Is there life after cancer? The answer is definitely yes. Cancer means something before and after for the life of many patients. It makes a difference because you are psychologically placed in a position of maximum vulnerability or fragility to life. It changes your perspective, your values, your vision that you had marked about your own existence.
At the first moment everything revolves around the disease, medical tests, treatments and outcomes derived from them. After passing the transition from active patient to treatment ending, it is time to go back to normality. You become a cancer survivor.
I like the word “survivor”. Surviving has different definitions: living after the death of another person, living after a certain period of time or living after a specific hazardous event. It also means overcoming a difficulty, a risk or a hard situation. Personally I prefer the second definition, because it implies that a challenge has been reached.
Due to treatment advances achieved in recent years and the increased patient self-awareness, we are witnessing in a significant number of patients cured era. There will be an even greater number of cancer patients and survivors, especially long-term survivors.
Cancer survival has three basic stages:
- Acute Survival: Living with cancer. It is the period starting from diagnosis to the completion of cancer treatment.
- Extended Survival: Crossing cancer. It is the period from the end of treatment untill cure.
- Permanent Survival: After cancer. It is the healing phase or prolonged survival after obtaining disease remission.
Many doctors talk about cancer cured after passing a complete remission of five years after treatment. Others prefer to say that there is no evidence disease (NED). But many doctors consider the patient is a long survivor after passing the time of five years, often with more years to go.
Having more long-term cancer survivors represents a new challenge for the entire medical community. Whenever we have achieved this coveted and sought healing by combining in different ways the therapeutic arsenal available today, it presents for us the opportunity to go a step further. It stands to reason that survivors deserve specific treatments for toxicities and sequelae that sometimes arise, in addition to learning to live or bear some of them.
Today, oncologic surgery is becoming less invasive or mutilating. Increasingly we opt for organ conservative treatments. With chemotherapy there are new advances being offered and there is preventive support for their potential toxicity and does not appear or it is bearable. In radiation therapy technological advances like IMRT can often help achieve it, decrease side effects considerably.
We face not only adding years to life, but adding life and overall quality of life to years of survival. It is estimated that each year there will be about 100,000 new survivors of cancer in Spain and is expected to reach 18 million people in the next decade in the USA. It is not a trivial matter. This is a situation that demands an extra interdisciplinary effort. This is a window to a new field development in oncology. We need to develop better strategies to enhance the quality of life of survivors ranging from skin and mucous tissues care, fatigue, infertility or sexual dysfunction, cognitive impairment to emotional, psychosocial support or even reintegration into working life.
American Cancer Society