The ‘end-of-treatment’ bell rings signifying the end of treatment. But what exactly does this mean for those who have lived through cancer? Does the end of treatment, the final chemotherapya cancer treatment that uses drugs to kill or slow the growth of cancer cells, while minimising damage to healthy cells or radiation dose mean the end of living with cancer and all its consequences? As we are finding out, a new phase of challenges may just be beginning.
Qualitative studies and anecdotal data have shown that the impact of a cancer diagnosis can be ongoing for years after finishing the active treatment. After-effects not just physical but mental, financial, emotional and practical can carry on for years after diagnosis.
Cancer survival rates are increasing steadily by the year, thanks to screening programs, faster diagnostic processes, and better awareness. This means that the number of people living beyond their treatment and the number of years lived beyond treatment are also rising rapidly. And as therapies continue improve, we can expect survivorshipthe ongoing care and support people with cancer receive after cancer diagnosis and treatment to become the norm.
However, as we progress towards that point, we have a growing population dealing with fallout of life after cancer –an existence beyond a serious, life-threatening disease, where daily activities consist of hospital visits and doctors’ appointments, where careers go on hold and where there is a dependence on others’ care. How to exist with fear of relapse or metastasis? How can you integrate your changed physicality and emotional self with what remains of your old life? How do you manage those altered emotions, and relationships?
Body image, cognitive functioning, health behaviours, mental health, hypervigilance, sleep problems, physical functioning, pain, social functioning and sexual problems are commonly reported as altered by a cancer experience.
When you look at it like that, of course there will be adjustment problems and gaps in support. For many there may be a long period of dealing with frustration, sadness, anger and worry ahead. And it’s generally accepted that recovery may take just as long as the treatment did. These emotional and physical impacts from the cancer and its treatments must be addressed with better healthcare structures.
The focus on the survivorship phase of a cancer experience has become its own discipline in cancer care to address the needs of those living beyond cancer. The cancer care continuum is working cooperatively toward the development of models of care delivery post treatment, and multi-disciplinary teams are addressing the reality and gravity of post-cancer survivorship issues.
Setting patients up for success post-cancer treatment with the best possible quality of life, physical and emotional well-being is complicated but essential as the need for guidance and support around “what comes next” increases.