I’ll never forget one of the first pieces of advice I received as a 28-year-old breast cancer patient.
I was early on in my journey, just beginning to feel the pain and discomfort from my chemo infusions. My coping mechanism was to focus on the “after:” that elusive moment when cancer would be just a memory, a thing of the past.
The advice — or really, the warning — I received was that I needed to prepare myself. The “after” that I sought was an illusion. Survivorship would bring a whole new swath of challenges.
At the time, that seemed impossible to believe; surely nothing could top the poking and prodding, the nausea and chills and aches that just would not subside.
But it was true.
This is a unique moment in healthcare
We find ourselves at a fascinating time in the history of human health. For decades, the world of medicine has been laser-focused on curing folks of terminal illness. The phrase “finding the cure for cancer” has become synonymous with “the ultimate goal,” the scientific nirvana.
And here’s the amazing thing: every year, we move closer to that goal. The progress being made, particularly in targeted therapeutics, is extraordinary. As a result, the population of “survivors” — folks living with and beyond cancer — is growing rapidly (our numbers are projected to more than double between 2008 and 2030).
The problem? We didn’t equip ourselves for the era of the survivor.
The status quo is costly to both survivors and the system
People who have lived through cancer are at higher risk of a range of conditions, both physical and mental. They can feel like they are thrown into the medical abyss, forced to manage an overwhelming constellation of scans, specialists, and stressors.
I’ll let the statistics speak for themselves.
Cancer survivors are more likely than the general population to suffer from:
- Heart disease
- Sexual dysfunction
- Diabetes
- Chronic pain
- Sleep disorders
- Anxiety and distress
- PTSD
- Death by suicide
A 2020 study by researchers at the NCI and ACS found that “medical costs associated with survivorship” totaled $183 billion in 2015, and are projected to increase 34% to $246 billion by 2030.
Now we are starting to see why survivorship care isn’t a nice-to-have: it’s a necessity.
We have to address the Survivorship Gap
As the population of folks living with and beyond cancer grows rapidly, we are seeing unprecedented strain on the cancer care ecosystem.
One study estimates that by 2025, there will be a 40% increase in demand for oncology services and only a 25% increase in supply of oncologists. With this workforce shortage, the challenge is clear: we have to figure out a way to effectively transition survivors out of acute cancer care and into long-term management and risk-reduction.
There's a challenge on the other side, though, too: many PCPs have reported feeling unequipped to manage the complex care of cancer survivors. To quote one study: "PCPs appear willing to assume an enhanced role in cancer survivorship care but feel unprepared to do so."
This convergence of forces—growing cancer and survival rates, oncology shortages, and gaps in primary care training—lead directly to what we call the Survivorship Gap.
And to solve the Survivorship Gap, we need new, innovative, and patient-centered models to deliver survivorship care, at scale, to tens of millions of survivors. So that they, too, do not fall into "the gap."
Survivorship isn’t just for cancer patients
Let me be clear: survivorship is not limited to cancer patients. Transplant survivors, cardiac survivors, ICU survivors … while the biology of our diseases are different, there is a lot that we share. Survivorship care may have its roots in the cancer world, but is broadly applicable to a number of patient groups.
Many of the struggles are the same: learning to cope with trauma and live with fear, navigating changing relationships, and even grappling to fit back into the workplace.
COVID has also brought survivorship into stark relief. As we learn more about Long COVID and the hardships survivors face, I hope we mobilize to take on the challenge of life after illness.
A call to action
Don’t get me wrong: I view my survival as a gift. My cancer was aggressive and I reaped the benefits of precision medicine. I’m grateful every day.
But we have entered a new era in healthcare, and if we don’t act now, both patients and the system will suffer the burden.
The good news is that there are amazing folks — some of whom I’m honored to call advisors — who have been ringing the alarm bell on this issue for years. They have pushed forward the survivorship agenda through pioneering research, advocacy, and care delivery, particularly within top cancer centers.
The challenge moving forward?
Creating a model for survivorship care that scales to support tens of millions of survivors. A model that mitigates disparities and increases access to survivorship care — not the other way around. A model designed by, with, and for survivors.
That’s what we’re building at VivorCare.
Is this a vision that excites you? If so: please reach out. We are here to help survivors lead happier, healthier lives — let’s do it together.
