Living Life to the Fullest: An Essential Goal

Living life to the fullest is an essential goal for everyone, and cancer survivors deserve no less. Almost 12 million cancer survivors in the US today are living longer and experiencing the long-term consequences of their disease and its treatments. Nurses will be providing much of the care that these survivors will require. The quotation cited in the article by Dr. Haylock articulates the problems of survivors living with advanced cancer. The words “I can’t die yet, I still have frequent flier miles”

illustrate the positive voice of this patient and of so many survivors. Nurses are trained to provide holistic care to meet the physical, psychological, social, and spiritual needs of patients. Research focused on the patient with advanced cancer who is dealing with treatment toxicities and an array of symptoms is a challenge. As Dr. Haylock describes, individuals living with advanced cancer have “unique and unmet needs.” Exploring these needs and the ways in which comorbidities and aging affect this patient population complicates the issues even further. Studies that document patients’ symptoms and concerns beyond 5 years are very important. Researchers focusing on this population can attest to the difficulty in recruiting those patients.

There is a difference in the treatment regimens that patients received in the 1970s, 1980s, and 1990s, and therefore the effects encountered also will be different. New vaccine therapies require studies to document associated symptoms. Studies will include a wider trajectory for future research in an effort to provide proactive and evidence-based care, and to better understand treatment outcomes and develop standards of care. Using our current SEER (Surveillance, Epidemiology and End Results Program) data base and National Cancer Data Base and broadening our studies to identify issues from a global perspective will help us move our understanding of the needs of the advanced cancer patient forward faster and more efficiently.

Survivorship Care Plans are being used to improve care and are an important recommendation from the IOM, the Lance Armstrong Foundation, the American Society of Clinical Oncology, and other national groups. Multiple templates have been developed, and the web sites of OncoLife, the Lance Armstrong Foundation, and Journey Forward offer excellent tools to help patients and healthcare professionals tailor care plans to address specific needs. They also provide valuable tools for sharing information with patients, primary care physicians, and oncologists.

Oncology nurses recognize the need to be part of the solution in optimizing management of survivors living with advanced cancer. It is important that we participate in policy development and research planning to help ensure that the multidisciplinary care of this patient population is appropriate and supports the best possible quality of remaining life.

References:

1. Hewitt M, Greenfield S, Stovall E: From Cancer Patient to Cancer Survivor: Lost in Transition. Institute of Medicine, Washington, DC, 2006.
2. Avis NE, Deimling GT: Cancer survivorship and aging. Cancer 113(12 Suppl):3519–3529, 2008.
3. Mao JJ, Armstrong K, Bowman MA, et al: Symptom burden among cancer survivors: Impact of age and comorbidity. J Am Board Fam Med 20(5):434–443, 2007.
4. OncoLife Survivorship Care Plan [2009]. Available at: www.oncolink.com. Accessed on May 4, 2009.
5. JourneyForward Survivorship Care Plan Builder. Available at: www.journeyforward.org. Accessed on May 4, 2009.
6. A National Action Plan for Cancer Survivorship: Advancing Public Health Strategies. The Lance Armstrong Foundation and the Centers for Disease Control and Prevention. Available at: http://www.livestrong.org/atf/cf/%7BFB6FFD43-0E4C-4414-8B37-0D001EFBDC49%7D/NationalActionPlan.pdf.