Survivorship in oncology is the focus of the well-being of an oncology patient from the time they are diagnosed with cancer until the end of life. This life includes the social, emotional, psychological, and financial effects that start at the beginning of diagnosis and commences up to the final stage of the disease (Nekhlyudov et al., 2019). The survivorship also encompasses issues related to cancer care and follow-up treatments. Family members are also considered to be a part of the process. The number of cancer survivors has drastically increased in the United States from 3 million to 13.7 million, and the numbers are expected to rise to approximately 18 million in 2022 (Shapiro,2018). The increase in the cancer rate is a worrying case that needs urgent intervention by the relevant authorities.
The main contributors of the striking number are the increased cancer incidence among the aging population, earlier detection, and enhanced treatment of various cancers. Of the cancer survivor, 45% are people aged 70 years and older as one in 5 of individuals older than 65 years is a cancer survivor. Around 5% of the survivors are below 40 years, and less than 1% are children (Shapiro, 2018). The most common cancer includes prostate, breast, melanoma, colorectal cancers, and 60% of the cancer survivors. 64% of the survivors were diagnosed approximately five years ago or older, 15% were diagnosed over 20 years ago, and 5% were diagnosed over 30 or more years ago (Shapiro,2018). The paper will highlight the psychosocial stages and the aspects of survivorship.
Acute Stage
The acute stage is also known as the immediate stage. It begins at the time of diagnosis, workups and continues through the initial phase of treatment. The survivor is usually referred to as the patient, and the primary focus is always on physical survival. Without any prior training, the clients must make complicated decisions full of fear, anxiety, and pressure. Most of the ailing individuals rely on the findings of the healthcare providers, while others may ask for explanations to make informed decisions (Nekhlyudov et al., 2019). Most supportive services are usually available, such as family support systems, patient networks, libraries, hotlines, medical teams, and counselors. Once the treatment ends, the picture changes dramatically.
Chronic Stage
When the disease responds to the initial treatment, the survivor moves to the chronic stage, which requires watchful waiting as the survivor monitor and observes their bodies for signs of recurrence. Uncertainty about the future arises, and medical-based support is no longer available. The recovery constitutes dealing with the emotional and physical effects of the treatment. The person may not feel completely healthy, and it’s usually tricky to term one as a survivor (Nekhlyudov et al., 2019). The individuals think happy for completing the treatment and sad as they do not know what the future holds. During this time, the need for care has recently received attention as the peers and the community replace the institution’s support; thus, the recovery entails getting physical and psychological stamina.
Permanent Stage
The individuals receive a particular state of comfort and trust, and survivors enter a permanent state of trust. It is usually equivalent to established remission or cure. The person undergoes gradual evolution from the stage of surviving to the stage of reviving. Others deals with the chronic and debilitating effects of therapy. Although the long-term survivors may not have the physical evidence of the disease, the life-threatening experience of being diagnosed with cancer is never forgotten (Ryans et al., 2021). The long-term support is not predictable due to scanty evidence on the specific guidelines to follow and lack of healthcare needs tailored to meet the needs of the adults. In this scenario, the individual is praised as one who has have overcome an adversary. At times, they may not want to raise complaints as society views them as healthy. Symptoms of psychosocial and biomedical distress should be addressed with seriousness. At this stage, the survivors need access to care and specialists who understand the consequence of the therapy and the issues that arise.
Psychosocial Aspects
The social and psychological adaptability of an individual to surviving cancer depends on a variety of issues. Some of the factors include age, the type of cancer and the staging, the duration of the treatments, how an individual respond to treatments, and the side effects of the therapy. However, the permanent disabilities and the already disfigured body are also pivotal factors that affect the psychosocial well-being of the survivor. The other critical aspects include the psychological variables, the individual life stage developments, the previous illness experiences, and what psychological strengths and weaknesses are brought to cancer experiences (Ryans et al., 2021). The kind of coping mechanisms used in the personal crisis will depend whether an individual has a prior history of depression, anxiety, or other mental health disorders. Other management strategies will be determined by the individual’s self-esteem, their independence and motivation, and also their interaction skills.
When the various aspects of social functioning are added, various social variables need to be addressed. The sociodemographic include marital status and social support systems, education, ethnicity, marital status, religious belief, and cultural beliefs (Nekhlyudov et al., 2019). Other influences that need to be ascribed are social roles related to the individual in question. Despite this wide range of variability, various cases occur along the continuum of survivorship (Molokwu et al., 2017). Thus, the common experiences are the collective problems shared with individuals with cancer.
