As a 20-plus-year cancer survivor, I have been heartened to see the number of cancer survivors increase (currently estimated at well over 10 million Americans), and new attention paid to the unique, wide-ranging, and long-term issues that follow the diagnosis and treatment of cancer. This volume reflects that trend. It reports the work of an Institute of Medicine (IOM) and National Research Council (NRC) of the National Academies "Committee on Cancer Survivorship: Improving Care and Quality of Life."
The committee consisted of a diverse group of 17 individuals from academia, not-for-profit health advocacy organizations, as well as health-care providers; its deliberations took place between July 2004 and March 2005. The stated goals of the work were to:
(1) raise awareness of medical, functional, and psychosocial consequences of cancer and its treatment; (2) define quality health care for cancer survivors and identify strategies to achieve it; and (3) improve the qualify of life of cancer survivors through policies to ensure their access to psychosocial services, fair employment practices and health insurance.
The book discusses the difficulties associated with defining cancer survivorship. Here, the committee and editors chose to focus on adults who completed primary treatment for cancer and had no recurrences. This leaves out survivors of childhood cancers, who were discussed in another IOM report (Childhood Cancer Survivorship: Improving Care and Quality of Life, 2003), as well as end-of-life cancer care, which also was covered in an earlier IOM report (Improving Palliative Care: We Can Take Better Care of People With Cancer, 2003). Although cancer survivors with chronic or intermittently treated cancers are not directly addressed, the recommendations of the current volume are also of relevance to them.
The committee took advantage of a plethora of available, but not necessarily integrated, sources of data. The resulting book is a valuable reference. Several chapters present descriptive data about cancer survivors, and the ways in which their lives are affected by a cancer diagnosis and its treatment. This coverage is quite broad, including discussion of physical, psychosocial, vocational, spiritual, and economic issues. It should be useful to patients, their advocates, and health-care providers. Several other chapters focus on defining optimal care for cancer survivorsboth medical and psychosocialas well as describing models for delivery. These chapters should be of interest to health-care providers, health advocates, and policy makers.
The committee's 10 recommendations are summarized below:
(1) Increase awareness of the physical and psychosocial issues associated with cancer survivorship.