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Special Report Cancer Survivorship – A Positive Side Effect of More Successful Cancer Treatment Elizabeth Charlotte Moser, 1 Safaa Ramadan, 2 John Bean, 3 and Françoise Meunier 4 1. Chair of EORTC Cancer Survivorship Task Force and Radiation Oncologist, Champalimaud Cancer Centre, Lisbon, Portugal; 2. Clinical Research Physician, EORTC Headquarters, Brussels, Belgium; 3. Medical Science Writer, EORTC Headquarters, Brussels, Belgium; 4. Director General, EORTC Headquarters, Brussels, Belgium Abstract Over the past decades, survival rates of cancer patients have increased impressively through the introduction of screening, new drugs and more personalised multi-modality treatments. This success in treating cancer has resulted in a large and rapidly increasing number of cancer survivors. Unfortunately, now that cancer is controlled in many patients, it has become clear that the life expectancy and quality of life of cancer survivors may be compromised by a spectrum of late adverse treatment effects. Some cancer survivors encounter second malignancies, severe cardiovascular or other morbidities which impair normal life in an important way. Some patients may be confronted with difficulties such as societal discrimination due to slower performance, chronic fatigue or partial inability, acceptance for work, education, insurance or credit history. To address these new issues, the EORTC is launching a variety of initiatives. Early in 2013, the EORTC Cancer Survivorship Task Force was created. The 1st EORTC Cancer Survivorship Summit will take place 30–31 January 2014 to facilitate interaction between clinicians, researchers, social workers, patients, insurers, bankers and policy makers. This summit will address the situation and needs of cancer survivors and guide future research and health policies in Europe in this field. Keywords EORTC, cancer, survivorship, second cancer, quality of life, late toxicity Disclosure: The authors have no conflicts of interest to declare. Received: 8 October 2013 Accepted: 15 October 2013 Citation: European Oncology & Haematology, 2013;9(2):74–6 Correspondence: John Bean, Mounierlaan 83/11, 1200 Brussels, Belgium. E: john.bean@eortc.be Over the past few decades, survival rates of cancer patients have increased impressively through the introduction of screening, new drugs and more personalised multi-modality treatments. This success in treating cancer has resulted in a large and rapidly increasing number of cancer survivors. Currently, there are over 13 million cancer survivors in the United States and close to 30 million survivors worldwide. 1,2 Some five million are survivors of breast cancer and there are also over three million survivors each of prostate and colorectal cancers. Survivors of these types of cancer are the most numerous, and women make up a slight majority of the cancer survivors (approximately 53 %). In the United States and Europe the overall five-year relative survival rate for all cancers combined has increased steadily over the past few decades and reached 66.1 % for patients diagnosed from 1999 to 2006. 3 Cure is now a reality for the majority of patients suffering from breast, colorectal and testicular cancer, Hodgkin’s disease or children’s leukemia, with survival rates reaching 90  %. Many other patients with cancer are now successfully treated, and their cancers are being considered a chronic disease. Cancer Survivors Face a Host of Issues Cancer patients face numerous challenges which were unforeseen in the 1970s, when a diagnosis of cancer was seen as a death sentence. Clinical trials were focused on more aggressive treatments to increase survival. Since the 1990s, and beginning mainly in paediatric oncology, cancer survivorship issues have become clearer, and new trials trying to reduce treatment toxicity have been introduced. Long-term toxicity data, however, are still scarce. Many patients have now become cancer 74 survivors and may face secondary problems for which neither standard oncology follow-up care nor society as a whole are well prepared. Some encounter second malignancies, severe cardiovascular or other morbidities which impair normal life in an important way. Patients are confronted with difficulties such as societal discrimination due to slower performance, chronic fatigue or partial inability, sterility, acceptance for work, education, insurance or credit history. The increasing number of reports on morbidity and mortality due to the physical and mental impact of cancer treatment raises questions concerning the classical follow-up of cancer patients by cancer specialists. Following the example of pediatric oncology, preventive care plans are under development for adult cancer survivors to reduce morbidity and early mortality due to late effects. However, many questions regarding risk assessment and potential interventions remain open. In view of the rapidly growing number of cancer survivors, the definition of cancer treatment follow-up urgently needs to be considered anew, and the restructuring discussed not just among cancer specialists, psychologists, social workers, but also with epidemiologists, general practitioners, policy makers and health insurers for correct guidance of cancer survivors in the future. EORTC Survivorship Task Force The European Organisation for Research and Treatment of Cancer (EORTC) is a pioneer in modern cancer care, has created a Europe-wide © Touc h ME d ic a l ME d ia 2013