March 10, 2011 -- Julia J. Rowland, PhD, loves her job -- and she should. Its very existence is based around the good news in our ongoing war against cancer.
As director of the National Cancer Institute’s office of cancer survivorship in Bethesda, Md., Rowland sees firsthand how improvements in the early detection and treatment of many cancers are allowing growing numbers of people to call themselves “cancer survivors.”
New research in the CDC’sMorbidity and Mortality Weekly Report for March 11 shows that there are now nearly 12 million cancers survivors in the U.S., up from 3 million in 1971 and 9.8 million in 2001.
The increase is due to improvements in diagnosis, treatment, and follow-up care as well as the growing aging population.
“A lot of wonderful things have happened,” Rowland says. “This is very good news.”
The cancers with the greatest number of survivors include breast, prostate, and colorectal cancer, the new report shows. There were also dramatic improvements in survival rates for childhood cancers. “We certainly do need better outcomes for pancreatic, lung, brain, and ovarian cancers,” Rowland says.
In the new report, researchers used information on the number of new cancer diagnoses, follow-up data from National Cancer Institute’s Surveillance, Epidemiology and End Results Program from 1971 to 2007, and U.S. census data from 2006 and 2007 to estimate the number of people diagnosed with cancer who were still alive on Jan. 1, 2007. The analysis did not include non-melanoma skin cancers which are treatable and common.
Health Needs of Cancer Survivors
The growing numbers of cancer survivors have health needs and challenges that are not yet fully understood, Rowland says.
“These stats tell us this wonderful success story, but at what cost are we curing and controlling cancer?” Rowland says. Some cancer treatments do have significant side effects that may linger, she says.
“More and more people realize that some cancers are curable and others can be controlled,” Rowland says.
“Life is not over when you get cancer,” says Arica White, PhD, MPH, an epidemic intelligence service officer in the CDC’s division of cancer prevention and control in Atlanta.
“There is tons of research going on right now that is trying to understand this population's medical and public health needs and make efforts to meet the needs,” she says. “We want to encourage all Americans, including cancer survivors, to quit smoking, engage in regular activity, and eat healthy foods.”
Open Discussion of the Cancer Experience
Mary McCabe, RN, director of the Memorial Sloan-Kettering Cancer Survivorship Program in New York City, says “no one wants to hear the word cancer in terms of them or anyone that they love, but many public figures have demonstrated that not only can you live past diagnosis and treatment period, but you can live well and successfully. We all know people who have been treated for cancer and they are more open about discussing their own experience.”
“We certainly need more work in diagnosis and treatment of lung cancer, pancreas, and head and neck cancers,” she says. “These are areas where research is extremely important in improving diagnosis, survival, and the quality of that survival.”
“There has been an increasing focus on research on quality of care during treatment and afterward,” McCabe says.
Many of today’s cancer treatments are more palatable, she says. “We have so many more supportive care interventions including relaxation modalities and other types of therapies to help people through treatment.”
Better Understanding of Cancer Survival
“We need a formal plan about how to follow cancer survivors and not just for risk of recurrence and surveillance,” McCabe says. “We need to make sure we understand the late or long-term effects of their treatments so we can intervene and improve health.”
“There will be even greater numbers of survivors in the future and we need a better understanding of cancer survivorship, and what it entails for patients, their families, and caregivers,” says J. Leonard Lichtenfeld, MD, deputy chief medical officer for the national office of the American Cancer Society in Atlanta. “We need to intensify and provide more focus on our efforts to understand the issues associated with cancer survival.”
These may include research on some of the long-term effects of cancer therapy such as “chemo brain,” which is how many survivors refer to the mental fuzziness after chemotherapy, or how therapies affect the bones and heart in the long term. “We can’t say ‘you beat cancer’ and forget about it,” Lichtenfeld says.