The 2005 Milly Haagedoorn Lecture. Five year survival: an end or a beginning?

Surviving cancer is now becoming more of a possibility and it appears that, while this is clearly an advantage, there is emerging a body of literature reporting findings of disadvantage or risk for survivors. This paper examines some of the literature on the nature of the group of diseases called cancer and its impact. Further, some analysis is made of surviving such a serious and potentially life-limiting illness. The phenomenon of "5-year survival" is considered as a target for cancer patients to achieve and marks a transition from patient to well person. Studies of those who have been cured of cancer (as indicated by the 5-year survival) reveal some consistent data on the psychological and social impact that this has on them and those close to them. This has implications for practitioners who may need to have additional education and training to assist survivors, or be aware of the possible risks to enable early referral to other professional disciplines. It has implications for cancer education as the evidence base for surviving cancer increases. New and different education programs may be required for the practitioners of today and those training for the future.