Surviving cancer can be defined in different ways:

• Having no disease after diagnosis or the completion of treatment
  
  
• The process of living with, through, and beyond cancer. By this definition, cancer survivorship begins at diagnosis.

A cancer diagnosis may lead to a change in a person's priorities regarding relationships, career, or lifestyle. Some survivors talk about appreciating life more and gaining a greater acceptance of self, and some survivors become anxious about their health and uncertain of how to cope with life after treatment. Survivorship is a unique journey for each person.

Survival statistics

The number of people living with cancer in the United States has increased dramatically, from 3 million in 1971 to 10.5 million in 2003 (source: National Cancer Institute). About 66% of people diagnosed with cancer today are expected to live at least five years beyond their diagnosis. Most cancer survivors today are age 65 or older.

The most common cancer diagnoses in survivors are:

• Breast cancer (23%)
  
  
• Prostate cancer (19%)
  
  
• Colorectal cancer (10%)
  
  
• Gynecologic (uterine, ovarian, and cervical) cancers (10%)

Approximately 14 % of all cancer survivors were diagnosed more than 20 years ago.

This increase in survival rates is largely attributed to the following four developments:

• Improved screening and early detection, such as mammography for breast cancer, the prostate specific antigen (PSA) test for prostate cancer, the Pap test for cervical cancer, and colonoscopy for colorectal cancer
  
  
• Improvements in treatment
  
  
• More effective treatment of side effects, making it possible to give patients higher, more effective doses of cancer drugs
  
  
• The development of targeted therapies, which are more specific and less toxic than standard chemotherapy

Surviving cancer: What to expect

At the completion of active treatment, the "safety net" of regular, frequent contact with the health-care team ends. Some survivors may miss this source of support, especially since anxieties may surface at this time. Some survivors have difficulty adjusting to and learning to live with uncertainty. Others may have physical problems, experience discrimination at work, or find that their social network feels inadequate. For more information, read ASCO Expert Corner: Finishing Treatment: What Comes Next? and Cancer.Net Feature: Making Positive Lifestyle Changes After a Cancer Diagnosis.

Fear of recurrence

Fear of recurrence (the return of cancer) is common among most cancer survivors. It may lead a person to over-interpret the significance of minor physical problems, such as a headache or joint stiffness. It is simply hard to know what is "normal," and what needs to be reported to the doctor. Discussing the actual risk of recurrence with your doctor and the symptoms to report can often reduce a person’s anxiety. Maintaining your schedule of follow-up visits can also provide a sense of control. Although many cancer survivors describe feeling scared and nervous at the time of routine follow-up visits, these feelings may ease with time.

Relationships

Relationships with family and friends may be tested during this transition. Some friends may become closer, while others distance themselves. Families can become overprotective, or may have exhausted their ability to be supportive. Relationship problems that may have been ignored before cancer can surface. The entire family is changed by the cancer experience, but they may not recognize these changes. Open communication helps with adapting to life and shifting relationships after cancer. Read more about Relationships and Cancer.

Getting back to "normal"

Returning to work is a sign of regaining a normal routine and lifestyle, and 80% of people with cancer return to work after a cancer diagnosis. Most people need their job and the medical insurance it provides. Studies show little, if any, difference in the work performance of survivors. Although obvious discrimination has decreased, there can still be subtle discrimination. When planning your return to work, it may be helpful to anticipate questions from coworkers, and decide how to answer these questions in advance. Coworkers may want to help but not know how. It may be up to you to start the conversation and set the limits. Disclosing and discussing a diagnosis is a personal decision. For more information, read Going Back to Work After Cancer.

Institute of Medicine Report

On November 7, 2005, the Institute of Medicine (IOM) issued the report, From Cancer Patient to Cancer Survivor: Lost in Transition. This report is a comprehensive look at the status and future requirements of the growing number of adult cancer survivors. An ASCO and IOM symposium was held on November 8, 2005, at the National Academy of Sciences in Washington, DC, to focus on implementation of the key recommendations proposed by the IOM report. Symposium attendees included cancer survivors, cancer advocates, health-care providers, government officials, insurers and payers, and representatives of the research community.

Read the executive summary of the IOM report: From Cancer Patient to Cancer Survivor: Lost in Transition

Order a copy of the full report and access IOM fact sheets on survivorship

The IOM has prepared a 17-minute video on cancer survivorship to accompany the report. Watch the IOM video.

Childhood Cancer Survivorship

Survivors of cancer that occurred in childhood or as teenagers or young adults may have common concerns and unique challenges. Cancer.Net address childhood cancer survivorship, including information on a 2003 IOM report on the topic, in the section entitled Childhood Cancer Survivorship.

More Information

Survivorship: Next Steps to Take

Cancer.Net Feature: Cancer Terms to Know After Treatment

Cancer.Net Q&A Forum: Cancer Survivorship: Living Beyond Cancer

Cancer.Net Feature: ASCO Implements Findings From Institute of Medicine Cancer Survivorship Report

2004 Meet the Expert: Cancer Survivorship - Increasing Survival, Improving Lives

In Their Own Words: Survivorship Issues

Additional Resources

Lance Armstrong Foundation: Living After Cancer Brochure Series

Lance Armstrong Foundation: Finding and Evaluating Survivorship Resources