Seasons of Survivorship
Cancer Survivorship Stats
The number of cancer survivors in the US has grown from 3 million in 1971 to 11.7 million in 2007, and it is estimated that by 2020 there will be 20 million cancer survivors in the United States.
While survival rates vary significantly by cancer type, overall survival rates have been increasing as seen in the figure below:
Figure 1: Relative Overall 5 and 10 year Cancer Survival Rates*Seasons of Survivorship
To improve care both in the hospital and at home, providers have constructed a framework with which to conceptualize this diverse and growing population. Although the data above captures all patients who have completed therapy, many define a cancer survivor as anyone who has ever been given a cancer diagnosis.
Every cancer patient is a survivor from the moment of diagnosis, and this phase encompasses the time from diagnosis through active treatment. Patients often find themselves surrounded by a support system ready and willing to help while the patient’s life is placed on hold for therapy.
This is a period of watchful waiting where patients are at highest risk of recurrence, still frequently seeing their physicians for surveillance and monitoring of risk. This is traditionally the 5-year post treatment period and is often fraught with uncertainty and fear that the cancer will come back.
There is now a growing population of survivors “living with cancer” as a chronic disease. These may be patients who can only become cancer free with ongoing treatment or those whose therapy maintains their cancer at a stable state. Chronic survivors not only have the day-to-day challenges of actively having cancer, but also must learn to incorporate their disease into their day to day life. These patients, who often can continue to be managed for years with medical therapy, can’t put their life on hold and must find ways to juggle their medical needs and their lives.
Thankfully, more and more survivors are entering this final category. This is the period where the fear of recurrence or secondary cancer has lessened. These patients are either “cancer free and free of cancer” or “cancer free but not free of cancer.” For those in the former, cancer is very much in the past and just another diagnosis on their past medical history. For the latter, their cancer may be gone but latent effects of surgery or chemotherapy or even the psychological toll being a cancer patient can last for years.
Implications for Patients and Caregivers
As medicine progresses and more and more patients enter these various subcategories of survivorship, patients, and caregivers must find ways to cope in the long term. For many survivors, support both from providers and from family and friends is greatest during active treatment but support is still needed long after the active survivorship phase ends. While the needs of each survivor will vary significantly, both patients and caregivers need to be aware that the effects of cancer—both physical and psychological—can persist long after the cancer itself is gone.
*Data retrieved from: Surveillance, Epidemiology, and End Results (SEER) Program (www.seer.cancer.gov) SEER*Stat Database: Incidence - SEER 18 Regs Research Data + Hurricane Katrina Impacted Louisiana Cases, Nov 2013 Sub (1973-2010 varying), National Cancer Institute, DCCPS, Surveillance Research Program, Surveillance Systems Branch, released April 2013, based on the November 2013 submission.
Source: Miller K. Ben-Aharon I, Haines L.: Seasons of survival: redefining the paradigm for cancer survivorship for 2011. Journal of Oncology Navigation & Survivorship, Vol 2 (5). 2011. Pg. 12-15.