The Power of the Cancer Survivor

November 30, 2009

On Thanksgiving Sunday, I read a fantastic book and a resonating letter. Both were authored by physicians intimately aware of the effects of cancer and cancer treatment. In What Helped Get Me Through: Cancer Survivors Share Wisdom and Hope (American Cancer Society, 2009), Dr. Julie Silver, MD, a Harvard Medical School professor and breast cancer survivor, culled and organized advice from cancer survivors and survivorship experts about the day-to-day operations of survivorship. What do I mean by the day-to-day operations? Well, this book is full of advice and stories from survivors and experts about how a survivor can live with, beyond, and through cancer. Silver interviewed hundreds of survivors, and she has grouped their stories and advice into organized chapters like, “How I Nurtured Myself,” “What Helped My Children Cope,” “What I Wish I Had Known at Diagnosis,” “What Would Have Helped but Was Too Hard to Ask For” and “How Cancer Changed My Life.”

The stories are inspiring, so the book is an easy read, but Dr. Sliver’s book is important for a reason far beyond the inspiration it provides. It is important because the book rests on a shift in the cancer paradigm. Silver, in writing every word, assumed that survivorship is always the goal from the date of diagnosis forward. This seems obvious to most of us, but it is a notion that has been taken for granted. It is so important to think about how to improve the balance of life after a cancer diagnosis, and it is empowering to know that much of that depends on a cancer survivor’s decision-making. Moreover, it is critical to start thinking about long-term survivorship at the date of diagnosis. Silver writes under this assumption – cancer survivors are not just victims; cancer survivors can and do make choices (both big and small) that change the quality of their lives, and those decisions start at the moment of diagnosis.

This assumption – that survivors have the power to affect their own lives positively – was also the subject of the Editor’s Letter in the November issue of the renowned American Journal of Hematology Oncology. Ann H. Partridge, MD, MPH, from the Dana-Farber Cancer Institute wrote, “oncology providers usually focus on how to best eradicate or control the disease for the longest period of time. Yet recent successes in cancer therapy, as well as a greater focus on quality-of-life considerations in our field, have compelled us to consider traditional survivorship issues more fully during the initial period of cancer diagnosis and treatment decision-making.” Dr. Partridge wrote this compelling letter asking doctors to be more proactive with patients and making the case that except in rare cases of “lymphoma, leukemia, or inflammatory breast cancer,” treatment should not be considered an emergency, so survivors should have the time to make an informed decision.

Dr. Partridge closes with a statement that could serve as the credo of survivorship-interested researchers; “More research aimed at improving decision-making and enhancing the availability of information regarding survivorship issues, given current limitations, is imperative.” At this point, we know there are hazards to the treatment of cancer, and we understand a bit of the complicated nature of healthy living after a cancer diagnosis, but to fill in the gaps, we need much more evidence. Above all, the take-home message from Dr. Partridge speaks to the messages conveyed by Dr. Silver. Namely, survivorship starts at diagnosis, and cancer survivors have the power to make the right choices for their own health.

So where does all this leave a cancer survivor today? If Dr. Partridge is correct, we need much more research before we have the evidence we need to inform good choices for survivors across the board. In the meantime (before we know everything there is to know about cancer and cancer survivorship), survivors should take the advice of Dr. Partridge and carefully consider each decision (treatment and otherwise), and cancer survivors should listen to other cancer survivors, like the ones given voice in Dr. Silver’s What Helped Get Me Through: Cancer Survivors Share Wisdom and Hope. We know that survivors do in fact have the power to affect their own lives, and we can use what we know from research (evidence) and other survivors (anecdotal) to inform those incredibly powerful choices.

The Power of the Cancer Survivor

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