de Moor et al pointed out that “there is little research on survivors with recurrent disease or second cancers. Survivors with recurrent disease report distress, lack of energy, difficulty sleeping, pain, worry, and sexual dysfunction. However, there are few studies and fewer interventions dedicated to this clinical population.”1

Enhancing quality and length of survival of all persons diagnosed with cancer while minimizing or stabilizing adverse effects is the primary mission of the Office of Cancer Survivorship, which the NCI created in 1996 to recognize “the large number of individuals now surviving cancer for long periods of time.”2 The office conducts and supports research “that both examines and addresses the long- and short-term physical, psychological, social, and economic effects of cancer and its treatment among pediatric and adult survivors of cancer and their families.”2

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The major areas of interest to the Office of Cancer Survivorship are 1) understudied cancer sites, 2) health disparities, 3) family and caregiver studies, 4) economic outcomes, patterns of care, and service delivery studies, 5) lifestyle and health behavior research, 6) cancer communitization initiatives, and 7) “development of instruments/theories that encompass the specific needs and outcomes of long-term cancer survivors and permit the cross-comparison of health-related outcomes with other healthy or chronically ill populations,” recognizing that “most quality-of-life and outcomes instruments currently used in oncology are geared toward patients undergoing, or who have recently completed, cancer treatments.”2

In mid-April of this year, the American Society of Clinical Oncology (ASCO) issued three evidence-based practice guidelines on cancer survivorship care, the first in a planned series. These guidelines, “Prevention and Management of Chemotherapy-induced Peripheral Neuropathy in Survivors of Adult Cancers”, “Screening, Assessment and Management of Fatigue in Adult Survivors of Cancer”, and “Screening, Assessment and Care of Anxiety and Depressive Symptoms in Adults with Cancer”, reinforce the need to care for the both physical and psychological needs of cancer survivors. According to ASCO, “if care is not planned and coordinated, cancer survivors are left without knowledge of their heightened risks and a follow-up plan of action.”9

Dr. Rowland said that encouraging patients to engage in healthy behaviors to live disease-free—such as quitting smoking, eating a balanced diet, exercise, and use of sun block—is “no less important for older patients.”


Editor’s note: The 7th Biennial Cancer Survivorship Research Conference, “Advancing Survivorship Care through Multilevel Collaborations,” will be held at the Westin Peachtree Plaza, Atlanta, Georgia, June 18-20, 2014. The conference is being sponsored by the American Cancer Society, the National Cancer Institute’s Office of Cancer Survivorship, LIVESTRONG Foundation, and the Centers for Disease Control and Prevention. For more information:


  1. de Moor JS, Mariotto AB, Parry C, et al. Cancer survivors in the United States: prevalence across the survivorship trajectory and implications for care. Cancer Epidemiol Biomarkers Prev. 2013;22(4):561-570.
  2. National Cancer Institute. Office of Cancer Survivorship. Accessed April 22, 2014.
  3. Parry C, Kent EE, Mariotto AB, et al. Cancer survivors: a booming population. Cancer Epidemiol Biomarkers Prev. 2011;20(10):1996-2005.
  4. Haque R, Prout M, Geiger AM, et al. Comorbidities and cardiovascular disease risk in older breast cancer survivors. Am J Manag Care. 2014;20(1):86-92.
  5. Obi N, Gornyk D, Heinz J, et al. Determinants of newly diagnosed comorbidities among breast cancer survivors. J Cancer Surviv. 2014 Feb 26. [Epub ahead of print] DOI 10.1007/s11764-013-0338-y.
  6. Dobek J, Winters-Stone KM, Bennett JA, Nail L. Musculoskeletal changes after 1 year of exercise in older breast cancer survivors. J Cancer Surviv. 2014;8(2):304-311. DOI: 10.1007/s11764-013-0313-7.
  7. Lipscombe LL, Chan WW, Yun L, et al. Incidence of diabetes among postmenopausal breast cancer survivors. Diabetologia. 2013;56(3):476-483.
  8. Mariotto AB, Rowland JH, Ries LAG, et al. Multiple cancer prevalence: a growing challenge in long-term survivorship. Cancer Epidemiol Biomarkers Prev. 2007;16(3):566-571.
  9. American Society of Clinical Oncology. ASCO releases first three guidelines on cancer survivorship care. Accessed April 28, 2014.