The New Social Worker Vol. 20, No. 2, Spring 2013 | Page 10

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Navigating Cancer Survivorship:
Responding to Contexts That Shape Practice
by Andrea Tanguay, BSSW

ancer was once a word that people were afraid to speak, and individuals rarely admitted to being
a cancer survivor. The disease was often
seen as a certain death sentence by those
who were diagnosed. Now, many cancer
survivors openly discuss and share their
cancer experiences. As a recent graduate with my bachelor’s in social work, I
have kick started my career in the field
of women’s oncology. In the time I have
spent as an oncology social worker, I
have learned the critical importance
of continually responding to contexts
that shape our practice. Because 65% of
adults who are diagnosed with cancer
will now be alive after at least five years,
perceptions of cancer have begun to
change. The view that cancer cannot be
cured and the fears that have historically
been attached to it are slowly changing. Because more and more people are
surviving cancer, there is increased attention and focus on the quality of life and
long-term outcomes of cancer survivors.
Researchers are working to learn more
about the challenges survivors face.
Survivors have many unique needs that
are not well understood. Some of these
obstacles are medical, such as permanent
side effects of treatment, the possibility of
second cancers caused by treatment, and
the need for long-term treatment and
medical follow-up. Other challenges are

emotional or social, like getting health
insurance, discrimination by employers,
relationship changes that may result from
life-threatening illness, or learning to live
with the possibility of cancer coming
back.

To react to the emerging trends, we
must first ask: Who is a cancer survivor?
And what is survivorship?

The definition of a survivor is dynamic, and has been evolving with the
current trends in cancer. The traditional
definition of a cancer survivor requires
that a patient be cancer free for at least
five years. A more recent description
considers someone a survivor after completing the first phase of treatment, such
as chemotherapy, radiation, surgery, or a
combination. The most current definition
has progressed to consider a patient a
survivor from the moment of diagnosis
until death. This means that a patient
becomes a survivor as soon as he or she
is diagnosed with cancer, and remains
a survivor through the phases of treatment and afterwards until the end of life.
Today, the definition professionals use to
describe a cancer survivor includes an
individual who has been diagnosed with
cancer, regardless of when that diagnosis
was received, who is still living. Some
patients do not feel comfortable calling
themselves survivors, while others embrace the term. Each patient defines his

or her own path, and navigates through
the changes in his or her experiences.

“Surviving” Survival

Many cancer survivors I have encountered admit that while they felt they
had a large amount of information and
support during their illness, once treatment stopped, they entered a whole new
world—one filled with new questions.
The end of cancer treatment is often
thought of as a time to rejoice. Patients
are usually relieved to be ?nished with
the demands of treatment and are ready
to put the experience behind them. Yet
at the same time, they may feel sad and
anxious. It is common for a patient to
be concerned about whether the cancer
will come back and what they should do
after treatment. When treatment ends,
most people expect life to return to the
way it was before the cancer diagnosis,
but it can take time to recover. One of
the hardest things after treatment is the
unknown—the fear of what happens next.

Those who have gone through
cancer treatment describe the end of
treatment as a time of change. It is not
so much “getting back to normal” as it
is finding out what is normal for them
now. People often say that life has new
meaning or that they look at things differently now. Things may keep changing
throughout recovery. The patient’s new
“normal” may include making small or
even drastic changes in everyday life.
The shift to survivorship can be extremely challenging, and patients need support
and assistance to make a successful
transition. In some ways, moving from
the period of “active treatment” into
survivorship is one of the most complex
aspects of the cancer experience, because
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