We asked our Current Oncology Section Editors how they would define the term “life after cancer” and how that theme presents itself in their chosen fields. Below is a response from Dr. Martin Chasen, Associate Professor, Division of Palliative Care, University of Ottawa:
For the 5,000,000-plus people who are alive after having been diagnosed with cancer, the largest gap occurs in the period after the acute treatment of the cancer and the time of recurrence of the disease. By extension, this includes those patients whose disease remains in remission and cured.
The many issues and needs that these cancer survivors face, including:
- The need to have their cancer survivorship issues legitimized and acknowledged by the people that they interact with. It is noted that many people are unaware of the range of physical, psychosocial, financial and existential issues as well as the fears that the cancer survivor experiences.
- The need to have some regaining of the sense of control. The earlier phase of the cancer trajectory is characterized by loss. Patients lose their independence to a large degree. In addition, Loss of hair or a breast, loss of job and or income, loss of relationships, both intimate and friendships. Patients need to rehabilitate and the most basic of needs appears to be regaining sense of control.
- Adequate communication with the health care provider. Traditionally the provider’s role has focused on medical treatment whilst patients see themselves as being passive rather than active participants in their own health care. With the availability of modern technology information systems, patients now feel more empowered to help make decisions, and want to exercise that right. Cancer survivors feel they are not provided with enough relevant information about their prognosis, their choices of treatment and the goals of treatment. In addition they want to be fully informed as to what resources exist for them both within the cancer system and outside in the community. There are some specific issues that cause discomfort both on the part of survivors and providers, for example, sexual dysfunction.