The University of UtahRedthread Home

Cancer Survivorship and the Train Ride of Life

RedThread - National Cancer Survivors - Train Ride of Life

By Jaehee Yi, Assistant Professor, College of Social Work, University of Utah, and Tian Tian, PhD Student, College of Social Work, University of Utah

In 2006, as part of a research project, a young woman – a survivor of childhood cancer – presented a photograph entitled “Train Ride of Life.” Using the photo, she expressed the sense of loss she felt as a result of her experience with cancer. She felt she had boarded the “train of cancer treatment” as a child, but stepped off the train as a young adult, losing all the years between while she underwent a rigorous treatment regimen.

On Sunday, June 3, 2012, we will recognize the 25th National Cancer Survivors Day. With the rapid advancement of cancer research and treatment options, survival rates are increasing, leading to a greater number of cancer survivors in Utah and worldwide. This observance prompts me to ask: Do we pay adequate attention to the cancer survivors in our lives? Yes, we celebrate as our family and friends walk out of the hospital alive after treatment, but we may neglect to care about the long-term impact cancer survivorship can have on many aspects of their lives, even after treatment has ended.

The term cancer survivorship is difficult to define and there are many different opinions about who qualifies as a survivor. Some say survivors are those who live at least five years after treatment, while other, broader definitions include anyone who has been diagnosed with cancer. Indeed, individuals experience many different phases of survivorship: receiving the diagnosis, informing their loved ones, undergoing each cycle of treatment, getting discharged, and returning to life, all while coping with the impact of cancer.

Many studies reveal the high prevalence of late effects among cancer survivors. According to the National Cancer Institute, late effects are “side effects of cancer treatment that appear months or years after treatment has ended.” Late effects include physical problems (such as cardiovascular disease, fatigue, and pain or numbness in extremities), mental health issues (such as memory and attention deficits, distress, or depression), and even reoccurrence of cancers.

Because of the life-threatening characteristics of many late effects and the serious impact of these effects on survivors and their families, cancer is viewed as a traumatic event in a person’s life. Cancer has even been identified as a significant cause of post-traumatic stress disorder (PTSD). In a recent study, about 14 percent of the participating cancer survivors reported clinical PTSD, manifesting through symptoms such as re-experiencing distressing events (for example, through nightmares), avoiding cancer-related experiences (such as office visits), and physical arousal (including hypervigilance, outburst of anger, or insomnia).

But the impact of cancer is not only negative; it can also have positive ramifications. The cancer experience can change the survivors’ worldviews and outlook on life in very meaningful ways. It is not unusual for cancer survivors to report they found new possibilities in life, a stronger sense of self, spiritual change, greater value of social relationships, and a greater appreciation of life in general. Both negative and positive aspects of cancer seem to have a lasting, often life-long impact on the affected individuals and families.

Most of us have a loved one who has survived cancer, or may even be survivors ourselves. For National Cancer Survivors Day, how about thinking of the survivors around you, making phone calls, or having a dinner with them? Thank them for pushing through all the challenges and ask them how cancer has impacted their lives. These valuable conversations could reveal a new layer of friendship.

Cancer is a chronic disease – something that will continue to impact a person throughout life, even after the completion of treatment. Families, friends, researchers, and clinicians can team up to enhance the survivor’s quality of life, to be there when the individual steps off the “train of cancer treatment,” and to survive together.