the number and longevity of many  persons with a history of cancer. Cancer researchers around the globe continue to work hard to allow ongoing improvements in cancer care and project positive outcomes (within the next ten years), as well as improving the quality of cancer survivorship care.  That means you can worry less and focus more on the things and people that are important and meaningful to you!

So what does this mean for you? For starters, seek and develop a good relationship with a primary care physician that you feel comfortable with and that will be your companion and advisor as you make the journey towards optimum health.

Lets get the conversation started! What is your definition of a cancer survivor?

Are You Searching Your Medical Symptoms on the Internet?

Are You Searching Your Medical Symptoms on the Internet?

As a cancer survivor, you may have lost trust in your body. When you notice things happening in your body, you may become concerned that it signals that your cancer has returned, or you have developed a new cancer or a treatment complication. You may turn to an internet search to research your symptoms, which may only further increase your level of concern and lack of sleep! You may not know when to reach out for help and which one of your multiple providers to call.

When educating my patients about the seemingly endless list of sign and symptoms of cancer recurrence, I prefer to avoid specifically identifying them. Instead, I advise my patients the following: if you should develop symptoms that are not acute (meaning life threatening or intense, i.e. a stroke, heart attack or an severe belly pain) and these non-acute symptoms last for one or two weeks, and these are either new symptoms or chronic ones that are different now, then it may be advisable to reach out to a provider whom you feel comfortable speaking with. Ideally, your cancer provider since they may be more skilled to evaluate whether it may or may not be related to cancer. This provider can advise you several things that usually translate to one of following messages:

  • This does not sound suspicious, please see your PCP for assessment and management.
  • This sounds a bit concerning. Why don’t we do some testing (like labs or scans) and have you come into the office to discuss the results.
  • Most commonly, you may be told that your symptom is real, but not yet specific enough to be diagnosed. In this case, you may be prescribed an empiric therapy such as medication to support your symptom(s) and be scheduled for a later reevaluation. Most commonly the symptom(s) will resolve and were therefore likely not related to cancer.

It is most important to remember that you are not alone! You are part of a team; you are the “monitor”, since you know best what is happening with your body. Your medical providers can help you make sense of your symptoms.

Optimize Bone Health and Reduce Fracture Risk

Optimize Bone Health and Reduce Fracture Risk

Cancer (treatments) may expedite the loss of bone mass and increase your fracture risk.

Calcium and Vitamin D are essential for bone health. Supplements may not be able to fully prevent fractures and may increase the risk for heart disease. Unless recommended/prescribed by your health care provider, and until we know more and understand better, your diet may be the preferred route to get (the bulk of) your daily Calcium/Vitamin D intake. The National Osteoporosis Foundation has created information on daily requirements and natural sources of Calcium and Vitamin D.

Your provider may recommend exercises (to prevent falls and/or strengthen your bone), a blood draw (to evaluate the need for a vitamin D boost), as well as a bone density test* (to evaluate the need for medications).

*Not to be confused with a nuclear bone scan used to detect cancer..

This site does not provide binding advice. Please communicate with your provider(s) before making any changes to your care plan. The content of this domain is protected. Entries and replies are not endorsements. Views are mine. No Conflict of Interest.

Which Vitamin Source?

Which Vitamin Source?

Dietary Supplements and Mortality Rate in Older Women The Iowa Women’s Health Study (JAMA 2011)

Do Cruciferous Vegetables Really Fight Cancer? (NYT 2018)

Bottom line – until we know more and understand better, it may be preferable to get your vitamins from a large variety of dietary sources rather than pills (unless specifically recommended/prescribed by your health care provider).

What is Cancer Survivorship

What is Cancer Survivorship

As you enter the post-cancer treatment phase, you may….

  • “Look better”, but you likely still have more healing to do – physically, functionally – but also emotionally and spiritually. Being told “you have cancer” and having to put your life unexpectedly and urgently on hold to undergo life-saving treatments can be traumatizing.
  • Feel alone, since it may be hard for others to understand you, especially if they haven’t experienced it themselves.
  • Feel like you are riding an emotional rollercoaster.
  • Notice that your priorities in life are changing, perhaps even rearranging!
  • Find yourself trying to balance your health and healing while minimizing disruption to your home, work, and financial status.
  • Have lost trust in your body, wondering “what will happen next?”, and be searching for ways that allow you to heal and stay healthy.
  • Be uncertain and concerned about what the future may hold for you and for your loved ones.
  • Find yourself spending hours on “Google” trying to answer your many questions, only to discover that you have even more questions!
  • Yearn to renew your pre cancer self and embrace the feeling of wholeness that may have been lost in your journey.

This juggling can be overwhelming, confusing, and stressful. You may have a large team of health care providers, but you may not always know what to do or where to direct your questions, your concerns and your needs. Your providers may not always have the time to work with you in finding the answers that you need, or the specific skills to support you and as a result, you may feel lost or abandoned in your journey.

Even though the field of cancer research and treatment field has made huge advancements towards the prevention, diagnosis, and survival of cancer patients over the last few decades, the post-treatment phase has been relatively undervalued and under-explored until recently. But the “times they are a changing” and that means good news for survivors, caregivers, and providers as well.

As a first step, to facilitate the transition of cancer survivors into the post-treatment phase [From Cancer Patient to Cancer Survivor: Lost in Transition (IOM 2005)], large organizations such as LIVESTRONGNational Coalition for Cancer Survivorship, Office of Cancer Survivorship at National Cancer Institute(https://cancercontrol.cancer.gov/ocs/), and American College of Surgeonshave identified the following five essential elements and recommend that providers incorporate these elements as an integral part of the post treatment care plan:

  • Surveillance (watch for cancer recurrence)
  • Screening (for new cancers)
  • Assessment and management of the effects of cancer treatment(s)
  • Adoption of positive health behaviors
  • Care coordination between health providers

These areas represent only the first steps to assuring successful survivorship for both patients, their families and health care providers; more improvements in cancer survivorship continue to emerge as recognition of the post treatment phase evolves.

This informational site hopes to help you to navigate your unique survivorship journey and to empower you to regain control and better care for yourself.

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