Coping with Treatment Challenges
The term “survivorship” can sometimes evoke mixed emotions in those battling cancer. While it signifies triumph over the disease, it may not always align with the complex feelings experienced during treatment. Cancer patients often grapple with various emotions, including fear, uncertainty, and vulnerability.
These emotions can make them question the label “survivor” because it might not fully capture their ongoing struggles and uncertainties. Some may feel it oversimplifies their journey or minimizes cancer treatment’s physical and emotional toll.
In essence, the word “survivorship” may not always resonate with individuals amid their cancer battle because it might not reflect the multifaceted nature of their experience and the ongoing challenges. Acknowledging and honoring these feelings as part of the cancer journey is essential.
Understanding Cancer Survivorship
As cancer survivors, we understand the challenges and uncertainties of a cancer diagnosis. Cancer survivorship refers to the physical, emotional, and psychosocial issues that arise after cancer treatment ends. It is a unique experience that varies from person to person and can last a lifetime.
Cancer survivorship encompasses many issues, including physical side effects from treatment, emotional distress, financial challenges, and social isolation. These issues can affect a survivor’s quality of life and require ongoing support and care.
Recognizing that cancer survivorship is not just about surviving cancer is essential. It is about living a whole and healthy life after cancer treatment ends. This means addressing the long-term effects of cancer and its treatment, such as fatigue, pain, and cognitive changes.
As cancer survivors, we must advocate for ourselves and seek the resources and support needed to manage our survivorship. This includes regular follow-up care with our healthcare providers, healthy lifestyle choices, and connecting with other survivors through support groups and online communities.
Cancer survivorship is a complex process requiring ongoing care and support. As survivors, we must take an active role in managing our survivorship and advocating for our needs. By doing so, we can live whole and healthy lives beyond cancer.
Types of Cancer and Survivorship
Surviving cancer is a significant accomplishment, but it can also be challenging. The cancer survivorship experience varies depending on the type of cancer and the individual survivor.
In this section, we will explore the survivorship experiences of various types of cancer, including prostate cancer, colorectal cancer, lung cancer, head and neck cancer, and lymphoma.
Prostate Cancer Survivorship
Prostate cancer is the most common cancer among men in the United States. After treatment, prostate cancer survivors may experience side effects such as urinary incontinence and erectile dysfunction. Survivorship care for prostate cancer may include regular follow-up visits with a healthcare provider, monitoring of PSA levels, and managing side effects.
Colorectal Cancer Survivorship
Colorectal cancer is the third most common cancer in both men and women in the United States. After treatment, colorectal cancer survivors may experience side effects such as bowel incontinence and sexual dysfunction. Survivorship care for colorectal cancer may include regular follow-up visits with a healthcare provider, monitoring CEA levels, and managing side effects.
Lung Cancer Survivorship
Lung cancer is the leading cause of cancer death among men and women in the United States. After treatment, lung cancer survivors may experience side effects such as shortness of breath and fatigue. Survivorship care for lung cancer may include regular follow-up visits with a healthcare provider, lung function monitoring, and side effects management.
Head and Neck Cancer Survivorship
Head and neck cancer includes mouth, throat, and nasal cavity cancers. After treatment, head and neck cancer survivors may experience side effects such as difficulty swallowing and changes in speech. Survivorship care for head and neck cancer may include regular follow-up visits with a healthcare provider, swallowing function monitoring, and side effects management.
Lymphoma Survivorship
Lymphoma is a cancer of the lymphatic system. After treatment, lymphoma survivors may experience side effects such as lymphedema and neuropathy. Survivorship care for lymphoma may include regular follow-up visits with a healthcare provider, monitoring lymph node size, and managing side effects.
As a two-time lymphoma cancer survivor, I understand the challenges of cancer survivorship. It is crucial to have a healthcare team that is knowledgeable and supportive throughout the survivorship journey. We must prioritize regular follow-up visits, monitoring of cancer markers, and management of side effects to ensure the best possible outcome.
Survivorship Care
Survivorship care is an essential aspect of cancer care that begins when the patient completes their primary treatment and continues throughout their life. It involves addressing the physical, emotional, and social effects of cancer and its treatment. Effective survivorship care requires coordinated efforts between healthcare providers, including primary care providers, oncologists, and specialists.
