There are roughly 1.4 million Australians with a personal history of cancer, that is ‘cancer survivors’. Most are long-term survivors, who might have completed treatment 5, 10 or more years ago. Others will still be having treatment, some of whom will be living with treatable but not curable cancers. The transition from on-treatment to the post-treatment phase can be difficult. This was recognised in the seminal US Institute of Medicine report, ‘From cancer patient to cancer survivor: Lost in transition’.
Survivors often report feeling lost and abandoned after treatment, or a period of treatment, has ended. They commonly experience a range of issues and consequences from cancer and cancer treatments, including physical effects (e.g. fatigue, pain, reduced function), emotional and psychological issues (e.g. fear of cancer recurrence, worry) and practical issues (e.g. financial toxicity, difficulty returning to work or study). Some are at risk of serious late effects. The major focus of ‘follow up’ in Australia continues to be on surveillance for disease recurrence or second cancers, however this limited focus frequently leaves survivors with a range of unmet needs. Primary care and community-based providers, including general practitioners, are not well integrated into follow up.
People with treatable but not curable cancers may have periods on and off treatment. They, and their caregivers, report a range of unmet needs. There is growing recognition of the need for specific focus on, and improved models of care, for this group of survivors.
This presentation will review the profile of survivors in Australia, common unmet needs, current models of care (and gaps between current and more ideal care), and will consider how to support more integrated care, so that survivors – those living with and beyond cancer – experience fewer tricky care transitions and rickety bridges, and more complete, comprehensive and seamless care.