Cancer survivors are living longer than ever. Approximately 15.5 million cancer survivors are currently alive in the United States, according to a research report issued by the American Cancer Society—a number projected to increase to 20 million by 2026.1 Treatment advances such as immunothereapy, precision medicine, and targeted therapies have extended life expectancies in a number of cancer subtypes.
Surviving cancer presents its own set of challenges to patients, providers, and payers. Older adults (aged 70 years or older) comprise nearly one-half of cancer survivors (47%),2 and the specific needs of this population have not been fully realized as the “Silver Tsunami” continues to affect the health care delivery system.3 Depression4 and anxiety5 are common among cancer survivors, who often fear disease recurrence and struggle to cope with the physical and emotion adverse effects of their disease and treatment. Research has further linked active depression with a reduced likelihood of utilizing appropriate follow-up care.6 Many cancer survivors continue to experience long-term treatment-related adverse events7—including peripheral neuropathy,8 cardiac dysfunction,9 incontinence,10 and cognitive defects11—that affect their quality of life and limit their employment ability.12
The field of cancer survivorship has emerged to address these areas of concern. ASCO has been at the forefront of the survivorship movement, offering guidelines on the management of chronic pain,13 chemotherapy-induced peripheral neuropathy,14 and fatigue15 for adult cancer survivors. The Society also holds a yearly Cancer Survivorship Symposium, which highlights cutting-edge research in the field. The 2017 Symposium—held January 27 through January 28 in San Diego, CA—featured data on screening techniques for interventional care; pilot programs to improve overall health among cancer survivors; and financial management tools to assuage the growing cost of long-term treatment. “The Cancer Survivorship Symposium is an important step in the continued progress we are making to understand and meet the needs of the millions of cancer survivors worldwide,” said Merry-Jennifer Markham, MD, FACP, ASCO expert and associate professor of hematology and oncology at University of Florida College of Medicine (Gainesville, FL). “The Survivorship Symposium [addresses] survivorship issues that both oncologists and primary care physicians are faced with throughout the cancer care continuum.”
-----
Cancer Survivors Largely Undereducated About Costs Prior to Treatment
Greater than one-half of cancer survivors reported experiencing some degree of financial distress following treatment, according to a study conducted by the LIVESTRONG Foundation (Austin, TX).
Researchers Offer Protocol for Cardiac Monitoring in Cancer Survivors
Researchers debuted guidelines for a two-tiered cardiac monitoring system aimed at identifying cancer survivors considered at high risk for cardiotoxic events.
Genetic Counseling Implementation Plausible During Routine Follow-up Care
More than 70% of childhood cancer survivors receiving follow-up treatment expressed interest in meeting with genetic counselors to better understand cancer predisposition, according to a pilot study conducted at a comprehensive survivorship clinic.
Follow-up Guidelines Needed for Young Adult Cancer Survivors
Many young adult (YA) cancer survivors are unaware of potential long-term adverse effects of cancer therapies and of the necessity of follow-up care, according to a focus group of survivors aged between 18 and 39 years.
-----
References
1. Cancer treatment & survivorship facts & statistics, 2016-2017. American Cancer Society website. https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/cancer-treatment-and-survivorship-facts-and-figures/cancer-treatment-and-survivorship-facts-and-figures-2016-2017.pdf. Published June 2, 2016. Accessed February 15, 2017.
2. Miller KD, Siegel RL, Lin CC, et al. Cancer treatment and survivorship statistics, 2016. CA Cancer J Clin. 2016;66(4):271-289.
3. Study forecasts “silver tsunami” of cancer survivors. National Cancer Institute website. https://www.cancer.gov/news-events/cancer-currents-blog/2016/cancer-silver-tsunami. Published July 8, 2016. Accessed February 15, 2017.
4. Deimling GT, Bowman KF, Sterns S, Wagner LJ, Kahana B. Cancer-related health worries and psychological distress among older adult, long-term cancer survivors. Psycho-Oncology. 2006;15(4):306-320.
5. Mitchell AJ, Ferguson DW, Gill J, Paul J, Symonds P. Depression and anxiety in long-term cancer survivors compared with spouses and healthy controls: a systematic review and meta-analysis. Lancet Oncol. 2013;14(8):721-732.
6. Cheruvu VK, Oancea SC. Current depression as a potential barrier to health care utilization in adult cancer survivors. Cancer Epidemiol. 2016;44:132-137.
7. Curtiss CP, Haylock PJ, Hawkins R. Improving the care of cancer survivors. Anticipating, assessing for, and managing the effects of cancer and its treatment. Am J Nurs. 2006;106(3):48-52.
8. Fontes F, Pereira S, Castro-Lopes JM, Lunet N. A prospective study on the neurological complications of breast cancer and its treatment: updated analysis three years after cancer diagnosis. Breast. 2016;29:31-38.
9. Armenian SH, Lacchetti C, Barac A. Prevention and monitoring of cardiac dysfunction in survivors of adult cancers: American Society of Clinical Oncology clinical practice guideline [published online December 5, 2016]. J Clin Oncol. doi:10.1200/JCO.2016.70.5400
10. Noonan EM, Farrell TW. Primary care of the prostate cancer survivor. Am Fam Physician. 2016;93(9):764-770.
11. Von Ah D. Cognitive changes associated with cancer and cancer treatment: state of the science. Clin J Oncol Nurs. 2015;19(1):47-56.
12. Jeon SH. The long-term effects of cancer on employment and earnings [published online April 4, 2016]. Health Econ. doi:10.1002/hec.3342.
13. Paice JA, Portenoy R, Lacchetti C, et al. Management of chronic pain in adult cancer survivors: American Society of Clinical Oncology clinical practice guideline [published online July 25, 2016]. doi:10.1200/JCO.2016.68.5206
14. Hershman DL, Lacchetti C, Dworkin RH, et al. Prevention and management of chemotherapy-induced peripheral neuropathy in survivors of adult cancers: American Society of Clinical Oncology clinical practice guideline [published online April 14, 2014]. doi:10.1200/JCO.2013.54.0914
15. Bower JE, Bak K, Berger A, et al. Screening, assessment, and management of fatigue in adult survivors of cancer guideline adoptions [published online April 14, 2014]. doi:10.1200/JCO.2013.53.4495
