What are survivorship issues for cancer patients?
Cancer survival: The survival rate for various types of cancer is the number of people who are alive for a given period of time after diagnosis (usually defined as five years). As of 2012, more than 13 million people in the United States had survived cancer, according to the Centers for Disease Control. The overall death rate from cancer began to decline in 1992 and continues to decline. Reasons for the decline include the availability of more effective treatments and more people being diagnosed at earlier, treatable stages of cancer. Also, more people are reducing their cancer risk by stopping smoking, using sun protection, and undergoing screening tests. The number of people being diagnosed with some cancers (lung cancer, bladder cancer, and prostate cancer), however, is increasing.
Issues facing cancer survivors: With increasing survival rates, those involved in cancer care are realizing the importance of addressing the unique needs of cancer survivors. For many patients, enduring and surviving cancer and its treatment become the sole focus of life. Once treatment is over, patients often are faced with worries about the future and decisions about how to transition to life as a survivor. Survivors may face financial issues, difficulties obtaining or returning to employment, or discrimination in obtaining health and life insurance or in finding employment. The experience of surviving cancer also may create emotional reactions, such as depression, guilt, or anxiety, that can evolve into significant emotional difficulties without appropriate help.
Resuming daily life: Cancer affects very basic aspects of patients’ lives, such as their daily routines. Those undergoing treatment are faced with a daily, often painful battle simply to survive the illness. Their entire lives and those of their families are consumed by treatments, doctor visits, and hospitalizations. Suddenly, they no longer lead a “normal” life, and daily activities such as going to work or school, buying groceries, or simply visiting with friends become things of the past. Life no longer seems to stretch out in a straight line before them; it no longer is as predictable as it once was.
After treatment, this time line changes, often just as suddenly. Patients may be left wondering what to do. Their daily lives may begin to resume their precancer patterns. Survivors may expect to resume life exactly as it was before cancer but may be impeded by fatigue or other physical changes. It also is possible that survivors will expect the world (jobs, school, and relationships) to be the same as it was before cancer, and they may be disappointed to learn that some things have changed while they were absorbed in cancer treatment.
This change in a person’s perception of time can create feelings of anxiety, frustration, anger, sadness, and fear. Feelings of vulnerability, uncertainty, and fear about the future may cause the survivor to feel lost, abandoned by others, and depressed.
Physical changes: After cancer treatment, some patients must face permanent physical changes, such as loss of a limb or a breast. Others may gain significant weight because of medications. Some people must cope with damage to other parts of the body as a result of their treatment. Radiation treatment, for example, not only destroys cancer cells but also can damage organs such as the thyroid gland or the liver. Certain types of chemotherapy may cause toxic effects, such as eye damage or bone degeneration. Women may experience early menopause or infertility resulting from treatment. Survivors simply may look fatigued, with sallow skin and dark circles under the eyes. Some changes, such as hair and nail loss, may be temporary. Experiencing such physical changes may affect survivors psychologically and emotionally. Seeing their changed appearance in the mirror may affect the self-image, self-confidence, and self-identity of survivors.
Disruptions in relationships with others: After surviving cancer, people may expect more from their relationships with spouses or children. They may approach relationships with more intensity if they feel that their lives may be shortened. Likewise, fears that they may not survive for long can cause the survivor to break off relationships with others, to push others away through anger or other behaviors, and to withdraw from social activities. To address these issues, some treatment centers offer coordinated recovery programs for survivors that include continued medical care and help with exercise, nutrition, counseling, and advocacy services.
Cassileth, Barrie. Survivorship: Living Well during and after Cancer. Ann Arbor: Spry, 2014. Print.
Feuerstein, Michael, and Patricia Findley. The Cancer Survivor’s Guide: The Essential Handbook to Life after Cancer. New York: Marlowe, 2006. Print.
Foxhall, Lewis E., and Maria Alma Rodriguez, eds. Advances in Cancer Survivorship Management. New York: Springer, 2015. Print.
Hunter, Brenda. Staying Alive: Life-Changing Strategies for Surviving Cancer. Colorado Springs: WaterBrook, 2004. Print.
Levine, Margie. Surviving Cancer: One Woman’s Story and Her Inspiring Program for Anyone Facing a Cancer Diagnosis. New York: Broadway, 2001. Print.
Miller, Kenneth, ed. Excellent Care for Cancer Survivors: A Guide to Fully Meet Their Needs in Medical Offices and in the Community. Santa Barbara: Praeger, 2012. Print.
Nessim, Susan, and Judith Ellis. Can Survive: Reclaiming Your Life after Cancer. Boston: Houghton, 2000. Print.