'Living Well' Conference 2013: The National Context of Survivorship
Progress on Cancer
Cancer Survivorship Programme
The cancer story is changing
A diagnosis of cancer used to mean either
you died within 18 months or you were
cured, now there is a big group of people
who are living with incurable cancer.
Many others are living with the
consequences of treatment.
Today we will cover the learning from the
National Cancer Survivorship Initiative.
The number of people living with cancer is set
to double by 2030
Source: Maddams J, Utley M, Møller H. Projections of cancer prevalence in the United Kingdom, 2010-2040. Br J Cancer 2012; 107: 1195-1202.
Cancer Care Review
•Post-treatment with GP assessment and care planning
•Financial impact of cancer
•Patient awareness of
•Possible late effects of cancer
•Information needs in primary
Stratified Pathways: Southampton UHT
t led ( high
Jan 12 –
Colorectal Jan 12 –
Jan 12 –
Supporting self management
•Frontline staff can influence healthy behaviour
•Raise /prompt issues of lifestyle (physical activity,
healthy eating) with patients
•Prompt self monitoring of behaviours
•Prompt specific goal setting related to behaviours
•Refer to appropriate specialist (lifestyle change
support) services if required
•New Top Tips for Professionals coming soon
The impact of cancer and its treatment
(PROMS) give insight:
• the quality of life for
those living with and
beyond cancer from their
experiences and point of
• the impact of cancer
and treatments on ability
to lead meaningful lives.
What did people tell us?
– 1 year post diagnosis nearly half feared recurrence and
almost a third were afraid of dying.
– 38% of prostate cancer survivors reported urinary
leakage and 58% reported impotence.
– 1 in 5 colorectal survivors had difficulty in bowel control.
– QOL is closely associated with disease status and
presence of other long term conditions.
– Almost a third reported doing no physical activity and
around a fifth did the weekly recommended CMO
physical activity i.e. 30 mins x 5.
– Increased physical activity associated with better QOL.
All patients reach one of these outcome groups
This is a survivorship outcome
– taking different routes from diagnosis
7+ years, no
with prostate cancer
in England in 2004
1-7 years, no
1-7 years, other
Key survivorship messages
• A shift in professional culture is essential to enable
supported self management.
• New models of cancer aftercare gives opportunities to
improve quality and reduce cost.
• Many people can self manage their health with
support, with rapid access to professionals when needed.
• There is significant unmet need arising from
consequences of treatment, which can be successfully
addressed through prevention and treatment.
• Good survivorship care requires timely communication