Division of Hematology/Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48106, USA.
Int J Med Sci. 2012;9(2):163-73. doi: 10.7150/ijms.3827. Epub 2012 Jan 17.
The number of cancer survivors in the U.S. has increased from 3 million in 1971, when the National Cancer Act was enacted, to over 12 million today. Over 70% of children affected by cancer survive more than 10 years, and most are cured. Most cancer survivors are adults, with two-thirds of them 65 years of age or older and two-thirds alive at five years. The most common cancer diagnoses among survivors include breast, prostate and colorectal cancers. This review was conducted to better appreciate the challenges associated with cancer survivors and the opportunities healthcare providers have in making a difference for these patients.
Comprehensive review of literature based on PubMed searches on topics related to cancer survivorship, and associated physical, cognitive, socio-economic, sexual/behavioral and legal issues.
At least 50% of cancer survivors suffer from late treatment-related side effects, often including physical, psychosocial, cognitive and sexual abnormalities, as well as concerns regarding recurrence and/or the development of new malignancies. Many are chronic in nature and some are severe and even life-threatening. Survivors also face issues involving lack of appropriate health maintenance counseling, increased unemployment rate and workplace discrimination.
Advances in the diagnosis and treatment of cancer will lead to more survivors and better quality of life. However, tools to recognize potentially serious long-lasting side effects of cancer therapy earlier in order to treat and/or prevent them must be developed. It is incumbent upon our health care delivery systems to make meeting these patients' needs a priority.
自 1971 年《国家癌症法案》颁布以来,美国的癌症幸存者人数从 300 万增加到了 1200 多万。超过 70%的癌症患儿存活时间超过 10 年,其中大多数已被治愈。大多数癌症幸存者是成年人,其中三分之二年龄在 65 岁及以上,三分之二在五年内存活。幸存者中最常见的癌症诊断包括乳腺癌、前列腺癌和结直肠癌。进行本次综述是为了更好地了解癌症幸存者面临的挑战,以及医疗保健提供者为这些患者带来改变的机会。
根据与癌症生存相关的主题,在 PubMed 上进行全面文献综述,包括与身体、认知、社会经济、性/行为和法律问题相关的搜索。
至少有 50%的癌症幸存者患有晚期治疗相关的副作用,这些副作用通常包括身体、心理社会、认知和性功能异常,以及对复发和/或新发恶性肿瘤的担忧。其中许多是慢性的,有些则很严重,甚至危及生命。幸存者还面临缺乏适当的健康维护咨询、失业率增加和工作场所歧视等问题。
癌症诊断和治疗的进步将导致更多的幸存者和更高的生活质量。然而,必须开发出更早识别癌症治疗潜在严重长期副作用的工具,以便进行治疗和/或预防。我们的医疗保健提供系统有责任优先满足这些患者的需求。