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Looking Beyond Survival: How Are We Looking at Survivorship?

Eva Grunfeld

From the Cancer Outcomes Research Program, Cancer Care Nova Scotia; Division of Medical Oncology, Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada

Address reprint requests to Eva Grunfeld, MD, DPhil, Cancer Outcomes Research Program, Cancer Care Nova Scotia, 5th Floor, Bethune Building, 1278 Tower Rd, Halifax, Nova Scotia, Canada B3J 3Z3; eva.grunfeld{at}ccns.nshealth.ca

BACKGROUND: 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.

RESULTS: Many national cancer control strategies or cancer charities consider survivorship obliquely, primarily under the umbrellas of quality of life and rehabilitation. Few have well-developed policies or plans specifically directed at survivorship. Cancer follow-up care is recognized internationally as a pressing health care issue. Many countries have tested new and innovative models to deliver follow-up care. Similarly, many countries have developed guidelines that specifically address follow-up care. Few studies or guidelines address the broader, multifaceted aspects of cancer survivorship.

DISCUSSION: 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.

Author's disclosures of potential conflicts of interest are found at the end of this article.

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