Cancer

In 2001, the National Cancer Institute's (NCI) Office of Cancer Survivorship and the American Cancer Society's (ACS) Behavioral Research Center forged a new partnership to champion the growing field of cancer survivorship research. As part of this partnership, the NCI and ACS made a commitment to cosponsor biennial scientific conferences that would bring together investigators, clinicians, and advocates engaged in conducting or promoting research among individuals and their families who had undergone treatment for cancer and their families. The first of these meetings was held June 2–4, 2002, in Washington, DC. This supplement to Cancer contains the expanded, peer-reviewed articles of most of the scientific talks given at this historic event.

The current article identified four pervasive assumptions about positive emotions and beliefs that may limit progress in understanding and promoting resilience among survivors of cancer, namely, that positive beliefs and emotions are absent, dangerous, delusional, or trivial among people managing life-threatening illnesses.

During the past 30 years, changes in treatment of children and adolescents with cancer have led to substantial improvements in their survival. However, there is limited information concerning the impact of treatment on their adult health status and quality of life. The ongoing evaluation of large and diverse cohorts of cancer survivors will aid in further identifying individuals who should be the target of innovative intervention strategies.

Data regarding problems in living for 752 patients from 3 states are presented from the implementation pilot for the American Cancer Society's prospective longitudinal study of the quality of life of adult cancer survivors who have been diagnosed with 1 of the 10 most commonly occurring cancers.

The authors studied mechanisms that can be used by cancer-control researchers and program staff to limit the divide between cancer survivorship initiatives and minority participation. They identified three strategies that must be used to address this divide effectively: the inclusion of minorities in clinical trials, intervention studies, treatment, and research programs; the development of culturally sensitive environments; and the ability to sustain minority participation.

The author describes the Family System Illness model, which offers a psychosocial map to address the challenges of cancer. It provides a set of terms and a common language within a framework that attends to the longitudinal, psychosocial pattern of a health condition within a multigenerational, life cycle, and belief system context.

For this report, the author reviewed randomized trials of group therapy interventions in patients with metastatic breast cancer. Five published trials provided clear evidence of a psychologic benefit; however, evidence for a survival benefit was not convincing.

To gain a better understanding of the determinants of quality of life and to create ways of optimizing the outcomes of patients with cancer and cancer survivors, the author's research group has focused on enhancing adaptation and providing patients with the skills for stress management that permit them to remain engaged in the pursuits that form their lives.

The transition from medical treatment to cancer survivorship (i.e., the reentry phase) is an understudied phase in the cancer trajectory. In this article, the authors have suggested several adaptive tasks of the reentry phase, described research on factors that predict positive adjustment during this phase, and provided examples of interventions to address the adaptive tasks of early cancer survivorship.

With improvements in cancer survival rates, there has been growing interest in the prevalence of unhealthy behaviors and interventions for modifying these behaviors among patients with cancer and survivors. The current review summarized the literature on modifying health risk behaviors (smoking, alcohol use, unhealthy diets, and sedentary lifestyle) among those treated for cancer.

The authors present a model that can assist oncologists and multidisciplinary teams in busy ambulatory settings to more readily identify cancer survivors who are distressed, whose quality of life is impaired, and who may benefit from further evaluation and treatment.

Curative therapy predisposes childhood cancer survivors to adverse health outcomes that affect their long-term quality of life and increase their risk of early mortality. Prospectively using a multidimensional, comprehensive approach that considers host-related, cancer-related, genetic, and lifestyle factors of survivors provides an optimal method of defining high-risk profiles for adverse outcomes across the age spectrum.

Ellen Stovall is President and Chief Executive Officer of the National Coalition for Cancer Survivorship, as well as a 30-year cancer survivor. In remarks delivered at the 2002 National Cancer Institute/American Cancer Society survivorship symposium, Ms. Stovall urged the attendees to continue to pursue and support research concerning survivorship issues.