The 'three Ps' of cancer survivorship care

What is the definition of ‘cancer survivor’ and what is ‘survivorship care’? With the growing numbers of individuals surviving long term and disease free after a cancer diagnosis, a group of individuals in the US came together in 1986 to establish the National Coalition for Cancer Survivorship (NCCS; http://www.canceradvocacy.org), and defined cancer survivors as individuals with cancer from the time of diagnosis and for the balance of life, and included in its definition family, friends and caregivers. This broad and all-inclusive definition reminds us that potentially anyone with a diagnosis of cancer can be a long-term survivor and that we must design therapies at the outset to maximize cure as well as minimize longterm side effects and other more serious effects of cancer treatments. In practical terms, however, we tend to focus on the post-treatment phase of the cancer experience, and that is where survivorship care really gets started (Figure 1).