Researchers throughout the United State are currently investigating the many different aspects of cancer survivorship, from quality of life and pain management, to psychological and social issues, to economic effects. And though the research is varied, the overall goal is generally the same: to improve the lives of cancer survivors.
The following information, which was compiled by the National Cancer Institute (NCI), a division of the National Institutes of Health (NIH), offers a broad overview of some of the primary survivorship research topics:
Chronic and Late Effects of Cancer and Its Treatment
Few cancer treatments are benign; most carry the potential to cause adverse long-term and late effects. As children and adults with a history of cancer live longer, and data from research studies supported by the NCI mature, more of these risks are being reported and documented.
Risks include, but are not limited to, neurocognitive problems, premature menopause, cardiorespiratory dysfunction, sexual impairment, infertility, chronic fatigue and pain syndromes, and second malignancies. Research shows that many survivors also experience psychosocial problems, including fear of recurrence, poor self-esteem, anxiety and depression, employment and insurance discrimination, and relationship difficulties.
A vital area of survivorship research looks at interventions, or how to prevent and/or reduce the adverse outcomes of cancer and its treatment while promoting better health and better physical, psychological and social functioning. The importance of this research is reflected in the fact that in late 2006 almost 40 percent of the grants that were funding survivorship research contained an intervention component.
Healthy Lifestyle and Behaviors
A relatively new but fast-moving focus of survivorship research is on the lifestyle choices and behaviors of survivors following cancer treatment. This includes research on the behaviors that affect cancer risk (e.g., physical activity, alcohol use, sun exposure, and smoking) and promote well being (e.g., exercise, a healthy diet), as well as research on interventions to improve health outcomes after cancer and its treatment.
Many researchers believe that the threat to life imposed by a cancer diagnosis can be life altering, particularly in the area of health behaviors. As an example, targeting a lack of physical inactivity following cancer and its adverse impact on weight and health, a number of researchers are using exercise interventions to improve survivors' emotional and functional well being.
While it is not clear if these types of interventions will alter the course of cancer, they do hold the promise of reducing cancer-related morbidity and improving quality of life. They also appear to have enormous appeal to survivors eager to reduce the perceived stress in their lives and "take control" of their bodies after cancer.
Benefit Finding and Post-traumatic Growth
Historically, survivorship research has sought to identify and address the adverse physical and psychosocial consequences of the disease. An emerging body of evidence suggests that cancer survivors, similar to survivors of other traumatic life events, also experience positive life changes following a cancer diagnosis, and further, that these positive effects of cancer frequently coexist with the negative.
Studies have shown that many survivors identify their experience as an event that has the potential to help them make personally meaningful health and lifestyle changes. These studies also suggest that for many survivors, the ability to identify positive aspects of the cancer experience may help them make lifestyle adjustments.
Researchers are beginning to appreciate the impact of cancer on the function and well being of the millions of family members affected by the disease, many of whom may themselves be at increased risk for cancer due to shared cancer-related genes, lifestyle, and/or toxic exposures.
Although social support is widely recognized as an important buffer to negative health events, attention to the role of family caregivers and other household members on survivors' health-related outcomes, as well as the impact of cancer on the health status of family members and caregivers, has only recently received adequate research attention.
Learning about Research Results
Research into these and many other areas of cancer survivorship is ongoing, with results periodically released by the various research organizations. One good source of information is the National Cancer Institute's Office of Cancer Survivorship (go to www.cancer.gov and type "Office of Cancer Survivorship" into the search engine). In addition, we will report on research findings of interest to survivors in future issues of Life After Cancer.
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