Watch the Cancer.Net video: Cancer Survivorship: An Overview, with Robert Miller, MD [2], adapted from this content.

A cancer diagnosis may lead to a change in a person's priorities regarding relationships, career, or lifestyle. Some people with a history of cancer - or survivors - talk about appreciating life more and gaining a greater acceptance of self, and some survivors become anxious about their health and uncertain of how to cope with life after treatment. Survivorship is a unique journey for each person.

Defining survivorship

Surviving cancer or “survivorship” can be defined in different ways. Two common definitions include:

• Having no disease after the completion of treatment,
• The process of living with, through, and beyond cancer. By this definition, cancer survivorship begins at diagnosis. It includes people who continue to have treatment to either reduce risk of recurrence or to manage chronic disease.

Sometimes, doctors use terms to describe the specific period a survivor is experiencing. These can include:

• Acute survivorship: describes the time when a person is being diagnosed and/or in treatment for cancer.
• Extended survivorship: describes the time immediately after treatment is completed
• Permanent survivorship: describes a longer-term period, often meaning that the passage of time since treatment is measured in years.

Survival statistic

The number of people with a history of cancer in the United States has increased dramatically, from 3 million in 1971 to about 13.7 million today. About 68% of today’s cancer survivors were diagnosed with cancer five or more years ago. And, approximately 15% of all cancer survivors were diagnosed 20 or more years ago. More than half (59%) of cancer survivors are 65 or older, and 5% are younger than 40.

Most cancer survivors were initially diagnosed with common cancers. For example, 22% of survivors had breast cancer, 20% had prostate cancer, 9% had colorectal cancer, and 8% had cervical, uterine, or ovarian cancer.

The increase in survival rates is largely attributed to the following four developments:

• Improved screening and early detection, such as mammography [3] for breast cancer, the prostate specific antigen (PSA) test for prostate cancer, the Pap test [4] for cervical cancer, and colonoscopy [5] for colorectal cancer
• Improvements in treatment
• More effective treatment of side effects, making it possible to give patients higher, more effective doses of cancer drugs
• The development of targeted therapies [6], which are more specific and often less toxic than standard chemotherapy

Source: National Cancer Institute Office of Cancer Survivorship, http://dccps.nci.nih.gov/ocs/prevalence/index.html [7]. Updated December 18, 2012.

Last Updated: February 6, 2013

Surviving cancer: What to expect

At the completion of active treatment, the "safety net" of regular, frequent contact with the health care team ends. Some survivors may miss this source of support, especially because anxieties may surface at this time. Learn more about after completing treatment [8]. Some survivors have difficulty adjusting to and learning to live with uncertainty. Others may have physical problems, sexual problems, fertility concerns, experience discrimination at work, or find that their social network feels inadequate. Find out more about coping [9] with such concerns, and how to make positive lifestyle changes after a cancer diagnosis [10].

Fear of recurrence

Fear of recurrence [11] (the return of cancer) is common among most cancer survivors. It may lead a person to over-interpret the significance of minor physical problems, such as a headache or joint stiffness. It is simply hard to know what is "normal," and what needs to be reported to the doctor. Discussing the actual risk of recurrence with your doctor and the symptoms to report can often reduce a person's anxiety. Maintaining your schedule of follow-up visits can also provide a sense of control. Although many cancer survivors describe feeling scared and nervous at the time of routine follow-up visits, these feelings may ease with time.

Relationships

Relationships with family and friends [12] may be tested during this transition. Some friends may become closer, while others distance themselves. Families can become overprotective, or may have exhausted their ability to be supportive. Relationship problems that may have been ignored before cancer can surface. The entire family is changed by the cancer experience, but they may not recognize these changes. Open communication helps with adapting to life and shifting relationships after cancer.

Getting back to "normal"

Returning to work [13] is a sign of regaining a normal routine and lifestyle, and many people with cancer return to work after a cancer diagnosis. Most people need their job and the health insurance it provides. Studies show little, if any, difference in the work performance of survivors. Although obvious discrimination has decreased, there can still be subtle discrimination. Learn more about dealing with discrimination [14]. When planning your return to work, it may be helpful to anticipate questions from coworkers, and decide how to answer these questions in advance. Coworkers may want to help but not know how. It may be up to you to start the conversation and set the limits. Disclosing and discussing a diagnosis is a personal decision. Find out more about sharing your story [15].

Institute of Medicine Report

In 2005, the Institute of Medicine (IOM) issued the report, From Cancer Patient to Cancer Survivor: Lost in Transition. This report is a comprehensive look at the status and future requirements of the growing number of adult cancer survivors. Read the executive summary [16], order a copy of the full report and access IOM fact sheets on survivorship [17], or watch the IOM video [18].

In 2007, the IOM issued a separate report regarding emotional and social issues that people with cancer often encounter and can greatly affect their well-being. Learn more about Caring for the Whole Patient [19].

Childhood Cancer Survivorship

Survivors of cancer that occurred in childhood or as teenagers or young adults may have common concerns and unique challenges. Cancer.Net addresses childhood cancer survivorship, including information on a 2003 IOM report on the topic. Learn more about Childhood Cancer Survivorship [20].

More Information

Survivorship: Next Steps to Take [8]

Cancer Terms to Know After Treatment [21]

Survivorship Stories [22]

Additional Resources

LIVESTRONG [23]

National Coalition for Cancer Survivorship [24]

Last Updated: July 18, 2011