Survivorship

A cancer survivor is anyone who is living with or beyond a cancer diagnosis. Survivorship can be defined as:

"…cover[ing] the physical, psychosocial and economic issues of cancer, from diagnosis until end of life. It focuses on the health and life of a person with cancer beyond the diagnosis and treatment phases. Survivorship includes issues related to the ability to get health care and follow-up treatment, late effects of treatment, second cancer and quality of life. Family members, friends and caregivers are also part of the survivorship experience."

Cancer survivors are living longer and experiencing long-term side-effects of cancer and its treatment; indeed, cancer is now being considered as a chronic condition by many people. This requires a change in service provision towards that laid out in the National Cancer Survivorship Initiative (NCSI) vision document. This will help enable those living with and beyond cancer to access the care and support they need to lead as healthy and active a life as possible, for as long as possible.

The survivorship pathway starts at the point of diagnosis. Its holistic and all-encompassing nature means that multiple aspects of peoples' lives need addressing within the survivorship umbrella, from work, finance, and personal relationships through to managing pain, fatigue and making positive lifestyle changes, such as promotion of a healthy diet and physical activity.

The LCA survivorship pathway group is improving key processes and services which will help identify and address the individual needs of each person, including:

  • holistic needs assessment and care planning
  • treatment summaries
  • risk-stratified follow-up
  • rehabilitation 
  • health and well-being clinics/information sharing forums

Holistic needs assessment

To improve their overall experience, holistic needs assessments (HNA) should be part of every cancer patient's care. They can be used to identify a person's areas of concern. It is vital that these are discussed with the patient to develop an individualised care plan with on-ward referrals made as required. This process allows for greater control and choice and supports people to self manage their condition.

Treatment summaries

These summarise the patient journey, from diagnosis through to the end of their treatment. They provide details of any on-going medication, and possible symptoms that may occur in the future. The summary explains whether these are a usual response to their treatment(s), or a possible sign that the cancer may have reoccurred. The summary provides details of who to contact in this instance, and also who to contact for advice/information if they have concerns. These have been developed largely to help ensure the patient's GP is able to best support them in the community, but also to provide the individual with important information they may need in other healthcare settings.

Cancer rehabilitation

Cancer rehabilitation "involves helping a person with cancer to help him or herself to obtain maximum physical, social, psychological, and vocational functioning within the limits imposed by disease and its treatment." (Cromes 1978, in Fialka-Moser et al, 2003)

Specialist rehabilitation services should be available to all patients based on clinical need assessed by informed professionals and the patient. Services should be compliant with the National Cancer Rehabilitation Pathways and Rehabilitation Peer Review requirements.

Follow-up services based upon evidenced stratified risk

Follow up after cancer treatment should be developed using evidence-based risk stratification as described by the National Cancer Survivorship Initiative. A patient's level of risk of recurrence, risk of developing consequences of being diagnosed and treated for cancer and risk of psycho-social morbidity should be assessed. Significant work has been undertaken nationally to help drive the change to much current practice.

Health and well-being clinics/information sharing forums

It is acknowledged that in order for people to be able to self-manage their on-going health needs after cancer, they need to be given the right information at the end of treatment and to know how and if or when to re-access services. One solution to this is health and well-being clinics, or similar. These are groups which are run by healthcare professionals, which give people the chance to get information, to start making positive lifestyle changes, and to ensure they have all the tools the need to start living beyond their cancer diagnosis and treatment.

Useful websites

Further information on survivorship can be found at:

Please note that this list is not exhaustive. There are many other websites available including:

  • other cancer charities
  • your local hospital
  • patient support groups

Please remember that anyone can put information on the internet. If you are unsure about what you read, please speak to a trusted healthcare professional for clarification.

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