Transition to Survivorship Care
Transitioning from active treatment to survivorship care can be challenging for cancer survivors. It is crucial to provide them with clear information about their follow-up care, including the potential long-term effects of their treatment and how to manage them. Survivorship care plans can help facilitate this transition and ensure survivors receive appropriate care.
Role of Primary Care Providers
Primary care providers play a critical role in survivorship care. They can monitor and manage survivors’ health, including screening for recurrence, managing long-term and late treatment effects, and promoting healthy lifestyle behaviors. Primary care providers can also coordinate care between specialists and other healthcare providers to ensure survivors receive comprehensive care.
Quality Survivorship Care
Quality survivorship care involves addressing survivors’ physical, emotional, and social needs. It should be patient-centered and tailored to individual needs and circumstances. In addition to providing survivorship care, it is crucial to incorporate strategies for promoting health and preventing disease. These measures aim to support survivors in maintaining their overall well-being and optimize their health outcomes.
Survivorship Care Guidelines
Survivorship care guidelines provide evidence-based recommendations for the care of cancer survivors. The American Cancer Society Survivorship Care Guidelines, address surveillance for recurrence, screening for second primary cancers, and assessing and managing physical and psychosocial long-term and late effects of cancer and its treatment.
These guidelines can help healthcare providers deliver high-quality, comprehensive survivorship care.
As a two-time lymphoma cancer survivor, I understand the importance of survivorship care. It can be overwhelming to navigate the transition to survivorship. Still, with the support of our healthcare providers and survivorship programs, we can receive the care we need to live healthy, fulfilling lives.
Healthcare providers must prioritize survivorship care and follow evidence-based guidelines to ensure survivors receive comprehensive, patient-centered care.
Post-Treatment Life
After completing cancer treatment, we may feel relieved and excited to move on with our lives. However, the transition to post-treatment life can be challenging. We may experience physical and emotional changes that affect our daily routine, including our ability to work and engage in physical activity.
Return to Work
Returning to work after cancer treatment can be a difficult decision. We may worry about our ability to perform our job duties or fear discrimination from employers. However, employment is essential to our lives and can provide a sense of purpose and financial stability.
To ease the transition, we can consider discussing our situation with our employer and exploring options such as a flexible work schedule, reduced workload, or job accommodations. We can also seek support from vocational rehabilitation services or career counselors who can help us identify new career paths or update our skills.
Physical Activity and Diet
Physical activity and a healthy diet are essential for our overall well-being and can help manage treatment-related side effects such as fatigue, weight gain, and muscle weakness. However, we may need to adjust our exercise routine and diet based on our current physical condition and treatment history.
We can start by consulting with our healthcare provider or a certified exercise specialist to develop a safe and effective exercise plan. We can also seek guidance from a registered dietitian who can help us create a balanced meal plan that meets our nutritional needs and preferences.
Weight Management
Weight gain or loss is a common side effect of cancer treatment and can affect physical and emotional health. We may need to make lifestyle changes to manage our weight and prevent long-term health problems like heart disease and diabetes.
We can start by monitoring our weight regularly and setting realistic weight loss or gain goals. For additional assistance, consulting with a healthcare provider or a registered dietitian is beneficial. They can aid in creating a tailor-made weight management plan that encompasses nutritious eating, physical activity, and effective behavioral strategies.
The transition to post-treatment life can be challenging, but with the proper support and strategies, we can manage our physical and emotional health and achieve our goals.
Late Effects of Cancer
Cancer survivors often face long-term and late effects of cancer treatment. These effects can vary depending on the type of cancer, the stage of cancer, and the treatment received. Understanding and managing these effects is crucial to maintaining our health and well-being.
Understanding Late Effects
Late effects are the physical, emotional, and cognitive changes that may occur months or even years after cancer treatment. These effects can include fatigue, pain, neuropathy, sexual dysfunction, and cognitive impairment. It is important to note that not all survivors will experience late effects, and the severity of these effects can vary.
