Dr. Tyler Severance is a pediatric hematologist-oncologist at University of Missouri Healthcare, which means he works with kids who have blood and cancer disorders.
He spoke about some of the short and long-term impacts cancer treatment can have on kids
For the month of July, we're focusing on the ways that cancer treatment can impact a person's health and well-being.
Dr. Tyler Severance: When our we're talking through chemotherapy and what that looks like, I tell families that chemotherapy is designed to attack cells that are growing and dividing quickly.
And I promise we don't have to get into a lecture about mitosis and meiosis and all those thing, but if you think about cancer cells, one of the features that makes them unique and dangerous is that they are growing and dividing so quickly.
And so, our chemotherapy mechanisms often target that unique attribute of cancer cells.
However, you can't just select, “I'm going to give a cancer cell this drug, but not a healthy cell,” and chemotherapy goes through our entire body, and so that means that our healthy cells are going to be exposed to those same treatments.
And when we think about some of the side effects of cancer, I usually say, “Let's start with the healthy cells in our body that are growing and dividing quickly.”
It's like the cells that line our mouth and our stomach, you know, our mouth's got saliva in it – that's pretty acidic. Our stomach churns out stomach acid every day, and one of the ways our body adapts with that is you're constantly replacing the cells that line your mouth and your stomach, so that way you don't, you know, get ulcers or pain or discomfort.
"And so, survivorship starts at diagnosis, and those are things that we are talking about on day one, so that families know that this isn't just a short-term cure; this is a long-term cure with long-term side effects, as well."Dr. Tyler Severance
And lo and behold, if those cells are growing and dividing quickly, they are at risk when we give medicines like chemotherapy.
And so, each treatment protocol is different, but you could see how that could lend itself to mouth sores, ulcers, breakdown of the GI tract.
When we think about what that looks like long-term, some of the cells that grow and divide meaningfully long-term are, say, the cells of our reproductive organs, and the ovaries and the testes are also potentially at risk when our body is getting high-intensity chemotherapy.
But we do make sure that each child that's diagnosed with cancer – we want them and we want their family to know – that we are aware there is a potential long-term risk to fertility, to their ability to mother or father children, and there are some mechanisms we have here that can help with mitigating that risk.
Again, we've got some really awesome colleagues in the women's hospital that can help with fertility preservation – whether that's sperm banking or egg preservation.
But sometimes you don't have the grace of that time, and for patients that are diagnosed acutely that need treatment now, we can't say, “Let's pause two weeks to harvest eggs,” and instead, we say, “Look, we really need to get started with treatment. There is a long term risk. We can talk about options down the road, but we really need to get this started.”
And so, survivorship starts at diagnosis, and those are things that we are talking about on day one, so that families know that this isn't just a short-term cure; this is a long-term cure with long-term side effects, as well.
The best moment is when a child is done with treatment and done with chemotherapy – they invite their friends, their family and their community to join our hospital team, our clinic team, in that clinic space to ring the end of treatment bell.
And that moment when you're saying, "I'm done with my treatment, I'm on my way, I'm ready to go forward.” That is the most incredible moment in all of medicine.
