Characterizing Survivors Living With Likely Incurable Cancer: A Closer Look at an Emerging Population

Area of Science:

• Oncology
• Cancer Survivorship
• Health Services Research

Background:

• The population of individuals with advanced and metastatic cancer, treated with life-prolonging intent, is increasing.
• This growing subgroup experiences cancer as a chronic disease, presenting unique survivorship challenges and needs.
• Existing guidelines address quality survivorship care, but a clear definition for this population is lacking.

Purpose of the Study:

• To address the lack of terminological clarity for individuals with likely incurable advanced and metastatic cancer.
• To identify a consistent definition that facilitates research and improves clinical care for this population.
• To explore strategies for identifying this subgroup within electronic health records and cancer registries.

Main Methods:

• Analysis of current terminology and definitions used for advanced cancer patients.
• Exploration of the divergence between cancer stage (advanced/metastatic) and treatment intent (curative/noncurative).
• Proposal of a defining characteristic based on treatment goals.

Main Results:

• A lack of clear, consistent definition for individuals with likely incurable advanced cancer hinders research and clinical care.
• Treatment intent (noncurative, life-prolonging) is proposed as the essential defining characteristic, irrespective of anatomic stage.
• Emerging strategies for identifying this population from electronic health records and cancer registries are discussed.

Conclusions:

• Establishing a precise definition for individuals with likely incurable advanced cancer is critical.
• Focusing on noncurative treatment intent, regardless of stage, offers a consistent way to define this population.
• Improved identification methods are needed to advance research and clinical care for advanced cancer survivors.