Cancer Survivorship: An Overview, with Robert Miller, MD

Last Updated: February 27, 2017

Dr. Robert Miller gives an introduction to survivorship and life following cancer treatment.

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Survivorship: Next Steps to Take


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Full text transcript

Cancer.Net®: Doctor-Approved Patient Information from ASCO®

Cancer Survivorship: An Overview

Robert Miller, MD, FACP, FASCO: I think there are probably multiple acceptable definitions for cancer survivorship. One popular definition is living with, through, and beyond cancer. And I think that implies that cancer survivorship really starts at the time of the diagnosis of the cancers.

Phases of Cancer Survivorship

Dr. Robert Miller: Sometimes you hear the term, the acute phase of survivorship, really referring to that initial period of time when a patient's been diagnosed, but the physician may be gathering more information. The patient may be undergoing various X-rays or blood tests to get a sense of the extent of the cancer, what types of treatments might be utilized, and what the long-term plan would be.

The next phase is more of the active treatment phase. The terminology is probably not that important, but I think it's sometimes easy to forget that when a patient is in the middle of chemotherapy, let's say, they really are part of-- this is really part of their survivorship phase of their illness. I think historically that the survivorship is thought to encompass predominantly the last phase, which is getting back to normal and sort of having the cancer diagnosis go to the  back burner or to try to incorporate it into the daily activities of life. And some people call that the extended phase or the follow-up phase.

Overcoming Concerns of Cancer Survivorship

Dr. Robert Miller: Cancer survivors have a lot of concerns, and as a clinical oncologist, we certainly see this every day in the office. Almost every cancer survivor is afraid of recurrence. They're fearful that the cancer's going to come back. But I think that equally important is just the concern about trying to get back to normal, trying to figure out what the new normal is. For example, patients often have an uncertain relationship with family and friends, and even the most supportive individuals, as they get further and further out from the initial phase of treatment. Many patients are concerned how they're going to relate to their spouse, for example, that they may have difficulty re-establishing the same type of relationship they had previously.

There are concerns about things like finances, for example, if a person had to miss a fair amount of work during the active treatment phase to go to chemotherapy treatments or radiation. They may have difficulty getting back into their regular schedule because of persistent fatigue or the need to go to lots of physician appointments. I think another concern that we see is one of sort of a subtle discrimination that some patients fear in the workplace or even social environments. I try to tell patients that many well-meaning people just don't know what to say. They don't know the right thing to say to a cancer survivor. Sometimes they're fearful themselves, even if they don't express this.

Where to Get More Information

Dr. Robert Miller: There are a rich set of resources at about survivorship. Survivorship is a very important topic for American Society of Clinical Oncology.

[Closing and Credits]

Cancer.Net®: Doctor-Approved Patient Information from ASCO®

ASCO's patient education programs are supported by Conquer Cancer Foundation of the American Society of Clinical Oncology.  

Special Thanks:

Helen F. Graham Cancer Center at Christiana Care Health System

Carolyn B. Hendricks, MD, The Cancer for Breast Health

The Adele R. Decof Comprehensive Cancer Center at The Miriam Hospital. The Miriam Hospital is a teaching hospital of The Warren Alpert Medical School of Brown University

The opinions expressed in the video do not necessarily reflect the views of ASCO or the Conquer Cancer Foundation.

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