5.1 Survivorship

5.1 Survivorship

In the past two decades, the number of people surviving cancer has increased. International research shows there is an important need to focus on helping cancer survivors cope with life beyond their acute treatment. Cancer survivors experience particular issues, often different from patients having active treatment for cancer.

Many cancer survivors experience persisting side effects at the end of treatment. Emotional and psychological issues include distress, anxiety, depression, cognitive changes and fear of cancer recurrence. Late effects may occur months or years later and are dependent on the type of cancer treatment. Survivors may experience altered relationships and may encounter practical issues, including difficulties with return to work or study, and financial hardship.

Survivors generally need to see a doctor for regular follow-up, often for five or more years after cancer treatment finishes. The Institute of Medicine, in its report From cancer patient to cancer survivor: Lost in transition, describes four essential components of survivorship care (Hewitt et al. 2006):

  • the prevention of recurrent and new cancers, as well as late effects
  • surveillance for cancer spread, recurrence or second cancers, and screening and assessment for medical and psychosocial late effects
  • interventions to deal with the consequences of cancer and cancer treatments (including manageing symptoms, distress and practical issues)
  • coordination of care between all providers to ensure the patient’s needs are met.

All patients should be educated in managing their own health needs (NCSI 2015).