It is essential to discuss any potential late effects with your healthcare team. They can provide information on what to expect and how to manage these effects. Maintaining regular follow-up appointments with your healthcare team to monitor any changes and address any concerns is also essential.
Managing Late Effects
Managing late effects can involve a combination of medical interventions, lifestyle changes, and support from loved ones. Your healthcare team may prescribe medications to manage pain, fatigue, or other symptoms. They may also recommend physical therapy or other rehabilitation services.
Lifestyle changes such as exercise, a healthy diet, and stress management techniques can also help manage late effects. Support from loved ones, support groups, or mental health professionals can also be beneficial in managing the emotional and cognitive effects of cancer treatment.
The late effects of cancer treatment can significantly impact our overall health and well-being. Understanding and managing these effects with the help of our healthcare team, loved ones, and support systems is essential. By taking an active role in our care, we can improve our quality of life and continue to thrive as cancer survivors.
Screening and Surveillance
As cancer survivors, we are acutely aware of the importance of screening and surveillance for cancer recurrence. Regular screenings and surveillance are essential to detecting any potential cancer recurrence early and taking prompt action to manage it.
Screening for Cancer Recurrence
Screening for cancer recurrence involves regular check-ups, medical tests, and imaging studies to detect any signs of cancer returning. The frequency and type of screening tests depend on various factors, including the type of cancer, stage of cancer, and treatment received.
For example, if you have breast cancer, you may require regular mammograms, breast exams, and blood tests. You may need regular colonoscopies and blood tests if you have colon cancer. Standard screening tests may include imaging studies like PET, CT, and MRIs.
Cancer Surveillance
Cancer surveillance involves ongoing monitoring of cancer survivors to detect any potential long-term and late effects of cancer and its treatment. This may include physical and psychosocial effects, such as fatigue, anxiety, depression, and pain.
Regular cancer surveillance may help detect potential long-term and late effects early and take prompt action to manage them. This may include lifestyle changes, medication, counseling, and other supportive care.
Working closely with your healthcare team to determine the appropriate screening and surveillance schedule for your needs is essential. Regular screening and surveillance can help us stay on top of our health and detect potential cancer recurrence or long-term effects early.
Resources and Tools
As cancer survivors, we understand the importance of access to reliable resources and evidence-based tools to help us navigate the survivorship journey. This section will explore some of the resources and tools that can help us better understand our survivorship care.
Resources for Cancer Survivors
The American Cancer Society’s National Cancer Survivorship Resource Center provides many resources for cancer survivors. Their Life After Treatment Guide is a quick and easy-to-read information guide that can help cancer survivors and their caregivers understand various aspects of the survivorship journey.
The guide also includes trusted resources for survivorship information and encourages communication with healthcare professionals. Additionally, the National Comprehensive Cancer Network (NCCN) provides guidelines for patients on survivorship for cancer-related late and long-term effects.
The Cancer Support Community is another excellent resource for cancer survivors. They offer free support services, including counseling, support groups, and educational workshops. Their website also provides a wealth of information on cancer survivorship, including tips for managing side effects, coping with stress, and navigating the healthcare system.
Evidence-Based Tools
The American Cancer Society’s National Cancer Survivorship Resource Center also provides evidence-based tools for healthcare professionals to help implement cancer survivorship care guidelines. The toolkit includes resources to help primary care providers train and activate cancer survivors to participate fully in their survivorship care. The toolkit also consists of a Cancer Survivorship Care Guideline Checklist for Providers, which outlines standards of survivorship care.
The NCCN also provides evidence-based survivorship care guidelines for healthcare professionals. The guidelines provide screening, evaluation, and treatment recommendations for the consequences of adult-onset cancer. Additionally, the NCCN provides guidelines for prevention, which is a crucial part of survivorship care.
Accessing reliable resources and evidence-based tools is essential for cancer survivors. Utilizing these resources and tools can better understand our survivorship care and improve our health, wellness, and quality of life.
Professional Guidelines and Recommendations
As survivors, we rely on professional guidelines and recommendations to address our complex and varied needs. Here are some essential guidelines and guidance from the American Society of Clinical Oncology (ASCO) and the National Comprehensive Cancer Network (NCCN).
