Watch the Cancer.Net video: Cancer Survivorship: An Overview, with Robert Miller, MD, adapted from this content.
After a cancer diagnosis, a person's priorities regarding relationships, career, or lifestyle may change. Cancer survivors, people with a history of cancer, often say they appreciate life more. They also say they have gained a greater acceptance of self. At the same time, some survivors also become anxious about their health. Some survivors become uncertain of how to cope with life after treatment, especially when regular visits to doctors stop.
Surviving cancer or “survivorship” is 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 and nurses use terms to describe the specific period a survivor is experiencing. These can include:
Acute survivorship: describes the time when a person is diagnosed and/or in treatment for cancer;
Extended survivorship: describes the time immediately after completed treatment, usually measured in months ; and
Permanent survivorship: describes the longer passage of time since completed treatment, usually measured in years.
Sometimes, people who have survived cancer consider their close friends and families “co-survivors” because of the experiences they have had in caring for the person with cancer. Others with metastatic cancer don’t feel that the “survivor” label applies to them because they continue to live with cancer every day. No matter the definition, survivorship is unique for each person.
The number of people with a history of cancer in the United States has increased dramatically, from 3 million in 1971 to more than 14 million today. About 64% 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 (60%) of cancer survivors are 65 or older.
Most cancer survivors were initially diagnosed with common cancers.
22% had breast cancer.
20% had prostate cancer.
9% had colorectal cancer.
8% had cervical, uterine, or ovarian cancers.
The increase in survival rates may be due to the following four developments:
Improved identification of cancers that can sometimes be found early through screening,
Mammography for breast cancer,
Prostate Specific Antigen (PSA) test for prostate cancer,
Pap test for cervical cancer
Colonoscopy for colorectal cancer
Improvements in treatment
More effective treatment of side effects, making it possible to give patients the planned doses of cancer drugs
Visit ASCO’s CancerProgress.Net website to learn more about the historical pace of cancer research.
Source: National Cancer Institute Office of Cancer Survivorship, http://cancercontrol.cancer.gov/ocs/statistics/statistics.html
Surviving cancer: What to expect
At the end of active treatment, many survivors often have mixed emotions. Some survivors feel relief that their treatment is over, as well as anxiety about the future. After 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. Others may have physical problems, psychological problems, sexual problems, and fertility concerns. Many survivors feel guilty about surviving, having lost friends or loved ones to the disease. Some survivors are uncertain about their future. Other survivors experience discrimination at work or find that their social network feels inadequate. Find out more about coping with such concerns. Learn more about the next steps to take in survivorship.
Fear of recurrence
Fear of recurrence, which is cancer that comes back after treatment, is common. It may lead a person to worry over common physical problems, such as a headaches, coughs, and joint stiffness. It is hard to know what is "normal," and what you should tell your doctor. Discussing the actual risk of recurrence with your doctor and the symptoms to report can often lower your anxiety. Maintaining a regular schedule of follow-up visits can also provide a sense of control. Many cancer survivors describe feeling scared and nervous about routine follow-up visits and tests. However, these feelings may ease with time.
When active treatment is over, some survivors need different types of support than they had before. Some friends may become closer, while others distance themselves. Families can become overprotective or may have exhausted their ability to be supportive. Ignored relationship problems prior to cancer diagnosis can surface. The entire family changes from the cancer experience in ways they may not be aware of. You need to recognize and work through these changes to get the support you need. Some people find that counseling helps. Open and ongoing communication helps with adapting to life and shifting relationships after cancer. Learn more about relationships and cancer.
Getting back to "normal"
Returning to a regular work schedule is a sign of getting back to a normal routine and lifestyle. Many people with cancer who took time off for treatment return to work afterwards. Many others may have worked throughout treatment. Some may not be able to return to work because of the effects of the cancer or its treatment. Most people need their job and the health insurance it provides.
Although many survivors are as productive as they were before treatment, some find they are treated differently or unfairly, compared to their status before cancer treatment. Learn more about dealing with discrimination. During and after treatment, it may be helpful to anticipate questions from coworkers. Decide how you want 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. When and how you choose to discuss a diagnosis is a personal decision. Find out more about sharing your story.