Cancer survivorship in Ireland
Currently there are more than 173,000 cancer survivors living in Ireland. This represents almost 4% of the population. The number of survivors is predicted to double over the next 25 years, mainly due to improvements in early detection, effective cancer treatment and new developments in treatment.
While survival is improving for most cancers in Ireland, there have been great advances in survival in some of the more common cancers e.g. the 5-year survival for breast and prostate cancer is over 80%.
What is cancer survivorship?
It is broadly accepted that cancer survivorship begins at the time of diagnosis and continues until end of life and is referred to as ‘living with and beyond cancer’.
Caregivers and family members are also cancer survivors.
For those who have metastatic cancer the ‘survivor’ label may not always be considered a good fit as these persons continue to live with cancer every day. Furthermore, since many forms of cancer are chronic, yet highly survivable, the definition of successful treatment can be seen to have shifted toward maximising the quality of life of individuals diagnosed with cancer for as long as they live.
Nationally and internationally there is increasing focus in understanding the needs of cancer survivors. Their needs can vary according to:
- stage of survivorship
- age of the patient
- cancer type and associated treatment effects
- co-morbid illnesses.
These needs are related to the difficulties often experienced by people affected by cancer. However it must be acknowledged that a minority of patients (approx. 20%) do live with persistent difficulties related to the cancer itself or complications of treatment.
What is the aim of the NCCP survivorship programme?
The aim of the NCCP survivorship programme is to optimise patient’s health and wellbeing by developing and enhancing;
- cancer survivorship services
- assessment and management of the consequences of treatment
- provision of information, guidance and support.
The NCCP and key stakeholders are working to improve the experience of patients and families of cancer patients across the cancer continuum. This includes the period of time when active treatment is complete and patients return to their families and communities.
Meeting the needs of cancer survivors within the Health Service
Cancer Survivorship is now regarded as a distinct and important phase of the cancer journey. In moving from being a ‘cancer patient’ to being a ‘cancer survivor’ there is a great need to improve overall awareness in relation to the importance of holistic recovery and life with and beyond cancer.
Patients themselves play an important role in their own recovery, both mentally and physically. Patients often describe a huge transition from the relative ‘safety and support’ that is inherent in undergoing cancer treatment to ‘feeling on their own’.
Our health service needs to play a greater role in identifying and meeting the needs of cancer ‘survivors’ so as to support and empower patients to improve their wellbeing in the cancer survivorship period.
Components of survivorship care
Cancer survivorship or living with and beyond cancer should be seen as part of the continuum of cancer care. The essential components of good survivorship care are;
- prevention and detection of reoccurrence and new cancers
- surveillance for reoccurrence and new cancers
- interventions for long term and late effects
- coordination between specialists and primary care.
In addition a number of elements of good quality survivorship care include;
- monitoring and intervention as needed for psychological and social effects
- encouragement of self-management with support
- information and health education
- familial genetic risk assessment if indicated
- guidance on work and financial issues
- guidance on prevention and healthy lifestyle.
Cancer survivors and healthy lifestyle
It is of critical importance that all cancer survivors become partners with their health advisors in relation to their long term health and health care. In this regard a healthy lifestyle is very important. Cancer survivors should;
- never smoke
- maintain a healthy weight
- be physically active
- eat healthy food
- protect against sun burn
- never use a sunbed
- attend recommended screening programmes.
Louise Mullen is the NCCP National Lead for Cancer Survivorship.