Cancer survivor
NCCS later expanded the definition of survivor even further to include family, friends and voluntary caregivers who are "impacted by the survivorship experience" in any way.
[5] A third term, the diers, is used by some terminally ill patients who reject the claim that dying is part of survivorship or should be covered up with inappropriately optimistic language.
The typical previvor has tested positive for a BRCA mutation, learned that she is at high risk for developing breast cancer and ovarian cancer, or he is at high risk of developing prostate or male breast cancer, and is attempting to manage that risk through a combination of increased surveillance through mammograms, breast MRIs, pelvic ultrasounds, oophorectomy, bilateral mastectomy, PSA testing, MRI, and other medical procedures.
[2] Problems commonly include fatigue,[13] pain,[13] sleep problems,[14] physical side effects like lymphoedema,[15] weight gain,[16] anxiety and depression,[17] fear of cancer recurrence,[18] impacted sexual desire and or function, and impaired quality of life.
[20] The energy needed to cope with a rigorous treatment program may have caused them to disconnect from previous daily patterns, such as working, normal self-care, and housekeeping.
Some survivors become dependent on the attention and sympathy that they received during their treatment and feel neglected when life returns to normal.
[30] Issues of pain and physical ailments have been hypothesized as major contributing factors in cancer survivors experiencing this suicidal ideation.
As of 2012[update], there are no psychometrically sound measures of this fear, which makes research into the effectiveness of treatment protocols difficult to interpret.
[41] Cancer survivors and their families have often incurred significant expenses or had to forego the opportunity to work regularly during treatment and recovery.
[5] As described by Gayle Sulik in her book Pink Ribbon Blues: How Breast Cancer Culture Undermines Women's Health, the ideal survivor is bravely committed to mainstream medicine and optimistic or even certain of a physical cure.
The ideal survivor, like a superwoman who simultaneously manages her home, family, and career, struggles valiantly to prevent cancer from affecting loved ones by appearing, behaving, and working as much as possible.
Once the immediate crisis is past, the person may feel strongly pressured to donate time, money, and energy to cancer-related organizations.
Cancer survivors frequently need medical monitoring, and some treatments for unrelated diseases in the future may be contraindicated.
[43] These are personalized documents that describe the person's diagnosis and treatment in detail, list common known side effects, and specifically outline the steps that the survivor should take in the future, ranging from maintaining a healthy weight to receiving specific medical tests on a stated schedule.
[2] This means that cancer survivors at low risk of future problems will be monitored mainly by the primary care provider, according to medical guidelines.
[2] Large centers may have a multi-disciplinary model, in which a team made up of providers in different specialties work together to meet all of the cancer survivor's needs in the same clinic.
The Children's Oncology Group recommends that monitoring should include periodic follow-up and screening by a clinician familiar with these patients' risks.
Improving these patients' longevity requires recognition and treatment of illnesses associated with late effects in the decades after therapy for childhood cancer.
For example, survivors of childhood cancer may have more difficulty than typical with breastfeeding and require more support to undertake this health-promoting activity.
[50] One challenge to achieving this goal is that childhood cancer survivors are both very adaptable and accustomed to denying difficulties; as a result, they tend to minimize their symptoms.
[47] Health behaviour interventions may be able to reduce the impact of some of the chronic issues cancer survivors face by improving their dietary intake.
[57] In addition, AYAs may experience greater difficulties adhering to treatment, which may negatively impact future outcomes.
For example, AYA survivors report that their education, employment, sexual functioning,[59] marriage, fertility, and other life values are impacted by their cancer.
Typically, most of these factors are stable for most older adults, and when they experience any changes, it would usually occur in one or two aspects of their life at a time.
This reality underscores the importance of a smooth transition from child-centered to adult-focused health care services through which they are consistently managed.
[65] The US Affordable Care Act (ACA) in 2010 makes it illegal for health insurance providers to deny coverage for a pre-existing condition, such as previously having survived cancer.
[66] Studies among endometrial cancer survivors show that satisfaction with information provided about the disease and treatment increases the quality of life, lowers depression and results in less anxiety.
[72] Physical activity improves quality of life among a range of cancer survivors[75] and may also assist with cancer-related fatigue and common co-morbidities.
[80][81] Digital behaviour change interventions can be successful at increasing physical activity and may also help with diet in cancer survivors.
[82] In breast cancer survivors, home-based multidimensional survivorship programmes have short-term beneficial impacts on quality of life and can reduce anxiety, fatigue and insomnia.
