June is National Cancer Survivor Month

National Cancer Survivor Month: Cancer Survivorship Trials

June is National Cancer Survivor Month in the United States. This month celebrates cancer survivors, raises awareness of cancer survivors and the issues they face throughout their lifetimes, and advocates for cancer survivorship research. Someone is a cancer survivor from diagnosis until the end of life. This includes people living with cancer, being treated for cancer, and those who had cancer and are now in remission or cancer-free. 

About Cancer Survivorship

There are approximately 18 million cancer survivors in the United States, more than 5 percent of the population. That number is expected to increase to 22.5 million by 2032. Due to significant advances in cancer treatment through clinical trials, more and more people diagnosed with cancer are surviving and living longer than before. In 2022, 69 percent of cancer survivors lived for 5 or more years after diagnosis, 47 percent lived 10 or more years, and 18 percent lived 20 or more years. 

Just a few decades ago, the outlook for individuals diagnosed with cancer was much more negative than it is today. In the 1970s, 1 out of 2 people diagnosed with cancer survived at least 5 years, compared with more than 2 out of 3 people surviving today. The greatest survival rate improvements have been seen in children, adolescents, and young adults. As people with cancer live longer or even become cancer-free, more research is occurring to better understand specific issues that cancer survivors face and to improve cancer survivors’ quality of life. This has created the relatively new and growing field of cancer survivorship research. 

Cancer Survivorship Research

Cancer survivors can participate in many types of clinical trials depending on where they are in their cancer journey. For example, for cancer survivors who are receiving treatment, they may be able to participate in a treatment trial to find a new treatment for their cancer. They also could participate in a supportive care trial to learn about ways to improve symptoms related to their cancer or reduce side effects from cancer treatments. A cancer survivor's family could also participate in supportive care trials to learn more about issues caregivers face. Learn more about different types of clinical trials in MNCCTN's blog post.

There are also specific survivorship trials. Survivorship trials can focus on a wide variety of topics and questions specific to cancer survivors’ experiences. The field of cancer survivorship began taking shape in the 1980s. In 1985, Dr. Fitzhugh Mullan used the term in a publication describing his journey with cancer, titled “Seasons of Survival.” The next year, the National Coalition for Cancer Survivorship (NCCS) was created. At the first NCCS meeting in October 1986, a new definition of “cancer survivor” was created. Prior to this, a cancer survivor referred to someone who had remained cancer-free for five years or more. The NCCS decided this definition was too strict and left out many people facing timely issues as a result of their cancer, such as fertility loss and making informed choices about treatment options. The NCCS proposed that people be referred to as cancer survivors from diagnosis onward.

The cancer survivorship movement continued to grow over the next two decades. In 1996, the Office of Cancer Survivorship was created at the NCI to promote and direct cancer survivorship research to address challenges faced by cancer survivors. The American Cancer Society (ACS) began funding cancer survivorship research and initiated the Study of Cancer Survivors in 2000. This longitudinal study surveyed cancer survivors over 12 years after being diagnosed with cancer to better understand cancer survivors and their quality of life post-diagnosis. Along with these milestones, cancer research organizations made cancer survivorship research a priority at their institutions as well.

As the field of cancer survivorship has grown over time, researchers are better understanding significant issues that cancer survivors face, especially in terms of quality of life and future health outcomes. Some of these issues include cancer recurrence, secondary cancers or other health conditions, long-term treatment side effects, fertility, mental health and well-being, economic burden, and more.

Unique Needs of Cancer Survivors

While cancer treatments have advanced greatly and can effectively cure or suppress a patient’s cancer, some treatments do not come without cost. Some treatments can cause long-term side effects and increase a cancer survivor’s risk for future cancers or other health conditions. For example, some types of chemotherapy may cause heart damage. Researchers are working to better understand how this heart damage occurs, as well as finding out whether strategies such as other medications may prevent heart damage without affecting the function and effectiveness of chemotherapy. 

Another example of a cancer treatment’s impact on cancer survivors is radiation therapy. Radiation can cause secondary cancers years after receiving treatment, but it is rare. If a secondary cancer does occur, it is usually ten or more years later, and the tumor is found near the area that radiation occurred. Researchers continue to study secondary cancers for cancer survivors to determine who is most at risk. So far, studies have found that age when radiation was received, the dose of radiation, and the area treated are factors that impact risk of secondary cancers from radiation. 

Other cancer treatment strategies, such as targeted therapies and immunotherapy, are so new that researchers don’t know if any long-term effects may exist yet. As a result, the NCI is funding research to follow cancer survivors who have received immunotherapy over time to determine if any late effects exist.

Cancer Survivorship Resources 

Cancer survivorship is an evolving field, and research is ongoing to learn about cancer survivors and improve health outcomes for children, adolescents, and adults living with and beyond cancer. The Masonic Cancer Center and M Health Fairview collaborate on the Cancer Survivorship Program. These organizations also put on the Cancer Survivorship Conference each year. To learn more and view survivorship resources, visit survivorship.umn.edu.