My New Year's Resolutions for Better Cancer Survivorship

From the Editor's Desk
January 23, 2018
Lidia Schapira, MD, FASCO

We live in times of constant change and innovation, so it’s not unusual to expect that the New Year will bring advances to cancer care and treatment. I am hopeful that we will also see some of our bright and dedicated clinicians and researchers focus on making progress in cancer survivorship.

We now recognize cancer survivorship as a distinct part of the cancer experience. There are more than 15 million cancer survivors in the United States, and this number is expected to reach 20 million by 2026.share on twitter  This expected rise in the number of survivors can be explained by the aging of the population and the success in treating cancer. Living longer increases the odds of being diagnosed with cancer, and early detection and improved treatments have increased the odds of being a long-term survivor.

Here are my resolutions for the oncology community for advances in cancer survivorship in 2018.

1. Provide greater long-term support

I hope to see more research and progress made in finding the best ways to offer long-term support to survivors. Cancer survivors and caregivers have taught us that cancer has a lasting impact on patients and families. We’ve learned that life doesn’t just snap back as it was before the cancer diagnosis. Symptoms may remain and worsen for months and years after treatment ends. The host of emotional and financial consequences of a cancer diagnosis can linger for a long while.

2. Manage the transition in care

Transitions are difficult, and we need to make transitioning out of oncology care more seamless and supportive for survivors. Survivors often describe leaving the oncology team’s care as a challenging time. Some feel lost or anxious about the future. Many often worry about a recurrence. Pair these concerns with the physical effects of cancer, such as fatigue, lingering pain, poor sleep, and it is easy to see how complex and challenging this transition is for patients, families, and clinicians.

Returning to work can be difficult on multiple levels. Survivors may be unsure about how much information to share with coworkers. They may be anxious about their ability to resume a full-time schedule.

Many people may need to reclaim or redefine roles and responsibilities within the family unit. Adjusting to change and shifting relationships may be stressful, potentially adding more pressure at a time when survivors crave to be “normal” again.

3. Make sure everyone has a survivorship care plan

Reaching the end of cancer therapy should be a time for joy at having reached an important milestone. It is also a time when some “take stock” and ask some questions about their cancer experience. Survivors often tell me that they were too overwhelmed and anxious during their diagnosis and treatment to remember all of the details.

We must resolve to give survivors a survivorship care plan, so they can review the details of their diagnosis and treatment. It is very important to have a clear summary and plan for follow-up care and to know who will be involved in that follow-up care.

4. Empower people to face the future with confidence

Any symptom, even minor ones such as a headache or indigestion, can lead to worries about recurrence. These feelings are normal and can be intense, especially right after treatment ends. If these worries become an ongoing problem, a support group or individual therapy may be very helpful.

My hope is that we will find more ways to help patients and caregivers face the future with confidence, before the fear of recurrence starts affecting well-being. New research has shown that short, web-based interventions can reduce fear of recurrence and distress. We need to explore how to best use social media to get people the information and support they need. How can we use social media to connect survivors and help support the exchange of perspectives and support?

In 2018, I look forward to learning how the cancer community will work to address these problems. I hope to see new practices and strategies that will reduce symptoms and improve well-being and confidence among patients, survivors, and their caregivers.

Comments

The numbers of cancer survivors do not only increase due to better treatment but mainly due to diagnosis of cancers that would never have threatened the life of the patients. It is great that they do survive but taking into account "that cancer has a lasting impact on patients and families. We’ve learned that life doesn’t just snap back as it was before the cancer diagnosis. Symptoms may remain and worsen for months and years after treatment ends. The host of emotional and financial consequences of a cancer diagnosis can linger for a long while" and that all these statements are true also for patients who never would have had any adverse effects from their cancer. This is a huge toll on society and the health system which should be weighed aganst the advantages of early diagnosis. In addition this emphasizes the importance of methods to monitor distant recurrence after the end of therapy which the ASCO guidelines do not satisfy at all. This leaves the patients with anxieties for which a support group or individual therapy is not sufficient. We need to develop true approaches which early detect distant recurrence and should devote much more resources into this Research.