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Cancer Survivors Face Challenges and Must Find Solutions

Both oncologists and primary care physicians do not provide adequate care to fully address cancer survivorship needs. Learn about why and solutions for people in their cancer journey.
As a 19-year brain tumor survivor diagnosed in 1998 when I was 24 years old, I’ve found some survivor statistics insightful. As of January 2016, it was estimated that there are 15.5 million cancer survivors in the United States, which represents 4.8 percent of the population. Moreover, the number of cancer survivors is projected to be 20.3 million by 2026, and 26.1 million by 2040. In 2016, 67 percent of survivors lived five years or more after diagnosis; 44 percent have survived 10 years or more; and, 17 percent survived 20 years or more.

Cancer patients who receive treatment need ongoing support, and oncologists must provide quality cancer care from diagnosis through the balance of life. In the past, physicians viewed survivorship care as largely confined to surveillance for cancer recurrence. As Kevin Oeffinger, M.D., at Duke University and a spokesperson for the American Society of Clinical Oncology recently told MedPage Today, some oncologists ultimately expanded care to include “surveillance for another cancer secondary to the treatment of the original cancer, late organ toxicity from the original regimen and psychological toxicities including financial toxicity from the cost of cancer theray.” 1

Along with their oncologists, cancer survivors need support from their general practitioner who knows about cancer survivorship and can address some challenges. A recent article in JAMA Internal Medicine showed that in a comparative case study of 12 advanced primary care practices in the United States, none of them offered any form of comprehensive cancer survivorship service. 2 Those problems have been recognized for a while.

Indeed, the Institute of Medicine (IOM) over 10 years ago released a seminal report, From Cancer Survivor: Lost in Translation, which outlined components of high-quality survivorship care. It explains that implementation of the IOM recommendations relied on the availability of well-informed and responsive primary care survivorship clinicians; however, those improvements have not been incorporated. Some leaders aspire to address gaps, including through the first annual survivorship symposium in 2016 organized by the American Society of Clinical Oncology (ASCO), American Academy of Family Physicians, and the American College of Physicians. Unfortunately, a recent JAMA Internal Medical article emphasizes that challenges continue: “Primary care clinicians continue to struggle with how to think about cancer survivors or offer high-quality survivorship care, suggesting either inadequate reach or ineffective technique of current educational initiatives and survivorship guidelines.” 3

Talk about this article with other patients, caregivers, and advocates in the Brain Cancer CURE discussion group.
Jeannine Walston is a brain tumor survivor since 1998, cancer coach, writer, consultant and speaker. Her extensive work includes for the U.S. Congress, cancer non-profits, NCI, FDA, NIH National Center for Complementary and Alternative Medicine, hospitals, clinics, doctors, providers, other businesses, cancer patients and caregivers.
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