Journal of clinical oncology : official journal of the American Society of Clinical Oncology
-
Regardless of how one defines survivorship, more than 10 million individuals in the United States have been treated for a malignant disease; about 250,000 were younger than 21 years of age at diagnosis. Thirty years ago, pediatric oncologists recognized that children with cancer might be cured by adding chemotherapy to surgery and radiation. Studies were then begun of complications that could reduce survival or the quality of survival, and that might be associated with previous therapy. ⋯ Clinicians need more data regarding the effects of aging to guide them in managing former patients. Caregivers and pediatric cancer survivors who are now adults seek the optimal venue in which to receive care as independent adults. In addition, medical oncologists need to determine whether the models for research and clinical care of survivors created in pediatric oncology can be applied to survivors of adult-onset cancer.
-
The United States devotes substantial resources to understanding the etiologies of cancer and improving treatments, but much less research has focused on the needs of cancer survivors after they have completed active treatment. This article augments findings from the Institute of Medicine about cancer survivorship research and ways to enhance quality of life and quality of care. ⋯ Opportunities to expand research on cancer survivors include clinical trials, large cohort studies, cancer registries, and national surveys. Research to understand the needs of cancer survivors will provide a foundation for effective programs to meet these needs.
-
The prevalence of cancer survivors is increasing worldwide. This creates the imperative to look beyond cancer survival to cancer survivorship. This review explores cancer survivorship from an international perspective in two ways: from a cancer control perspective through a review of cancer control strategies and from a cancer care perspective through a review of clinical practice guidelines and research on cancer follow-up care. ⋯ This review suggests that research and recognition of cancer survivorship as a unique phase of the cancer care trajectory need to be improved. In many of the poorer countries of the world, the imperative remains the basics of cancer care: timely diagnosis, access to treatment, and alleviation of suffering.