Cancer survivors are living longer than ever after their diagnosis, necessitating a change in the way health and support services are designed and delivered.
That’s according to a new report from the American Cancer Society (ACS), published in CA: A Cancer Journal for Clinicians in October 2018.
“Cancer care delivery is being shaped by growing numbers of cancer survivors coupled with provider shortages, rising costs of primary treatment and follow‐up care, significant survivorship health disparities, increased reliance on informal caregivers, and the transition to value‐based care,” it said.
These factors, it went on, were creating a “compelling need” to provide “coordinated, comprehensive, personalized care” that met the needs of cancer survivors and their families.
The number of new cancer cases in the US continues to increase year-on-year, and more than 1.7 million people are expected to be diagnosed by the end of 2018. That figure is expected to rise to 20.3 million by 2026 and 26.1 million by 2040.
At the same time, advances in treatments and early detection rates have contributed to the number of people surviving the disease.
There are almost 15.5 million people with a history of cancer currently living in the US, 67% of whom were diagnosed five or more years ago. A total of 17%, were diagnosed 20 or more years ago.
The report points out that this growing group of cancer survivors and caregivers have particular support and care needs and identifies three “priority areas”.
These are routinely assessing survivors’ and caregivers’ needs, making sure they have access to tailored information and appropriate onward referrals, and implementing new interventions and care models to help them.
“Research has documented the impact of cancer and treatment on four domains of survivors’ well‐being, including physical, emotional, social, and spiritual,” said the report.
“Problems in these quality‐of‐life domains interact to impair survivors’ ability to function sufficiently to participate fully in work and life roles.”
Studies have shown 37% of adult survivors are restricted from performing daily activities. In older survivors, 64% report limitations that impact in their mobility or daily activities.
“Over 50% of adult cancer survivors and 65% of older adult survivors experience persistent functional limitations many years beyond treatment. These decrements in functioning affect survivors’ ability to work and increase health care utilization and costs,” said the report.
This impacts on caregivers as well as survivors.
Lead author and ACS Vice President of Survivorship, Dr. Catherine Alfano, said the report mapped out a comprehensive strategy to meet survivors’ and caregivers’ unique needs.
“Our investment in new, better cancer treatments has been a literal lifesaver, with more survivors than ever living years beyond their original diagnosis.These survivors then must cope with new risks and ongoing symptoms, so failing to invest in efforts to address the long-term problems confronting survivors and their caregivers is unethical,” she said.
Alfano CM, Leach CR, Smith TG, Miller KD, Alcaraz KI, Cannady RS, et al. Equitably improving outcomes for cancer survivors and supporting caregivers: A blueprint for care delivery, research, education, and policy. CA Cancer J Clin 2019; 69:35-49.
American Cancer Society. (2018) Report outlines priorities to improve the lives of cancer survivors and caregivers [Press release]. October 30, 2018. Available at: https://www.eurekalert.org/pub_releases/2018-10/acs-rop102518.php (accessed February 2019).