Pharmaceutical Systems and Policy, West Virginia University School of Pharmacy, Morgantown, WV, 26501, USA.
J Cancer Surviv. 2011 Jun;5(2):158-66. doi: 10.1007/s11764-010-0167-1. Epub 2011 Jan 15.
Breast cancer is the leading cause of cancer, and the second leading cause of cancer death in women. Due to advances in medicine, the 10 year survival rate is 80%, resulting in a large and growing number of breast cancer survivors. Definitions of cancer survivorship from a number of professional organizations and researchers vary, but the research is scant on the meaning of cancer survivorship to people with and without a prior cancer history.
Two studies were conducted (1) to compare individuals with and without a prior personal cancer diagnosis in terms of those who identified as survivors vs. those who did not identify as survivors and (2) to explore explanations of those with and without a prior personal cancer for the term cancer survivor. In Study 1, individuals were surveyed at cancer-themed community health fairs. In Study 2, women were surveyed at a breast oncology clinic.
In Study 1 comparing those with and without a prior cancer diagnosis, prior cancer history was the best predictor of survivorship identity, and only three individuals without a prior cancer history included family and friends as survivors. In Study 2 of those with a personal history, longer time since diagnosis, type of cancer (ductal), and comparative risk (higher) were associated with survivor identity.
Completion of treatment was seen as a 'rite of passage', and thus, may be seen as a shift from the patient identity, which may have negative connotations, to the positive identity of survivor.
Definitions of survivorship vary considerably, and caution should be used when applying the term to those who have no prior personal cancer diagnosis and to those who have had a more recent cancer diagnosis with a more severe disease course.
乳腺癌是癌症的主要病因,也是女性癌症死亡的第二大主要病因。由于医学的进步,10 年生存率为 80%,因此导致了大量且不断增加的乳腺癌幸存者。许多专业组织和研究人员对癌症生存的定义各不相同,但对于有和没有既往癌症史的人来说,癌症生存的意义的研究很少。
进行了两项研究:(1)比较有和没有既往个人癌症诊断的个体,在自我认同为幸存者与不自我认同为幸存者方面;(2)探讨有和没有既往个人癌症的个体对“癌症幸存者”这一术语的解释。在研究 1 中,在癌症主题社区健康博览会上对个人进行了调查。在研究 2 中,在乳腺癌肿瘤诊所对女性进行了调查。
在研究 1 中比较有和没有既往癌症诊断的个体时,既往癌症史是生存身份的最佳预测指标,只有 3 名没有既往癌症史的个体将家人和朋友视为幸存者。在研究 2 中对有个人病史的个体进行研究时,诊断后时间较长、癌症类型(导管)和比较风险(更高)与生存者身份相关。
完成治疗被视为“成年礼”,因此,可能会从可能带有负面含义的患者身份转变为带有积极意义的幸存者身份。
生存的定义差异很大,在将该术语应用于没有既往个人癌症诊断的个体和那些最近诊断出疾病更严重的癌症且疾病进程更严重的个体时应谨慎。