Living Longer, Living Healthier With Major Illnesses

Flashback: There was a time when a diagnosis of a serious illness automatically prompted end-of-life discussions. The prognosis was often grim for those diagnosed with cancer, a major cardiac event or another life-threatening illness.

But now, when it comes to treatment and survival of major illnesses, patients and their families have more options to preserve and extend the quality of life, says Thinh Tran, M.D., chief medical officer at Baptist Health South Florida. In some cases, even serious illnesses such as cancer can be held in remission or kept at bay as a chronic disease, Dr. Tran says.

“The emergence of genomic and personalized treatments allows us to target many types of diseases in a very effective way,” he says. “We have targeted multiple genetic markers in cancer that allow us to prolong the life of patients with various types of cancer.”

Medical advances, early intervention and technology have provided life-sustaining treatments for many illnesses and chronic conditions. Here are a few:

Cystic Fibrosis: Genetic testing has enabled physicians to rapidly diagnose cystic fibrosis, an inherited disease in which dangerous levels of mucus collect in the lungs and gastro-intestinal areas, according to Mario Almeida-Suarez, M.D., an internist affiliated with Doctors Hospital. Early diagnosis through genetic testing enables a doctor to rapidly start the necessary treatment to help patients survive acute crises.

Historically, most cystic fibrosis patients have lived to their mid- to-late 30s, and those who live past that point have typically required an organ transplant, Dr. Almeida says.  But one 50-something patient (Let’s call him “Lester”) is an exception to that rule and provides a model of longevity for those with cystic fibrosis.  Here’s how:

• Early diagnosis: Lester, a successful businessman, was diagnosed with the disease during his teenage years, which provided a head start for developing a treatment plan and a road map for the rest of his life.
• Knowledge:  Education is power, and Lester’s detailed knowledge about cystic fibrosis enables him to recognize signs of distress and to seek medical help as needed, his physician says. “He knows when it’s time to get help, and that has led to good medical outcomes,” Dr. Almeida says.
• Organization and discipline:  As a chronic disease, cystic fibrosis can involve a daily regimen with six different types of treatments and many supplements — with periodic crisis intervention to clear away mucus. The daily ordeal can be overwhelming and tedious, and some cystic fibrosis patients surrender to the ongoing battle. Lester, however, is committed to his medical treatments and shares his knowledge with others.

“He’s such a life coach for other patients,” Dr. Almeida says. “He’s one of the most amazing cystic fibrosis stories, I’ve seen in 30 years.”

Aortic Dissection: In 2003, news reports detailed the death of Three’s Company sitcom actor John Ritter, who died at age 54 from an aortic dissection. It’s an often deadly disease in which the aorta ruptures and blood seeps back into the heart. About 90 percent of patients with the condition die within 24 hours of this cardiac event, according to medical research. But for those who survive the first 24 hours, modern surgery techniques in valve replacement and reconstruction of the aorta can be life-sustaining, says Baptist Health Medical Group heart surgeon and Chief of Cardiothoracic Surgery Niberto Moreno, M.D.

For example, recently in the middle of the night, Dr. Moreno and his partner Lisardo Garcia, M.D., operated on a male patient who had an aortic dissection. The patient is now back to work. The cardiothoracic team at Baptist Health has completed 29 surgeries related to valve replacement and reconstruction of the aorta in the last 18 months.

“Surgical technologies are better,” Dr. Moreno says, adding that the combination of modern procedures, an experienced surgical team and excellent post-operative care can be life-sustaining.

Cancer Survivors: “Basically, the number of cancers survivors is increasing rapidly, in part, due to early detection and better treatment,” says Grace Wang, M.D., a medical oncologist affiliated with Baptist Health.

Cancer survivorship is defined in terms of either being in “remission” or “living with cancer.”

• Remission – When cancer is diagnosed at an early stage, the malignancy can be completely removed and the cancer can be cured or placed in remission, Dr. Wang says. “Some cancers can return 20 to 30 years later. It depends upon the stage of the diagnosis,” she says.
• Living longer with cancer – Due to modern treatments, some patients are living longer with cancer as a chronic condition.

Survivorship involves a long-term partnership between the patient, the cancer specialist and the primary care doctor to monitor blood pressure, bone density and other health screenings, Dr. Wang says.

The health team also keeps tabs on possible long-term effects of cancer treatments, which can include neuropathy, heart disease, osteoporosis, osteopenia and chemo-brain, a potential side effect of chemotherapy that impairs the memory or limits the patient’s ability to multitask.

“It’s a partnership with the primary care doctor to make sure the patient is as healthy as possible,” Dr. Wang says, adding that for some patients the initial cancer diagnosis is a wakeup call to improve lifestyle habits that could place them at risk for cancer and other illnesses.

Indeed, Dr. Tran says, beyond medical advances, you can also make choices that can help you battle major illnesses and conditions.

“By modifying lifestyle and dietary intake, we’re also able to blunt the effect of chronic and major diseases,” he says.