The recent Centers for Disease Control and Prevention (CDC) report carrying good news about cancer survivorship is an urgent “heads up” for all of us in cancer care. The report states that between the years 1971 and 2001, the number of cancer survivors increased by more than three-fold (from 3 million to nearly 10 million). Only 6 years later (between 2001 and 2007), the survivor cohort had increased again, to nearly 12 million. Besides changing numbers, the report depicts an evolving face of cancer survivorship. Consider the following findings:
• Nearly 60% of all survivors are over 65 years of age. The majority of cancer survivors are elderly females, as older women with breast cancer (65–84 years of age) represent the largest subset of survivors.
• Females account for the largest segment of survivors at 5, 15, and 25 years; more than 75% of survivors at 25 years are female.
• Survival of a solid tumor (ie, breast, prostate, colorectal) accounts for 51% of all survivors.
• Approximately one-third (35.2%) of survivors are middle-aged, with most in this age group having survived melanoma, thyroid cancers, and cervical cancers.
Also of note is another recent major report addressing the cost of cancer. In the United States, treatment of the most common cancers—breast, prostate, and colorectal malignancies—represents the largest national expenditure by cancer site. The current cost of cancer is nearly $125 billion (compared with $104 billion in 2006), with a projected cost escalation of 27% anticipated by the year 2020.[2,3]
A caveat is in order. We need to remember that the recent CDC report was based on data up to the year 2007. Researchers estimate that there were 13.8 million cancer survivors in the US in 2010. Based on 2010 US Census Bureau data, this would be equivalent to the populations of Colorado and New Jersey being cancer survivors. With the advent of programs and initiatives directed at prevention and wellness, early screening, and genetic breakthroughs, it could be that our future will require us to care for more cancer survivors than patients undergoing active treatment.
All cancer care professionals must embrace cancer survivorship as a critical element of our specialty. With its escalation in prominence come concerns about detecting second and third primaries in cancer survivors, the potential predominance of new long-term effects, and a dire need for rehabilitation programs and an infusion of geriatric expertise.
How best to ready yourself for a new future of cancer care? Start by becoming attuned to your patients’ needs following the cessation of first-line treatment. Develop a better awareness of the cost of therapies that you are delivering. Keep up with issues in women’s health. Enhance your proficiency in eldercare. All these approaches are a must, as the future is now.
—Deborah A. Boyle