Online Health Chat with Joylene Sutton-Aransevia, ARNP

August 30, 2016


While fighting cancer, many patients have extensive care and support along with their treatment. Thus, it is common to have new questions and concerns about how to progress once the cancer goes into remission and that care becomes less prevalent. Some common concerns that cancer survivors have included:

  • Risk of development of new cancers
  • Risk of cancer recurrence
  • Impaired fertility
  • Neuropathy
  • Lymphedema
  • Lung function
  • Heart damage
  • Weight loss or gain
  • Mood imbalances
  • Fatigue
  • Digestive problems
  • Cognitive changes
  • Chronic pain

It is important to remember while experiencing doubt and concern after cancer that there are many resources available, both at Cleveland Clinic Florida and beyond, for help including social workers, cancer support groups, mental health professionals, hospital counselors, and family and friends. Following the completion of cancer treatments, there are preventative screenings, genetic testing, and follow-up visits which can be scheduled to ensure continued recovery.

The Maroone Cancer Center located in the Egil and Pauline Braathen Center provides world-class care and cancer services. The center is at the forefront of new and emerging cancer research and has services to benefit patients in remission. Services include a patient and education center in addition to support care services that aim to make the lives of those affected by cancer less stressful, focusing on relieving pain and meeting emotional, spiritual, and practical needs.

About the Speaker

Joylene Sutton-Aransevia, ARNP, has a career in nursing that spans over 20 years, which led to her obtaining a nurse practitioner degree in 2011. She began her career in Canada and relocated to Miami where she’s spent the past 16 years working with oncology patients. Currently, she is using her extensive experience to work with patients at Cleveland Clinic Florida’s Cancer Survivorship Program. In her current role, Joylene is helping patients make sense of where they have been and what to expect after completion of their cancer treatments.

Let’s Chat About Survivorship: Life After Cancer

Welcome to our Online Health Chat “Survivorship: Life After Cancer" with Joylene Sutton-Aransevia, ARNP. We are thrilled to have her here today for this chat. Let’s begin with the questions.

Cancer Recurrence

roland: A person in my family had bladder cancer removed last year. What is the chance that it returns?

Joylene_Sutton-Aransevia,_ARNP: Thank you for joining us today. Regarding the person with bladder cancer which was removed last year: this will depend on the actual staging of the disease, keeping in mind that with all diagnosis of cancer the patient must be monitored consistently by their medical oncologist and surgical oncologist in order to detect any recurrence. Additionally, the patient must report to his medical oncologist/PCP and or surgical oncologist any changes and or signs and symptoms of recurrence.

MRQUARTERMAIN: I was diagnosed with lung cancer in 2010. I had surgery, no chemo or anything. I haven't had any problems since. What are the chances of it returning?

Joylene_Sutton-Aransevia,_ARNP: It depends on the staging. It sounds like you had a very early stage cancer. There is no real set time in which cancer may or may not recur. However, as with all diagnosis of cancer, it is important to continue to follow-up with your medical and surgical oncologist and to report any changes in your condition or returning/new symptoms for patients with early stage cancers. You should follow-up with their medical oncologist at least every 3-6 months for the first five years. He/she would continue to do assessments and monitoring lab work and images such as CT scans, etc. This can detect any early recurrences.

Side Effects after Cancer Treatment

Michael_Thompson10: My wife is a breast cancer survivor and overall doing well. I do notice that she's fatigued a lot. We have younger children who are active but I worry that it might be related to her cancer treatments. Is fatigue a long-term effect of chemotherapy?

Joylene_Sutton-Aransevia,_ARNP: Yes, fatigue is definitely a long-term side effect of cancer treatment including chemotherapy and radiation therapy. Some of the best treatments for fatigue (and this is evidence based) is to keep active; starting off with low impact exercises, and keeping your nutrition well-balanced. If fatigue continues, please have your wife be examined by her medical oncologist.

Magster: Are feelings of depression normal following cancer treatment? If so, is this permanent? How long should I expect to feel this way? Before the cancer, I was generally an upbeat person.

Joylene_Sutton-Aransevia,_ARNP: Yes, for many people feelings of depression occurs after cancer diagnosis and treatment. In my experience, depression does not tend to last long, however, in some patients it may be very well prolonged. This is when we encourage patients to seek the help of a psychotherapist/psychiatrist who can help them to cope with this. There is really no definitive time for this but again, as stated above, some patients may be depressed longer than others and will need additional help and coping.

gene58: How do you deal with chemo-induced peripheral neuropathy?

Joylene_Sutton-Aransevia,_ARNP: Peripheral neuropathy (numbness and tingling in the fingers and toes) are common side effects of certain chemotherapies. It depends on the severity, and can range from mild to severe. However, with mild cases, some patients with moderate to severe cases may need treatment to help alleviate symptoms and can be prescribed by your medical oncologist. Moderate to severe neuropathy can be caused by many problems with activity of daily living. These patients are cautioned about walking, as there is a potential for falling and driving and this can be dangerous. Please speak to your medical oncologist if peripheral neuropathy is interfering with her activity of daily living.