ASCO Guidelines
The ASCO guidelines for survivorship care provide recommendations for healthcare professionals who work with cancer survivors. They cover a wide range of topics, including surveillance for recurrence, screening for second primary cancers, assessment and management of physical and psychosocial long-term and late effects of cancer and its treatment, health promotion, and care coordination and practice implications.
One of the key recommendations from the ASCO guidelines is the importance of survivorship care plans. These plans should include a summary of the survivor’s cancer treatment, a schedule for follow-up care, and information on potential late and long-term treatment effects.
NCCN Guidelines
The NCCN guidelines for survivorship provide screening, evaluation, and treatment recommendations for the consequences of adult-onset cancer. These guidelines cover a wide range of topics, including surveillance for recurrence, screening for second primary cancers, assessment and management of physical and psychosocial long-term and late effects of cancer and its treatment, and health promotion.
One of the key recommendations from the NCCN guidelines is the importance of survivorship care plans. These plans should include a summary of the survivor’s cancer treatment, a schedule for follow-up care, and information on potential late and long-term treatment effects.
In addition to these guidelines, the NCCN also provides specific survivorship care guidelines for certain types of cancer, such as breast, colorectal, and prostate cancer. These guidelines provide detailed information on these cancers’ particular long-term and late effects, their treatments, and recommendations for screening and management.
Overall, the ASCO and NCCN guidelines provide essential recommendations for survivorship care that can help ensure that cancer survivors receive the best possible care and support. As cancer survivors, we should work closely with our healthcare providers to ensure that we follow these guidelines and receive the care we need.
Psychological Aspects of Survivorship
Surviving cancer can be a challenging experience that can significantly impact an individual’s mental and emotional health. In this section, we will discuss some of the psychological aspects of survivorship, including coping with cancer survivorship and fear of recurrence.
Coping with Cancer Survivorship
Coping with cancer survivorship can be a complex and ongoing process. After treatment, individuals may experience various emotions, including anxiety, depression, and fear. Coping strategies can help individuals manage these emotions and improve their quality of life.
One effective coping strategy is seeking support from others. This can include seeking help from family, friends, or a support group. Support groups can provide a safe space for individuals to share their experiences and receive emotional support from others who have gone through similar experiences.
Another effective coping strategy is engaging in self-care activities. This can include exercise, meditation, or other stress-reducing activities. Self-care activities can help individuals manage their emotions and improve their overall well-being.
Fear of Recurrence
Fear of recurrence is a common concern among cancer survivors. This fear can be overwhelming and impact an individual’s mental and emotional health. Individuals must recognize and address their fears to improve their quality of life.
One effective way to address the fear of recurrence is by staying informed about one’s health. This can include attending follow-up appointments and discussing concerns with a healthcare provider. Staying informed can help individuals feel more in control of their health and reduce anxiety.
Another effective way to address the fear of recurrence is by engaging in mindfulness practices. Mindfulness practices can help individuals focus on the present moment and reduce their anxiety about the future. This can include meditation, deep breathing exercises, or other mindfulness techniques.
However, there are effective coping strategies that can help individuals manage their emotions and improve their quality of life. Seeking support from others and engaging in self-care activities can help individuals manage their feelings while staying informed about their health, and engaging in mindfulness practices can help address the fear of recurrence.
International Perspectives on Survivorship
As cancer survivorship becomes an increasingly important issue, countries worldwide are reevaluating their approaches to survivorship care. Here are some international perspectives on survivorship from Canada, the United Kingdom, and Australia.
Survivorship in Canada
In Canada, survivorship care is becoming more integrated into the healthcare system. The Canadian Partnership Against Cancer has developed a framework for survivorship care that emphasizes the importance of addressing survivors’ physical, emotional, and practical needs. The framework also emphasizes the importance of providing survivorship care tailored to each survivor’s individual needs.
Survivorship in the United Kingdom
In the United Kingdom, survivorship care is a priority for the National Health Service (NHS). The NHS has developed a comprehensive strategy for cancer survivorship care that focuses on improving survivors’ quality of life. The strategy emphasizes the importance of addressing the physical and emotional needs of survivors, as well as the importance of providing support for survivors’ families and caregivers.
