The Journey of Cancer Survivorship

CURE, Summer 2007, Volume 6, Issue 4

A timeline for the development of awareness about cancer survivorship.

1913

The American Society for the Control of Cancer—later to become the American Cancer Society—is founded in New York City by a group of prominent physicians and businessmen.

1937

Legislation is signed on July 23 authorizing the establishment of the National Cancer Institute, seven years after the establishment of the National Institute of Health.

1938

Public attention to cancer, and even some attention to survivorship, is noted as Time magazine marks the 25th anniversary of the American Society for the Control of Cancer. In its April 4 issue, the magazine reports that a Massachusetts woman and 18-year breast cancer survivor, Dr. Anna Mary Chipman Palmer, was named president of the newly formed Cured Cancer Club. Their slogan, according to Time: “We will drive away the fear that keeps so many people from going to a physician in time to be saved.” In the same item, Time notes that the American College of Surgeons has records of 29,195 people who have recovered from cancer.

1944

The American Society for the Control of Cancer is reorganized to become the American Cancer Society. Mary Lasker, a well-connected philanthropist who helped push to establish the National Cancer Institute and, later, promoted the National Cancer Act, is instrumental in helping to raise more than $4 million for the cancer society the year after its reorganization.

1946

The first report of a trial of chemotherapy was published, based on wartime studies of the effects of poison gas on lymphomas. The article, appearing in The Journal of the American Medical Association, is titled: “Nitrogen mustard therapy: use of methyl-bis(beta-chloroethyl)amine hydrochloride and tris(beta-chloroethyl)amine hydrochloride for Hodgkin’s disease, lymphosarcoma, leukemia, and certain allied and miscellaneous disorders.” In 1949, nitrogen mustard wins FDA approval as a therapy to kill cancer cells.

1964

Surgeon General Luther L. Terry, who had convened a committee of experts to conduct a comprehensive review of the scientific literature on the impact of smoking on health, issues a landmark report on Jan. 11. Titled “Smoking and Health: Report of the Advisory Committee to the Surgeon General,” the report blames cigarette smoking for a 70 percent increase in the death rate of smokers, compared with nonsmokers.

Terry chooses to issue the report on a Saturday to minimize the impact on the stock market, and maximize play in the Sunday papers. Later he says the report “hit the country like a bombshell.”

1971

In his State of the Union address, President Richard Nixon takes aim at cancer. “The time has come in America when the same kind of concentrated effort that split the atom and took man to the moon should be turned toward conquering this dread disease,” he says. Later that year, Nixon signs the National Cancer Act, which notes “that a great opportunity is offered as a result of recent advances … to conduct energetically a national program against cancer.” The measure expanded the scope and influence of the National Cancer Institute and the National Institutes of Health.

1971

Hollywood legend John Wayne, diagnosed with lung cancer in 1964, films a public service announcement for the American Cancer Society. In the announcement, he says:

“I was just finishing my 199th picture, never felt better in my life, and I said to myself when this is finished I’m going out on my boat. And then I got nagged into going for a medical checkup. They found a spot on the X-rays. It was lung cancer. If I’d waited a few more weeks I wouldn’t be here now.

“That’s me, seven years after surgery, in True Grit, because I did myself a favor and got a checkup. So why don’t all of you do yourselves a favor—get a checkup. Talk someone you like into getting a checkup. Nag someone you love into getting a checkup.

“While you’re at it, send a check to the American Cancer Society, too. It’s great to be alive.”

1975

The first national research conference on psycho-oncology—a field of research and practice focusing largely on the psychological issues that surround cancer for patients, survivors, their families and healthcare providers—is held in San Antonio, Texas. Building on work from the 1950s dealing with such topics as guilt and shame related to cancer, and responses to colostomy and radical mastectomy, conference attendees addressed questions of how to better scientifically study psychological issues relevant to cancer care.

1982

Along with friends, Dallas resident Nancy Brinker launches the Susan G. Komen Breast Cancer Foundation in memory of her sister, to support women fighting breast cancer. Brinker would later write: “I wanted to do something to let her know how special she would always be in my heart. I was haunted by our last conversation and lay awake sometimes all night wondering what I could do to help other women with breast cancer.” The foundation, later renamed Susan G. Komen for the Cure, becomes the world’s largest grass-roots network of breast cancer survivors and other activists.

1985

The New England Journal of Medicine publishes “Seasons of Survival: Reflections of a Physician with Cancer,” by Fitzhugh Mullan, MD. Mullan, a health official for the state of New Mexico, writes, “It did not occur to me while I was acutely ill or for some time afterward that the simple concepts of sickness and cure were insufficient to describe what was happening to me.” He goes on to describe the period after treatment, when the support of doctors and nurses wanes. “The result is a void that leaves many cancer patients and their families fending awkwardly for themselves in a ‘healthy’ world.”

1986

On Oct. 26, some two dozen experts from areas of cancer research, information and advocacy gather around a hotel conference table in Albuquerque, New Mexico, and found the National Coalition for Cancer Survivorship. Founding members pass a hat to set up their office with the aid of the grass-roots group People Living Through Cancer. The NCCS charter states: “from the moment of diagnosis and for the balance of life, an individual diagnosed with cancer is a survivor.” Barbara Hoffman, JD, founding chair of NCCS, notes that the need for an organization to be a hub for cancer survivorship issues was acute. “With rare exception there were few resources to deal with anything but the immediate medical consequences of cancer.”

1996

In July, the National Cancer Institute establishes the Office of Cancer Survivorship, in recognition of the growing number of Americans living long after cancer treatment ends. The office’s mission is to enhance the quality and length of survival of people diagnosed with cancer, and to minimize or stabilize adverse effects experienced during cancer survivorship.

1997

Cycling champion Lance Armstrong, diagnosed the previous year with advanced testicular cancer that had spread to his lungs, abdomen and brain, launches the Lance Armstrong Foundation. The next year it awards its first grant and holds its inaugural gala. The year after that, Armstrong wins his first of seven consecutive victories in the arduous Tour de France race, cementing in the public mind the idea that people cannot only survive, but thrive, after cancer treatment.

The organization’s manifesto begins:

We believe in life.

Your life.

We believe in living every minute of it with every ounce of your being.

And that you must not let cancer take control of it.

2005

On Nov. 7, the Institute of Medicine releases the 536-page report “From Cancer Patient to Cancer Survivor: Lost in Transition,” detailing the many and urgent needs of the growing population of cancer survivors. In a video accompanying the report’s release, Patricia Ganz, MD, of the University of California, Los Angeles, says: “We’re beginning to think about cancer now as a chronic disease, similar to the way we would think about diabetes or heart disease, where in fact the treatment may be finished, but the susceptibility or ongoing follow-up needs of that individual person exist.” (The report can be read, and the video viewed, at www.iom.edu/CMS/28312/4931/30869.aspx).

2006

For the first time in its 40-year history, the American Society of Clinical Oncology, the leading professional organization for cancer physicians, chooses the issue of survivorship as a theme for its annual meeting.

2006

A statistical review by the American Cancer Society shows a decline in cancer deaths for a second straight year—2003 and 2004—with some 3,000 fewer Americans dying of cancer in the later year. The biggest drop appears in colorectal cancer, with more than 2,000 fewer deaths.