Among health professionals, people with a cancer history, and the public, views differ as to when a person with cancer becomes a survivor. Many consider a person to be a survivor from the moment of diagnosis; in recent years, this view has become increasingly prevalent. Some, however, think that a person with a cancer diagnosis cannot be considered a survivor until he or she completes initial treatment. Others believe a person with cancer can be considered a survivor if he or she lives 5 years beyond diagnosis. Still others believe survivorship begins at some other point after diagnosis or treatment, and some reject the term “survivor” entirely, preferring to think of people with a cancer history as fighters, “thrivers,” champions, patients, or simply as individuals who have had a life-threatening disease. A considerable number of people with a cancer history maintain that they will have survived cancer if they die from another cause.
SOURCE: President’s Cancer Panel (2004b).
The cancer control continuum has been used at least since the mid-1970s to describe the various points from cancer prevention, early detection, diagnosis, treatment, survivorship, and end of life. The continuum has changed somewhat over time. Because survivors are now a large and growing population, survivorship has been added to the continuum. Rehabilitation was once a specific phase; now it is generally considered part of treatment and survivorship care.
Like many other useful concepts, the continuum is oversimplified. As modern biology has changed our understanding of cancer, it is now recognized that the categories are useful labels, but the processes are not so discrete. For example, colonoscopy is now recognized as both a screening test for colon cancer and a prevention strategy if polyps are found. Moreover, many topics are cross-cutting. For example, communication, decision making, quality of care, and health disparities are of concern at each point along the continuum.
SOURCE: Adapted from National Cancer Institute figure on the “Cancer Control Continuum” (NCI, 2005a).