Antoni van Leeuwenhoek, Netherlands Cancer Institute, Amsterdam, the Netherlands.
University of Amsterdam, Amsterdam, the Netherlands.
Yale J Biol Med. 2024 Jun 28;97(2):247-252. doi: 10.59249/FQVX3500. eCollection 2024 Jun.
In the Netherlands, one out of two people will be confronted with the diagnosis of cancer sometime in their life. Against this increased number of patients, a large proportion luckily can be cured. Today, a rather high proportion of people receive treatment to control cancer growth or stabilize the disease, sometimes, for the rest of their lives. If such long-standing treatment is administered for more than 10-20 years, the stage of cancer is presently often not referred to as "palliative" anymore, but much more often as "chronic." It could be argued that regardless of the cancer disease stage you are in and whether you are or can be cured, your cancer diagnosis nevertheless has become part of your life, including the experience of chronicity. Discussions surrounding the chronicity of cancer in the context of cancer are still ongoing. This is especially the case because "experiencing chronicity" is dependent on the type of cancer and is less applicable in cancers where the prognosis is often less than one year, such as is more frequently the case with lung or pancreatic cancer. In all situations, experiencing chronicity nevertheless brings along uncertainty, either with or without chronic stress. Combatting stress by choosing the right wording, maintaining an optimistic stance along with physical activity and/or psychosocial education seems important to optimize well-being and to stabilize tumor growth or remove the tumor. In conclusion, chronicity in the context of treating and caring for cancer seems a somewhat gray area. However, regardless in how we, as medical professionals, speak about cancer with long-standing disease trajectories (that sometimes even can be cured), it first of all seems important to approach, take care, and treat patients well. This can facilitate discussions with patients about their disease and disease experiences. Moreover, it can stimulate patients themselves to take responsibility for their own health, which can be of added value to the entire disease trajectory.
在荷兰,每两个人中就有一人会在其一生中的某个时刻被诊断出患有癌症。尽管患者数量有所增加,但幸运的是,很大一部分人可以治愈。如今,相当一部分人接受治疗以控制癌症的生长或稳定病情,有时甚至需要终身接受治疗。如果这种长期治疗持续超过 10-20 年,那么目前通常不再将癌症阶段称为“姑息治疗”,而是更多地称为“慢性”。可以说,无论你处于癌症的哪个阶段,无论你是否可以治愈,你的癌症诊断都已经成为你生活的一部分,包括慢性期的经历。围绕癌症慢性期的讨论仍在继续。这尤其是因为“经历慢性期”取决于癌症的类型,在预后通常不到一年的癌症中,如肺癌或胰腺癌,这种情况就不太适用。在所有情况下,经历慢性期仍然会带来不确定性,无论是伴有慢性压力还是没有慢性压力。通过选择正确的措辞来应对压力,保持乐观的态度,同时进行身体活动和/或心理社会教育,似乎对于优化幸福感、稳定肿瘤生长或消除肿瘤很重要。总之,在治疗和护理癌症的背景下,慢性期似乎是一个有些模糊的领域。然而,无论我们作为医疗专业人员如何谈论具有长期疾病轨迹(有时甚至可以治愈)的癌症,首先似乎都重要的是要妥善照顾和治疗患者。这可以促进与患者就其疾病和疾病经历进行讨论。此外,它可以激发患者自己为自己的健康负责,这对整个疾病轨迹都有额外的价值。