Need of Cancer Survivors
Various comprehensive studies were conducted regarding the needs of cancer survivors. In these investigations, the identified and unmet needs of the cancer survivors included emotional and social issues, economic needs, medical staff needs, and communication needs (Nekhlyudov et al., 2019). Other investigations have pointed out that the greatest needs of cancer survivors were prompt medical attention, emotional needs, effective pain management, and financial issues, and practical assistance. Some evidence has also shown that cancer survivors’ needs are often not met. The necessities include reassurance control, control information, and the need to talk about the cancer experience (Ryans et al., 2021). These requirements are essential in these patient’s recovery process
Lack of Societal Norms of the Cancer Experience
Many of the problems that arise due to cancer are due to a lack of knowledge and the skills needed for negotiating the cancer experience. Cancer survivors experience a series of crises for which the chronic problem-solving skills are not adequate and do not cause the previously achieved balance state. This makes cancer normless for many individuals in society (Ryans et al., 2021). Anomia is a sudden mind state which is characterized by unexpected alteration in one state of mind. It is categorized by an abrupt loss of purpose, shock, anxiety, and depression. Added to this is the stigma that arises due to the diagnosis of cancer. Individuals with cancer may not know how to talk or relieve the stress and depression associated with the various stages and the uncertainties of life.
Sick individuals need information, but they may not know how to ask about it because of the anxiety and shock. Cancers remain stigmatized despite the increased survival rates, and persons with cancer must learn how to deal with societal attitudes and prejudices (Ryans et al., 2021). Eventually, most people know what to expect medically, enabling them to navigate various healthcare systems.
Problems with Reentry
As the active cancer treatment ends, people with cancer therapy ends, and the successful end of cancer therapy treatment does not signify the end of their cancer issues. The period of waiting to see whether the treatment will manage the disease and some active interventions creates anxiety and fear (Nekhlyudov et al., 2019). The individual enters the neutral time characterized by fear, anxiety and other social issues, and lack of safety signals hoping that the disease will not be exacerbated. And most of the patients face identity crises related to the illness. They may not term themselves as cancer patients since they are not on active treatment, and the reentry of their usual roles is affected (Anderson et al., 2021). The patients have problems with assuming previous roles and responsibilities with readjustment and re-adaptation to life. It disrupts the patterns of everyday life, and an individual requires readjustment to life.
Employment Discrimination
The cancer survivors have limited ability to retain their jobs before and after therapy. Even many who can work experience discrimination and can be demoted or benefits limited even when they can work. Approximately 25% of individuals with a history of cancer experience some form of discrimination (Molokwu et al., 2017). Cancer survivors should be given equal chances with the general population as some can work, and when supported, they can maximally assume their roles.
Living with Uncertainty
Most cancer survivors have to live with vulnerability associated with physical compromises and a lack of hope for the future. Such individuals always do not understand if cancer can be exacerbated. The family members live with fear and overprotectiveness even after the individual has completed the treatment (Molokwu et al., 2017). Studies have shown that even and year after active treatments, the survivors live with the fear and watch the activity level of an individual even when they do not have complaints.
Conclusion
Cancer survivors experience many issues related to psychosocial well-being. Most of the survivors experience anxiety, fear, depression, and a lack of certainty on what the future holds for them. The three-stage of survivorship has their issue that arises at each stage. Cancer survivors always wish that the disease would not exacerbate. They experience stressful moments and are always careful in each of the activities. The family members always protect them. Evidence has shown that cancer patients in the initial stages have inadequate information about the disease in the initial stages. Still, at the stages of survivorship progress, they are equipped with knowledge and know-how to navigate various healthcare systems. Survivorship care and guidelines for both adults and pediatrics should be followed to ensure that cancer survivors’ psychological well-being is followed.
References
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Molokwu, J., Shokar, N., & Dwivedi, A. (2017). Impact of targeted education on colorectal cancer screening knowledge and psychosocial attitudes in a predominantly Hispanic population. Family & Community Health, 40(4), 298-305. Web.
Nekhlyudov, L., Mollica, M. A., Jacobsen, P. B., Mayer, D. K., Shulman, L. N., & Geiger, A. M. (2019). Developing a quality of cancer survivorship care framework: Implications for clinical care, research, and policy. Journal of the National Cancer Institute, 111(11), 1120–1130. Web.
Ryans, K., Perdomo, M., Davies, C. C., Levenhagen, K., & Gilchrist, L. (2021). Rehabilitation interventions for managing breast cancer-related lymphedema: Developing a patient-centered, evidence-based plan of care throughout survivorship. Journal of Cancer Survivorship: Research and Practice.
Shapiro, C. L. (2018). Cancer survivorship. The New England Journal of Medicine, 379(25), 2438–2450. Web.