Survivorship in Australia
In Australia, survivorship care is becoming more integrated into the healthcare system. The Australian government has developed a national framework for survivorship care that emphasizes the importance of providing survivorship care tailored to each survivor’s individual needs. The framework also emphasizes the importance of addressing survivors’ physical, emotional, and practical needs.
As a two-time lymphoma cancer survivor, I understand firsthand the importance of survivorship care. We must continue to improve survivorship care worldwide so survivors can lead healthy and fulfilling lives. We need to ensure that survivorship care is tailored to the individual needs of each survivor and that survivors have access to the support they need to thrive.
Research and Literature Reviews
As we reevaluate the “cancer survivorship” label, it is important to consider the existing research and literature on this topic. In this section, we will review the findings of systematic reviews and literature reviews exploring survivorship and patient-reported outcomes.
Systematic Reviews on Survivorship
Several systematic reviews have been conducted to evaluate survivorship care models and their impact on patient outcomes. One such study published in the Journal of Cancer Survivorship found that survivorship care models that addressed patient and caregiver experience, communication and decision-making, care coordination, quality of life, healthcare utilization, costs, and mortality effectively improved outcomes for cancer survivors [1].
Another systematic review published in the Journal of Clinical Oncology found that survivorship care plans appeared feasible and may improve healthcare professionals’ knowledge of late effects and survivorship care. Still, there was no evidence that they affected cancer survivors’ patient-reported outcomes [2].
Patient-Reported Outcomes
Patient-reported outcomes (PROs) are increasingly recognized as essential to cancer survivorship care. PROs can provide valuable information on cancer survivors’ physical, emotional, and social well-being and help guide survivorship care planning. A literature review published in the Journal of Cancer Survivorship found that PROs were critical in identifying unmet survivorship needs and improving survivorship care [3].
Another literature review published in the Journal of Clinical Oncology found that PROs helped identify patients at risk for poor outcomes and guide survivorship care planning [4].
As cancer survivors, we understand the importance of survivorship care and the need for continued research to improve outcomes for survivors. By reviewing the existing literature on survivorship care models and patient-reported effects, we can better understand the current state of survivorship care and work towards improving it for all cancer survivors.
References:
- Effectiveness and implementation of models of cancer survivorship care: A systematic review
- Survivorship Care Plans in Cancer: A Meta-Analysis and Systematic Review of Care Plan Outcomes
- Patient-reported outcomes in cancer survivors: a population-wide cross-sectional study
- Patient-reported outcomes in cancer survivors: a review and roadmap for future research
Frequently Asked Questions
What is the NCI definition of a cancer survivor?
According to the National Cancer Institute (NCI), a cancer survivor is anyone who has been diagnosed with cancer from the time of diagnosis throughout the rest of their life. This includes people currently undergoing treatment, those who have completed treatment, and those who have never had a recurrence.
Why is being 5-year cancer-free a critical milestone?
Being 5-year cancer-free is often considered a significant milestone because it is a time when the risk of recurrence decreases significantly. However, it is essential to note that this milestone does not mean that the cancer is cured or that the risk of recurrence is zero. The risk of recurrence can vary depending on the type and stage of cancer.
What research is being done on cancer survivorship?
There is ongoing research on cancer survivorship that focuses on improving the quality of life for cancer survivors. This research includes studies on the physical, emotional, and social effects of cancer and its treatment and interventions to address these effects. Additionally, research is being done to understand the long-term effects of cancer treatment better and to develop new, less toxic therapies.
How is survivorship measured in cancer patients?
Survivorship in cancer patients is measured in various ways, including overall survival, disease-free survival, and quality of life. Overall survival refers to the length of time from diagnosis until death from any cause. Disease-free survival refers to the time from diagnosis until the cancer recurs or until a new cancer is diagnosed. Quality of life measures include physical, emotional, and social well-being, functional status, and symptom burden.
As a two-time lymphoma cancer survivor, we know firsthand the challenges of cancer survivorship. It can be a difficult journey, but it is essential to remember that you are not alone. Ongoing research and support are available to help improve cancer survivors’ quality of life. It is crucial to stay informed and advocate for your health.
