Understanding Cancer Survivorship, Quality of Life and Caregivers

The five-year survival rate for all cancers combined has reached 70%, reflecting major advances in early detection and treatment, according to study findings published in CA: A Cancer Journal for Clinicians. But as more people live longer with cancer — including those with metastatic disease — survivorship care is becoming an increasingly important part of oncology.

Dr. Marleen Meyers, medical oncologist and clinical professor at NYU Grossman School of Medicine and director of the Cancer Survivorship Program at NYU Langone’s Perlmutter Cancer Center, spoke with CURE about how longer survival is reshaping cancer care, the needs of younger patients, and supporting caregivers alongside survivors.

CURE: How does the rising five-year survival rate change how we define success in cancer care?

Meyers: My interest is not only in breast medical oncology but also in quality of life, particularly because we have so many more survivors going forward. We think not only about patients who have been cured of cancer, but also people who are living for long periods of time with metastatic cancer, and we consider them survivors as well. The importance we’ve seen in recent years is how to improve their quality of life, and that’s something we really strive very hard to do going forward.

Our success model is a good one, but it’s not a great one yet. Progress varies from cancer to cancer. We’ve made significant advances in some cancers and much less in others, but it is a process moving forward. Many things can improve survival rates — better screening, prevention and lifestyle changes. In the metastatic setting, targeted therapies are also helping make treatments better and much less toxic.

For patients facing advanced cancer today, how should survival statistics shape their sense of hope?

Statistics are hopeful, but they’re just numbers. Each person has within them the possibility of doing well and the possibility of hope.

While survival statistics are excellent for some cancers and less so for others, it doesn’t mean an individual patient will have a poor outcome. We always hope for the best and strive to get each person on the best treatment possible.

Targeted therapies have made that more possible. Instead of using across-the-board chemotherapy that is highly toxic to all cells, we can test tumors for mutations and use individualized therapies, particularly in lung cancer and breast cancer.

What gives me the most hope is that we’re learning so much more about what makes cancers tick, why they stop responding to therapy and what we can do to slow that resistance so we can get the best results from each treatment.

What survivorship challenges are most important for younger adults diagnosed with cancer?

Survivorship needs vary depending on the cancer type, but some issues are very common among younger patients.

One is fertility. It’s crucial that anyone of childbearing age who may want children in the future has the ability to preserve their ovaries or sperm before treatment if possible. Psychosocial health is also extremely important. Many patients experience anxiety, depression and fear of recurrence.

Education is another key area. We talk about nutrition, exercise, avoiding alcohol and not smoking — all things that may help reduce recurrence risk, but they’re often hard to implement. Cancer at a young age often occurs when people are starting families or advancing their careers. They’re making important life decisions while managing their health, so having strong psychosocial support and community is very important.

How has survivorship changed for patients living with metastatic cancer?

People generally feel better on targeted therapies. They can still have side effects, but typically there is less fatigue and fewer acute side effects than with chemotherapy.

However, people living with metastatic disease have their own unique survivorship needs. They may be living with cancer for many years — sometimes eight, nine or even 10 years — and they must navigate life knowing their disease may not be curable.

Patients often must make major decisions about work, finances and life plans. Should they keep working or retire? Should they travel now or save money for the future?

While we are very happy to see improvements in survival, it also means we are addressing a different kind of survivorship that we didn’t see as often in the past.

What message do you have for caregivers supporting survivors’ long term?

We define a survivor as someone from the time of diagnosis, and that includes family members, loved ones and friends who are on the journey with them. Caregivers provide essential support, but they also need to take care of themselves. I often see spouses who have neglected their own health while caring for a loved one. You’re not good to anybody if you’re not healthy yourself.

It’s important for caregivers to take breaks, use respite care and allow others to step in when possible. Extended survival also means extended stress, and that stress can affect both patients and caregivers. Having a flexible long-term plan is important to support everyone involved.

References

1. “Cancer statistics, 2026” by Dr. Rebecca Siegel, et al., CA: A Cancer Journal for Clinicians.

Transcript has been edited for clarity and conciseness.

For more news on cancer updates, research and education, don’t forget to subscribe to CURE®’s newsletters here.