Cancer survivorship: meeting psychosocial needs.

Attention to issues unique to cancer survivorship has increased in recent years as the number of cancer survivors has grown. In 2004, the latest year with complete statistics in the United States, an estimated 10.8 million cancer survivors represented approximately 3.7% of the population (Ries et al., 2007). The cancer sites with the highest frequency of survivors were breast (22%), prostate (19%), colorectal (10%), and gynecologic (9%) (Ries et al.). An individual is defined as a cancer survivor from initial diagnosis until the end of life. Family members, friends, and caregivers also are considered survivors because they share the impact of the experience (National Cancer Institute [NCI], 2006a). Cancer survivorship has been conceptualized as consisting of three phases of survival, each with its own dimensions. Phase 1, acute survival, is devoted to coping with the diagnosis and the initial treatments and side effects. Phase 2, extended survival, refers to the period when the individual may be in remission or receiving consolidation therapy but is returning to a normal life while being followed regularly. Phase 3, permanent survival, relates to long-term adjustment and adaptation to life beyond cancer (Mullan, 1985) (see Figure 1).