survivorship(ser-VY-ver-ship) – In cancer, survivorship covers the physical, psychosocial, and economic issues of cancer, from diagnosis until the end of life. It includes issues related to the ability to get health care and follow-up treatment, late effects of treatment, second cancers, and quality of life.
“An individual is considered a cancer survivor from the time of diagnosis, through the balance of his or her life. Family members, friends, and caregivers are also impacted by the survivorship experience and are therefore included in this definition.” National Cancer Institute
Definitions vary, but survivorship is a unique journey for each person. There is no single definition for true or correct survivorship. But there are many more survivors than people realize. There are approximately 12 million Americans alive with a history of cancer—some considered cured, others in remission or receiving treatment. The overall survival rate for all types of cancer is 66%. And each person surviving their diagnosis of cancer believes their lives to be changed. How it is changed can depend upon their approach to “survivorship.”
A cancer diagnosis often leads to a change in priorities, relationships, goals, or spirituality. Survivors speak of a greater appreciation of life, a greater acceptance of self, and a greater appreciation of others. Many survivors choose to focus on the good that has resulted from their cancer experience rather than the bad. Many survivors describe their journey after cancer as a daily experience rather than staying alive until their next doctor checkup. Whatever your definition of survivorship, it can greatly affect how you see your life taking course after cancer treatment.
At the completion of treatment, the “safety net” of regular contact with your health care team ends. Anxieties may surface as you try to adjust and live with uncertainty. Fear of your cancer coming back is normal for cancer survivors. It is simply hard to know what is “normal” and what needs to be reported to your doctor. Remember that your oncology team is still available to help. Discuss your concerns with them and attend your scheduled follow-up visits so that your journey is not directed by feelings of anxiety and helplessness. Often times, your oncology team can provide you with information that can be empowering so you can live life without worry, knowing that your team is watchfully behind you.
The Portnuef Cancer Center interdisciplinary team will provide you with a Treatment Summary and Survivorship Plan as you finish your cancer treatments. The plan provides a summary of your cancer treatments, recommended follow-up appointments, and support staff contact information.
Relationships with family and friends may be tested during this transition. Some friends may become closer, while others distance themselves. Families can become overprotective, or may have exhausted their ability to be supportive. Marital problems that may have been ignored before cancer can surface. The entire family is changed by the cancer experience, but may not recognize the positive or negative changes. Open communication is key to adapting to life and shifting relationships after cancer.
Getting Back to “Normal”
Returning to work is a sign of returning to normal and away from the role of being sick. Most people need their job and the medical insurance it provides. Eighty percent (80%) of people with cancer return to work after a cancer diagnosis. Studies show little, if any, difference in the work performance of survivors. Although outright discrimination has decreased, there is still subtle discrimination. When planning your return to work, it may be helpful to anticipate questions from coworkers, and decide how to answer these questions in advance. Coworkers may want to help, but not know how. It may be up to you to start the conversation and set the limits. Disclosing a diagnosis is a personal decision.
Sharing Your Story
Each cancer survivor has a story to share when the time or situation is right. Some are more inclined to share information about their cancer diagnosis and its treatment. Others may prefer to keep details private or may feel uncomfortable discussing certain parts of the body. Or, the topic may be too painful or too recent to discuss. Telling other people about a cancer experience involves sharing personal information. This is an individual choice. It is always your decision how much to share, regardless of any probing or intrusive interest or questions.