Cancer

Through jointly written articles addressing various aspects of cancer survivorship offered from the point of view of each author's respective continent, the present supplement to Cancer is intended to stimulate an international dialogue among researchers for increased collaboration and aid in the development of a shared care model to improve the quality of life of cancer survivors worldwide.

The growing number of cancer survivors worldwide has led to the emergence of diverse survivorship movements in the United States and Europe. Understanding the evolution of cancer survivorship within the context of different political and health care systems is important for identifying the future steps that need to be taken and collaborations needed to promote research among and enhance the care of those living long-term after cancer.

Population-based cancer registries, which collect data on incident cases, play an important role in quality-of-life studies of survivor health. The results from this review indicate that studies tend to focus on the more prevalent cancers and that relatively few studies focus on the quality of life of elderly survivors, although they are understudied in clinical trials.

This article presents the contrasting European and American perspectives on cancer-related fatigue and its impact on functioning in survivors with regard to 3 sections (state of the art, intervention studies, and future areas of research), as well as research gaps and future directions for research and collaboration related to fatigue. Coordinated intercontinental efforts would increase understanding of the biological, psychological, and social mechanisms underlying fatigue and assist in future intervention studies as well as revisions to clinical guidelines.

Ongoing and future research should incorporate cardiovascular management principles into the long-term assessment of cancer survivors. Cardiac biomarkers and sophisticated imaging are becoming essential in the management of cardiac disease in cancer survivors; recognizing the increased cardiovascular risk of cancer therapy will remain of paramount importance.

In this article, the authors describe the similarities and differences in research and clinical priorities related to energy balance interventions among post-treatment cancer survivors in Europe versus North America. Exercise and weight control demonstrate great promise in preventing or ameliorating the chronic and late effects of cancer; however, future research in key strategic areas is needed to develop empirical guidelines that can facilitate the prescription of these interventions and effectively deliver them to all cancer survivors.

The authors provide an overview of the current state of scientific research about employment and cancer and provide a cancer survivorship and work model that integrates significant individual cancer-related, treatment-related, and work-related factors and outcomes.

Informal caregivers provide essential support to cancer patients and survivors. A broad overview of the state of the research and knowledge, both in the United States and in Europe, and observations on the directions for future research are provided.

Cancer rehabilitation is a rapidly growing specialty in both Europe and the United States, and there is tremendous variability in its delivery. Evolution in the field must include improving our understanding of the rehabilitation needs of survivors through the continuum of the cancer experience and developing a greater emphasis on cancer rehabilitation at comprehensive cancer centers so that we can best meet those needs.

Care planning, based on a holistic assessment of immediate and long-term goals for recovery and including surveillance guidance for disease recurrence and late effects, guides the provision of support, self-management, medical services, rehabilitation, and lifestyle advice. Survivorship programs, which implement these plans to promote and support health, are explored in this article, with key components identified and contrasted across the United States and Europe exploring the evidence base for benefit.

This article reviews health policy development over time for the United States and the European Union and the impact for cancer survivors. Differing political systems and beliefs regarding social welfare are reflected in past and future initiatives to improve cancer survivorship care.