Artist697: My 70-year-old father was treated for lung cancer and I've noticed he seems confused at times and has problems understanding me. Is this related to his cancer treatments or due to his age? Not sure if I should take him to someone for an evaluation of these symptoms.

Joylene_Sutton-Aransevia,_ARNP: There could be a variety of reason why your father may be confused at times. Taken into fact his previous diagnosis with lung cancer, I would have him get checked out by his oncologist to rule potential recurrence. Lung cancer can recur and metastasize to the brain. Also, there may be other causes of your father's confusion including age-related issues. Please take him to be examined as soon as possible by his primary care doctor or medical oncologist.

LaliCali: My mom is a breast cancer survivor of two years now. I recently read an article about breast cancer and heart disease. Is her risk for heart disease higher after her radiation treatments? Should she be seeing a cardiologist?

Joylene_Sutton-Aransevia,_ARNP: Congratulations to your mom for reaching her two-year anniversary without any issues! Cardiac problems post treatment is a risk for some patients who have undergone certain cancer treatment and radiation treatment. Chemotherapy such as doxorubicin, Herceptin can cause cardiac toxicity, hence why patients receiving these drugs are monitored throughout their treatment by the oncologist as well as a cardiologist. However, today there are advances in technology to make the heart and surrounding breast tissue much less likely to be exposed to radiation. The target areas are extremely precise and aims just the right amount of radiation only at tissue that needs to be treated. Your mom should be educated on signs of heart disease and report these to her PCP/oncologist. She should continue to get annual checkups by PCP which will include monitoring of the heart.

Lifestyle Changes after Cancer

DMar: What is the role of meditation and surviving cancer?

Joylene_Sutton-Aransevia,_ARNP: I'm not sure that there is a role with regards to meditation and surviving cancer, I'm not familiar with any research in regards to this.

susan: How best to deal with the stress from worrying about recurrence?

Joylene_Sutton-Aransevia,_ARNP: Many patients deal with stress and worry differently, keeping all follow-up appointments with your oncologists, joining a support group, and keeping active with exercise and nutrition may help contribute to decreasing stress.

tony: What is the latest immune booster therapy to fight cancer?

Joylene_Sutton-Aransevia,_ARNP: I am not sure if this question is in regards to medications or nutrition. However, I am not aware of any medications per se to boost the immune system to fight cancer. Although it is known that proper nutrition and taking care of your body including maintaining an active lifestyle promotes health. If you are speaking specifically with regards to medications to help boost the immune system to fight cancer please consult your medical oncologist or primary care provider.


PeaceofKate: I completed chemo on 8/18. How long does it take for chemo to completely leave my system? (Carbo/Taxol)

Joylene_Sutton-Aransevia,_ARNP: Did you complete chemotherapy 8/18/2016 or 8/18/2015? If it was 8/18/2015, then it should've left your system already. If it was 8/18/2016, it will take a couple of weeks, maybe even a couple of months to leave the system.

Cancer Symptoms and Screenings

2004 Silverado: My family has a history of bone cancer what are some of the symptoms of bone cancer?

Joylene_Sutton-Aransevia,_ARNP: Some bone cancer symptoms may include pain, swelling, fractures, fatigue, and weight loss. However, symptoms may vary in patients. Please see your doctor if you have concerns about symptoms related to bone or any other cancer.

Mfitz249: Prostate cancer is something that runs in my family. Should I get checked for this at a younger age because of the history in my family?

Joylene_Sutton-Aransevia,_ARNP: Yes, definitely. According to research, The American Cancer Society recommends men at average risk have a discussion with their PCP starting at age 50. Those with higher than average risk (including those who have first and second degree relatives diagnosed with prostate cancer) should have the discussion starting at age 40 or 45. Also, black men who were diagnosed with prostate cancer at a young age (less than 65) are considered high risk. Men with more than one of these close relatives diagnosed before age 65 are at even higher risk. (

JumpingGillyBean: What is a survivorship care plan? How is it different from my cancer treatment plan?

Joylene_Sutton-Aransevia,_ARNP: It is now required that patients who are diagnosed with early stage, curable cancer be provided with what's known as a survivorship care. The survivorship care plan is really a condensed summary of everything you have undergone since the time of your diagnosis, and includes the names of your medical care team, your cancer diagnosis information, the summary of your treatments (including surgical & pathology reports/chemotherapy), name of the drugs, cycles and dates, and radiation therapy (dosage and dates).

It will also include family cancer risk assessment, genetics screenings, and follow-up care recommendations as well as other recommendations such as health maintenance screenings and social service contacts. This is just to condense summary that you keep for your personal records. You may share this information with other providers if you move out of town, state or country. Oftentimes patients do keep a record of their treatments as they go along, but most of the times it does not include many of their diagnostic and follow-up information. The survivorship care plan is a more accurate way for patients to keep track of what has happened during and after their diagnosis and treatment.

For Appointments

To make an appointment with Joylene Sutton-Aransevia, ARNP, Nurse Practitioner or any of the other specialists in the Maroone Cancer Center at Cleveland Clinic Florida, please call 877.463.2010. You can also visit us online at

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