Addressing the Physical and Emotional Concerns of Bone Marrow Transplant Survivors

By 2030, there is estimated to be 500,000 bone marrow transplant (BMT) survivors living in the United States, according to the Center for International Blood and Marrow Transplant Research. And with each of these survivors comes unique physical and emotional concerns, such as cardiovascular disease, bone health, endocrine function, chronic graft versus host disease (cGVHD), second cancers and anxiety and depression.

During an Oct. 29 Lunch and Learn hosted by the National Bone Marrow Transplant Link, three experts in the field discussed key ways to address the issues, including survivor follow-up, mindfulness and meditation and healthy habits.

Survivors should first educate themselves on the late effects they may experience, according to Christina Ferraro, nurse practitioner and head of the Victor Fazio, MD BMT Cancer Survivorship Program at Cleveland Clinic in Ohio. For instance, they should be knowledgeable in being screened for a second cancer, surveillance for disease recurrence and late complications, routine health maintenance, psychosocial support, rehabilitation, financial counseling and returning to work, home or school.

When it comes to comorbidities, such as cardiovascular disease, patients should be informed about their personal and family health history, cholesterol should be checked at least once a year and blood pressure should be monitored. Bone health, which can be affected by certain treatments, can be screened for with a bone density test every two years and by having vitamin D levels checked every year.

Topical and systemic steroids and other medications can be used to treat cGVHD, Ferraro noted. However, steroids come with their own distinct concerns, such as weight gain, anxiety, insomnia, muscle loss and moodiness.

Sleep issues are also a concer, For instance, if a survivor is getting poor sleep, they should consult their physician and perhaps see a specialist, explained Katie Schoeppner, manager of counseling services at Be The Match: The National Marrow Donor Program. Meditation or music can also help, as well as practicing good sleep hygiene such as turning off screens and buying cozy pajamas or sheets.

Finding Control

To help keep some of these health concerns in check, patients can make certain modifications to their lifestyle. Experts recommend the Mediterranean diet, which includes leaner meats like turkey and chicken, fish, vegetables, fruits and whole grains. It may be beneficial to speak with a dietician, experiment with different tastes and plan meals. Patients should also try to be more active by getting at least 30 minutes of aerobic exercise a day, and maintain a healthy weight and cholesterol level.

Some patients have found meditation and mindfulness to be helpful in reducing stress following cancer and BMT. Meditation has been used to clear the mind, focus on breathing and keep people in the present time. Mindfulness is the act of being fully present and aware of surroundings, explained Amanda Budai, a licensed clinical social worker at UPMC Hillman Cancer Center in Pittsburgh.

“How often do we sit and talk with someone without something else going on?” said Budai. “Enjoy things. Don’t eat lunch while watching TV or while at your desk working.”

Patients and survivors can find their community by creating new relationships, reestablishing old ones and considering peer support.

To move forward, it’s crucial to create a plan that works for you, according to Schoeppner. Grieve the loss, but then assess, make a daily plan and celebrate that success, she explained.