Cancer as a Chronic Illness
Cancer, and people with cancer, has been a regular feature in the news for as long as most of us can remember. And until recently, the focus of these news reports and headlines was often on "cancer: the death sentence." Several years ago, however, that perspective started to change. Now there is a steadily growing focus on survival and survivors. "Cancer: the chronic illness" is today a much more realistic approach to a cancer diagnosis.
Part I: Times are Changing
"Survivorship is a lot more common than it used to be, and has really picked up steam in the last three to five years," says Swedish medical oncologist Hank Kaplan, M.D. "Even if the cancer is not cured, we are seeing patients live much longer."
Statistics bear Dr. Kaplan out. The most recent report from the nation's leading cancer organizations shows cancer death rates decreased on average 2.1 percent per year from 2002 through 2004, nearly twice the annual decrease of 1.1 percent per year from 1993 through 2002.
These findings were published in the Annual Report to the Nation on the Status of Cancer, 1975-2004, which was released in late 2007.
Death rates decreased for the majority of the top 15 cancers in men and women. Important declines were noted for the three leading causes of cancer deaths in men: lung, prostate and colorectal cancers. In women, death rates from colorectal cancer and breast cancer decreased, while the rate of increase for lung-cancer deaths slowed substantially.
Most everyone would agree that the prospect of living with cancer is always preferable to the alternative. Still, having to deal with cancer as a chronic illness does pose its challenges.
"There are a multitude of issues involved in living with cancer," says Dr. Kaplan. "Some are more general and related to all types of cancer, while others are relative to specific cancers."
Issues that confront all long-term survivors range from recurrence and the uncertainty of never knowing if cancer will once again invade your body, to how to best deal with the financial, emotional and social repercussions of living with a chronic illness.
Issues related to the different kinds of cancer vary greatly, with one very common example being the intimacy issues and hormonal changes experienced by many breast-cancer survivors.
Part II: The New Normal
Regardless of the type of cancer involved, it's very important when living with cancer as a chronic illness to give voice to any issues you may have, says Dr. Kaplan. "You need to know that you are not alone - that support and help is available — and that there are specific remedies for your physical issues, as well as help for any other issues you may be facing. "You can always talk to your doctor," says Dr. Kaplan
Many people living with cancer also find that support groups provide a wonderful outlet and a great way to create their own "new normal," or a new way of looking at life and living it to the fullest, says Sandi Johnson,OSW, LICSW, oncology social work supervisor for the Swedish Cancer Institute (SCI).
Johnson, who leads the SCI's Living with Cancer support group, sees tremendous value in the interaction that takes place between group members, as they ask questions, discuss personal experiences and provide each other with the kind of support that, in most cases, only another cancer survivor could offer.
"When you are living with cancer — especially advanced cancer — it's in your face, every day, encouraging you to reevaluate and redefine your life and create that ‘new normal,' a way to successfully live with the cancer," says Johnson.
Johnson says that in Living With Cancer meetings, members of the group discuss such things as:
Share stories about their lives - what provides them with value and meaning
The importance of preparing a will or estate plan to ensure your family's future
What it's like to live with the possibility of running out of health insurance and other financial challenges
New drugs that may change the face of cancer treatment
Johnson agrees with Dr. Kaplan that it's very important for survivors to know they are not alone, and that help is available from many sources and in many forms. Getting that help is oftentimes as simple as asking.
"Everyone living with cancer as a chronic illness should look for quality in life," says Johnson. "Ask yourself, ‘What do I want in life?' Then do what you can to get it."
SCI's Living With Cancer support group meets every Thursday, from 1:30-3 p.m., on Swedish's First Hill campus. On the same day and time, there is also a companion support group for caregivers. For more information, call 206-540-0477.
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