"Missing the wood for the trees" in cancer management- "Cancer survivor-ship" a grossly ignored component in most parts of world

The battle of cancer management is quite tricky- while you may win against this disease, it may leave a person with some long term complications- the appropriate analogy is “wounds heal- scars remain”

It is quite understandable that most of us focus on quality of life (QOL) in terminally ill cancer patients respecting the dictum “ add life to years – not years to life”- meaning there by “it is important to focus more on the quality of life ( though shorter), than just prolonging the life with suffering”

When QOL is given importance in stage 4 disease, why not in early stage diseases, which may have long term complications.

This leads to an important concept called “Cancer Survivorship”. While there may be many ways to define this- the most comfortable one for me is “ a focused approach on the health and well-being of a person with cancer from the time of diagnosis until the end of life.”

To elaborate more on what constitutes the survivorship, let us understand more on each of the the steps

Q1. What are the phases of cancer survivorship?

1. Acute survivorship, including the time of diagnosis (shock) and treatment.

2. Transitional survivorship, when treatment has ended, but survivors may still feel anxious,

depressed, and isolated as they engage in ‘watchful waiting’ to see if cancer will return.

3. Extended survivorship, which comes in three forms: cancer-free (treatment-free remission); maintained remission (staying cancer-free due to ongoing therapy); or living with cancer (as a chronic, advanced disease that requires continued treatment).

4. Permanent survivorship, which has four subgroups, including survivors who are cancer-free and asymptomatic; are cancer free but with long-term/late problems (such as fatigue or depression); develop second cancers (unrelated to earlier treatment); or have secondary cancers (related to earlier treatment).

These transitions are quite often emotionally taxing, and may not be smooth. The journey ‘fight mode’during treatment to ‘I hope it doesn’t come back mode’ after treatment” is quite challenging and demanding – both, financially, emotionally and physically.

Embracing a “ new normal”-It is not easy to adjust physical and emotional changes after cancer treatment and tips on coping with fear of recurrence.

The interesting reeds from NCI elobortaes more on the “Feelings and Cancer”. It is important to understand that cancer can bring up a wide range of feelings a person not used to dealing with. It can also make existing feelings seem more intense. They may change daily, hourly, or even minute to minute. This is true whether someone is currently in treatment, done with treatment, or a friend or family member. These feelings are all normal. They range from

Overwhelmed, Denial Anger, Fear and Worry, Hope, Stress and Anxiety, Sadness and Depression, Guilt, Loneliness, Gratitude. While it may be out of scope to elaborate on each of them, we need to focus on “Ways to Cope with Your Emotions”

The most important is to Express Your Feelings- It is proven medically that when strong feelings like anger or sadness are expressed , one could let go of them easily. Either one on one or in groups with the company that makes them more comfortable and those who can understand the same. Sometimes writing them down is a good way. Most important to is to Choose When, where and with whom to Talk about Your Cancer

The next step is to look for the Positive “ a small good in the worst of phases, may make you smile”. But we ought to use a focused energy on wellness to achieve this One common thing people do is “Blame themselves for Cancer”- while it is important that lifestyle contributes to cancer, the medical science is clueless as of now “ why only a few persons with the same habits are getting cancer”- so it may not be right to always blame oneself. Remember, cancer can happen to anyone.

Last but not least is to find Ways to Help Yourself Relax- starting from yoga to meditation, there are multiple options, chose the one that is most apt for you and be as Active as You Can and Look for Things You Enjoy and What You Can Control While a lot can be chalked down on the

? Late Effects of Cancer Treatment

? Family Issues after Treatment

? Care for Childhood Cancer Survivors

? Follow up medical care

This in itself becomes quite more. For any further details, you may refer to authentic resources like ASCO, NCI, NHS, ISO etc.