The number of Americans with a history of cancer is growing due to the aging and growth of the population, as well as improving survival rates. In response to this demographic trend, The American Cancer Society (ACS) and the National Cancer Institute (NCI) compiled a comprehensive survivorship report providing current and projected cancer prevalence estimates for the United States, information on the common effects of cancer and it's treatment, and survivorship resources.
The ACS defines a cancer survivor as any person who has been diagnosed with cancer, from the time of diagnosis through the balance of life. There are at least three distinct phases associated with cancer survival, including the time from diagnosis to the end of initial treatment, the transition from treatment to extended survival, and long-term survival. In reality though, survivorship encompasses many different scenarios including:
- Living cancer-free for the remainder of life
- Living cancer-free for many years, but experiencing one or more serious complications of treatment
- Living cancer-free for many years, but dying after a late recurrence
- Living cancer-free after the first cancer is treated, but developing a second cancer
- Living with intermittent periods of active disease requiring treatment
- Living with cancer continuously without a disease-free period
According to the NCI, an estimated 13.7 million Americans with a history of cancer were alive on January 1, 2012, and of that total, 10% are men and women under the age of 39. The three most common cancers among male survivors are prostate (43%), colon and rec- tum (9%), and melanoma (7%). Among female survivors, the most common cancers are breast (41%), uterine corpus (8%), and colon and rectum (8%). As of January 1, 2022, it is estimated that the population of cancer survivors will increase to almost 18 million: 8.8 million males and 9.2 million females.
Many children, adolescent and young adult cancer survivors must cope with the long-term effects of treatment, such as infertility and sexual dysfunction. For younger survivors, the loss of fertility can be life-changing, with irreversible consequences that can affect quality of life. Women under 35 are at risk for infertility and premature menopause, even when their menstrual cycle resumes. Toxic effect of chemotherapy on the ovaries increases with older age, higher doses, and longer duration of treatment. Male infertility from cancer surgery or radiation can result from anatomic changes, hormonal imbalances, or lower production and quality of sperm. Cancer patients, caregivers, and survivors must have the information and support they need to play an active role in decisions that affect treatment and quality of life.