Cancer as a Chronic Illness

It’s time to celebrate! Cancer survival rates in New South Wales are amongst the best in the world -- on average there is a 65 percent five-year survival rate for men, and 66 percent rate for women. Early detected breast cancers are up to a 97 percent five-year survival rate. So it appears that screening and population education is making an impact in terms of catching cancers early enough that people don't die of them anymore.

But this creates its own problems. I'm happy that more people are surviving cancer, but it is now more commonly being seen as a chronic illness, like diabetes or emphysema, where an acute episode is treated and then a person goes back to living day-to-day with their cancer.

Chronic illnesses are expensive, both at an individual level and a social level. I'm not denying that surviving cancer is a tremendous achievement, both on a personal scale and from the point of view of medical science, but is our Western medical framework keeping up with survivorship rates?

Much of the focus on care is getting people into treatment and possibly out the other end. Palliative and end-of-life treatments are getting better and there is much discussion on the patient and family's requirements at this stage.

But what about survivors?

Possibly the pediatric and AYA community is doing this better than the adult community because it's something that they've had to deal with. We're aware of the survivorship issues surrounding the younger groups, but what do we know about the survivorship needs of the 50-year-olds? How does a middle-aged person who has taken time off work to have a cancer treatment get back into the workforce when we know that a healthy person of the same age struggles to find a job (too old to employ, too young to retire).

It's something worth thinking about and something that is becoming more obvious. The adult cancer survivor not only has cancer to deal with, but needs to return to being a socially functional person. I don't know what pathways or programs others have in place to support adult cancer survivors, but things could be better.

Support groups continue to be the mainstay for promoting normalcy and support for "the new you" (as one patient finishing her treatment described it). The Peter MacCallum Institute in Melbourne houses the Australian Cancer Survivorship Centre, which is trying to improve services for survivors, through research into needs. On a local level there is recognition for the need for screening for the supportive care needs for patients finishing their treatment.

As treatments improve and more people survive their cancers, we must consider how we can support patients and their families cope with an illness that may hang over them for many years. Cancer as a chronic illness may turn out to be as big a challenge as cancer in its acute form.

To learn more, watch the ABC report Positive news in cancer survival rates.