Bloomington / Normal, IL

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Stages of Cancer Survivorship


By Lisa Lowry, RN, BSN

Did you know that there are currently over 14 million adults and children living in the U.S. with a history of cancer and that the number of survivors is predicted to increase to almost 19 million by the year 2024?  Sixty-one percent of survivors in the U.S. were diagnosed over five years ago with 15 percent of them having been diagnosed over 20 years ago. What do these facts mean for you and your loved ones?

First, we will start with the term survivor, which has been known to have several different meanings. When people think of a cancer survivor they think of someone who has been treated for some form of cancer and is now in remission. In the past, a patient would be labeled a survivor at five years post-treatment. Today the definition of a cancer survivor has changed. The National Cancer Institute states that a person is a survivor from the time of diagnosis throughout the balance of his or her life. Families, friends, and caregivers are considered secondary survivors, as they are also impacted by a loved one’s cancer journey.

There are three phases in survivorship that require different levels of care and follow-up. They are living with, living through, and living beyond cancer. A survivor is considered to be living with cancer during the period after diagnosis and while receiving treatment for cancer. This includes chemotherapy, radiation, surgery, or a combination of treatments. The goal of treatment, according to the American Cancer Society, should strive to cure the cancer or extend survival, while allowing the patient to maintain quality of life during and after treatment. It is important for patients to discuss the goal of their treatment with their physicians and to be an active participant in their treatment decisions.

In the living through cancer stage, the treatment for cancer is complete and it is time for the survivor to begin regular follow-up appointments with their oncology team. This is a time when the risk of recurrence is relatively high. In the past, many survivors were lost in the transition from active treatment to active follow-up. In 2015, the Commission on Cancer, established by the American College of Surgeons, the professional organization that sets the standards for oncology care, will require that each cancer treatment facility implement a survivorship program to help patients make a successful transition.

A survivorship program may involve many different services. One of the required activities is providing cancer survivors with an individualized survivorship care plan, which consists of contact information for the patient’s care team, a brief summary of diagnosis and treatments, a timeline of follow-up appointments, information on how to manage ongoing symptoms, as well as what to expect after treatment. These care plans are shared with patients and members of their care team, including their primary care physician.

Even after treatment for cancer is complete, many survivors can be affected by side effects for years to come. Some of the most common long-term effects of cancer treatment are fatigue, pain, infertility, lymphedema, and bone density loss. A cancer diagnosis and treatment can also cause psychological changes in a survivor that can lead to distress, cognitive deficits (such as problems with attention, concentration, and memory), and patients often have a fear of recurrence. All of these issues should be discussed with your oncology care team, whether it be your physician, a nurse, or social worker. An oncology team has the resources and services available to patients to help them cope with these long-term effects. It would also be beneficial for patients to join support groups or survivorship wellness classes, which are offered at the Community Cancer Center on a regular basis, during any phase of survivorship.

Living beyond cancer, which refers to long-term survivorship, can be stressful for a survivor as they try to find a “new normal.” Making changes for a healthier lifestyle can increase a person’s overall survival. These changes would include a healthy diet, exercise, limited sun exposure, and continued smoking cessation. During this time the cancer survivor and oncology care team will make a long-term health care plan that involves transitioning patients back to their primary physicians.

For questions about survivorship, you may contact Lisa at Mid-Illinois Hematology and Oncology Associates Ltd. at 309-452-9701 ext. 342 or email: To learn about the Community Cancer Center’s support groups and survivor wellness classes, please contact 309-451-8500.

Photo credit: Snowleopard1/iStock