Cancer survivorship: Creating a national agenda

Margaret Fitch, Svetlana Ristovski-Slijepcevic, Kathy Scalzo, Fay Bennie, Irene Nicoll, Richard Doll


The cadre of individuals who are living after a diagnosis of cancer is growing steadily. In developed countries, as many as 78% of pediatric patients are alive five years following diagnosis, as are 60% of adult patients (Curtiss & Haylock, 2006). At present in Canada, about one million individuals are living as cancer survivors (Canadian Cancer Society, 2008). With the anticipated increase in the incidence of cancer around the world and the success of treatment approaches, it is anticipated this cadre will continue to grow.

Unfortunately, cancer survivorship does not come without cost. It is becoming increasingly evident there are late and long-term effects cancer survivors experience, both physical and psychosocial, that can compromise quality of life and increase the burden of suffering. Compared to matched population controls, cancer survivors have significantly lower outcomes on many burden of illness measures and experience difficulties accessing appropriate health care for a broad range of chronic medical conditions (Yabroff, Lawrence, Clauser, Davis, & Brown, 2004; Earle & Neville, 2004). A history of cancer may shift attention from important health problems unrelated to cancer and the roles of primary care providers and specialists in cancer care of survivors are not yet clear.

As well, quality of life issues are different for survivors than for individuals at the point of diagnosis and treatment. Cancer survivors face a range of physical and psychosocial challenges. Up to 75% of survivors have health deficits related to their treatments (Aziz & Rowland, 2003), more than 50% live with chronic pain (Lance Armstrong Foundation, 2004), 70% have experienced depression (Lance Armstrong Foundation, 2004), and between 18% and 43% have reported emotional distress (Vachon, 2006). Regardless of tumour type, there are commonly reported challenges: living with fear and uncertainty; changes in family roles; alterations in self image and self esteem; changes in comfort, physiological functioning and mobility; alterations in cognitive functioning; changes in employment and recreation; altered fertility and sexuality (Aziz & Rowland, 2003; Denmark-Wahnefried, Aziz, Rowland, & Pinto, 2005; Ganz, 2001; Lance Armstrong Foundation, 2005). Clearly, cancer survivors are a vulnerable population. New approaches are needed to overcome the barriers cancer survivors experience and ensure they receive appropriate care.

Full Text:



Aziz, N.M., & Rowland, J.H. (2003). Trends and advances in cancer

survivorship research: Challenges and opportunity. Radiation

Oncology, 13(3), 248–266.

Canadian Cancer Society (2008). Canadian Cancer Statistics 2008.

Toronto, ON: Author.

C-Change. Website:

Coalition for Cancer Survivorship. Website:

Curtiss, C.P., & Haylock, P.J. (2006). State of the science on nursing

approaches to managing the late and long term sequelae of cancer

and cancer treatment. American Journal of Nursing 106(Suppl. 3).

Denmark-Wahnefried, W., Aziz, N.M., Rowland, J.H., & Pinto, B.M.

(2005). Riding the crest of the teachable moment: Promoting long

term health after the diagnosis of cancer. Journal of Clinical

Oncology, 23(24), 5814–5830.

Earle, C.C., & Neville, B.A. (2004). Under-use of necessary care

among cancer survivors. Cancer, 101(8), 1712–1719.

Ganz, P. (ed.) (2007). Cancer survivorship: Today and tomorrow.

Los Angeles: Springer.

Ganz, P.A. (2001). Late effects of cancer and its treatment. Seminars

in Oncology Nursing, 17(4), 241–248.

Haylock, P.J., Mitchell, S.A., Cox, T., Temple, S.V., & Curtiss, C.P.

(2007). The cancer survivor’s prescription for living. American

Journal of Nursing, 107(4), 58–70.

Institute of Medicine. (2003). Childhood cancer survivorship:

Improving care and quality of life. Washington, DC: National

Academics Press.

Institute of Medicine. (2004). Meeting the psychosocial needs of

women with breast cancer. Washington, DC: National

Academics Press.

Institute of Medicine and National Research Council. (2005). From

cancer patient to cancer survivor: Lost in transition.

Washington, DC: National Academics Press.

Lance Armstrong Foundation. (2004). A national action plan for

cancer survivorship: Advancing public health strategies.

Austin, TX: Author.

Lance Armstrong Foundation. (2005). Livestrong—Inspirational

stories from cancer survivors. New York: Broadway Books.

Vachon, M. (2006). Psychosocial distress and coping after cancer

treatment: How clinicians can assess distress and which

interventions are appropriate—What we know and what we don’t.

American Journal of Nursing, 106(Suppl. 3), 26–31.

Yabroff, K.R., Lawrence, W.F., Clauser, S., Davis, W.W., & Brown,

M.L. (2004). Burden of illness in cancer survivors: Findings from

a population-based national sample. Journal of the National

Cancer Institute, 96(17), 1322–1330.


  • There are currently no refbacks.