Cancer Survivorship Oncology nursing is a specialized field dedicated to the care of patients diagnosed with cancer. As we progress through the new millennium, the landscape of cancer care is changing dramatically. More individuals are living with cancer than dying from it, highlighting the importance of survivorship care. This paper explores the concept of cancer survivorship, the steps taken globally to enhance the lives of cancer survivors, the funding available for their care, and the challenges faced by underserved populations and various ethnic groups.
What Is Cancer Survivorship?
Cancer survivorship refers to the phase of life that follows a cancer diagnosis and treatment, encompassing the ongoing health and well-being of individuals who have experienced cancer. The National Cancer Institute (NCI) defines cancer survivorship as including the physical, psychosocial, and economic sequelae of cancer diagnosis and its treatment (NCI, 2003). This concept has evolved from focusing solely on cancer treatment to emphasizing the long-term effects and quality of life for survivors.
The Evolution of the Term
The term “survivor” is derived from the Latin word “supervisere,” meaning to live more. Thus, cancer survivorship signifies living beyond a cancer diagnosis and encompasses a wide range of experiences, from living without disease to managing chronic health conditions resulting from treatment. The NCI has established cancer survivorship as a vital area of research, recognizing the unique needs of this population.
Steps for Cancer Survivorship Worldwide
The focus on cancer survivorship has gained momentum through the efforts of various organizations, particularly the National Coalition for Cancer Survivorship (NCCS). Founded in 1986, the NCCS aims to shift the narrative from being a victim of cancer to being a survivor living with the disease. This shift has led to increased attention on the survivorship experience and the development of programs to support cancer survivors.
Key Initiatives
In 1996, the NCI established the Office of Cancer Survivorship (OCS), acknowledging the growing number of individuals living beyond cancer. The OCS has funded numerous initiatives to stimulate research on long-term cancer survivorship, addressing critical areas such as follow-up care, psychological support, and health behavior modification.
Research Focus
Dr. Andrew von Eschenbach, in his annual report, identified key areas for survivorship research, emphasizing the importance of long-term follow-up for childhood cancer survivors and the unique challenges faced by underserved populations. This research is vital as it can help inform best practices for oncology nursing and improve the quality of care provided to cancer survivors.
Funded Care For Cancer Survivors
One significant initiative in addressing the needs of cancer survivors is the Childhood Cancer Survivor Study (CCCS). This comprehensive study, funded by the National Cancer Institute, surveys over 14,500 childhood cancer survivors diagnosed between 1970 and 1986. It provides valuable insights into the long-term effects of cancer treatment, including the incidence of secondary malignancies and quality of life outcomes.
Findings from the CCCS
Key findings from the CCCS include:
- Secondary Malignancies: The study revealed a statistically significant increase in secondary malignancies, particularly breast cancer and thyroid cancer (Neglia et al., 2001).
- Physical and Mental Health: Survivors reported reduced physical and mental health, experiencing limitations in daily activities compared to their siblings (Hudson et al., 2003).
- Educational Needs: There was an increased need for special education services among survivors (Mitby et al., 2003).
- Psychosocial Distress: Survivors exhibited higher rates of depressive and somatic distress (Zebrack et al., 2002).
These findings underscore the importance of targeted interventions and resources to support cancer survivors in managing the long-term consequences of their illness and treatment.
Cancer Survivorship and Underserved Populations
Cancer survivorship is not uniform across different populations. Survivors from underserved backgrounds, including low-income individuals, ethnic minorities, and the elderly, face unique challenges that can hinder their access to care and support.
Challenges Faced by Underserved Populations
- Access to Care: Many underserved populations encounter significant barriers to accessing healthcare, including financial constraints, lack of transportation, and limited availability of services in their communities.
- Cost of Treatment: The high cost of cancer treatment can deter individuals from seeking necessary care or adhering to treatment regimens (Brandeis et al., 2001).
- Educational Support: Limited access to educational resources and emotional support can adversely affect the ability of cancer survivors to navigate their health journey (Wilson et al., 2000).
- Cultural Considerations: Understanding the cultural beliefs and practices of underserved populations is essential for providing effective care and support.
Cancer Survivorship and Ethnicity
Disparities in Cancer Outcomes
Research has shown that cancer survivorship outcomes vary significantly among different ethnic groups. Ethnic minorities often face higher cancer mortality rates and lower survival rates compared to their white counterparts.
- Limited Research: A review of the current literature indicates that the majority of studies on cancer survivorship have focused on Caucasian populations, leaving a gap in understanding the unique experiences of ethnic minorities (Aziz & Rowland, 2002).
- Sociocultural Influences: Factors such as socioeconomic status, access to healthcare, cultural beliefs about illness, and family dynamics play a crucial role in how different ethnic groups experience cancer survivorship.
- Need for Culturally Relevant Research: The lack of culturally relevant measures to capture the concerns of cancer survivors from diverse backgrounds is a significant barrier to improving care.
Conclusion
As the number of cancer survivors continues to rise, it is imperative to address the multifaceted challenges they face. From understanding the unique needs of underserved populations to promoting research that encompasses the experiences of all ethnic groups, oncology nursing plays a crucial role in enhancing the quality of life for cancer survivors.
Investing in research, advocacy, and education will empower healthcare providers to offer comprehensive support, ensuring that all cancer survivors have access to the resources they need to thrive after their diagnosis. As the field of oncology nursing evolves, the commitment to improving the survivorship experience remains essential for the future of cancer care.