Surviving cancer starts at diagnosis and continues after treatment – earlier survivorship care can help patients feel better and live longer

The article explains that cancer survivorship begins the moment a person is diagnosed with cancer, not just after treatment ends. This is a shift from the common belief that survivorship starts post-treatment. Survivorship refers to the patient’s entire experience with cancer, including its physical, emotional, and social effects. For example, a person diagnosed with cancer is considered a survivor from that point onward, even if they are still undergoing treatment. The focus of survivorship care is to address the complex needs of patients beyond just medical treatment, such as coordinating care and promoting overall well-being. This approach aims to support patients throughout their cancer journey, not just at the end.

Survivorship care is a type of healthcare designed to meet the needs of cancer survivors, which can include physical, emotional, social, and practical challenges. It involves a team of specialists working together to provide comprehensive support. For instance, in a survivorship clinic at UPMC in Pittsburgh, Pennsylvania, the team includes surgeons, nurses, swallowing therapists, a physical therapist, a dental care team, and a dietitian. These professionals address issues like swallowing difficulties, nutrition, dental health, physical function, and mood. The clinic offers all services in one location during a single visit, often under one copay, and provides a care plan to coordinate communication among the survivor’s oncology team and primary care clinician. This ensures ongoing support as the survivor’s needs evolve over time.

The article highlights that starting survivorship care earlier, even before treatment ends, can lead to better outcomes. For example, in a study of 471 head and neck cancer survivors, 62% of those who attended a survivorship clinic before completing radiation finished treatment on time, compared to 48% of those who did not attend. At three years after treatment, 60% of patients seen in the clinic before completing radiation were alive and cancer-free, versus 39% of those not seen before completion. The study suggests that early survivorship care may improve treatment completion and long-term survival, though further research is needed to confirm these findings. Currently, most survivorship care is offered after treatment, partly due to accreditation requirements from the American College of Surgeons Commission on Cancer, which mandates at least three services for survivors post-treatment.

Despite the benefits of survivorship care, access to these services is often limited. A 2024 survey of 384 accredited cancer facilities found that only 1 in 5 programs estimated that most eligible patients receive survivorship care. Even when services are available, they may not address all needs comprehensively. For head and neck cancer survivors, nearly all clinicians routinely check for cancer recurrence, swallowing issues, and thyroid function. However, only about half address psychological symptoms like anxiety and depression, and fewer than 1 in 3 address body image or sleep problems. Barriers include communication gaps, lack of referrals, and limited staffing in some hospitals, which can delay or prevent patients from receiving necessary support.