This article was written by Dr. Anand Govindarajan, Clinical Lead, Survivorship Program, Ontario Health
“Will I live?” When a person is diagnosed with cancer, this is often among their first questions. Thanks to advances in cancer screening, diagnosis and treatment, the answer is increasingly yes. From April 2019 to March 2022, the number of cancer survivors (people living with a current or previous solid tumour cancer diagnosis) in Ontario increased 13 per cent.
While this is unquestionably good news, we need to understand the challenges faced by patients, their care partners and the health system as more people survive and live longer with cancer.
Identifying Care Needs
As a system, we need to expect survivorship as an outcome of treatment, recognize that cancer survivors have unique needs, and be prepared to address those needs and ensure they receive the right care in the right place.
The third edition of Ontario Health’s Provincial Survivorship Report identifies who Ontario’s cancer survivors are, their symptoms and patterns of care.
The report helps us understand that many cancer survivors experience significant long-term side effects associated with their treatment (surgery, chemotherapy, radiation, hormones). In addition to the need to monitor for disease recurrence, patients may also require ongoing care for physical and psychosocial symptoms, including pain, fatigue and loss of appetite. Psychologically, depression, anxiety, body image concerns, and fear of recurrence are common among patients and their care partners. Personal relationships may be challenged. They may also suffer financial hardship, especially if they are unable to return to previous employment or have ongoing medical expenses that are not covered by provincial or private insurance (for example, ostomy supplies).
Health System Response
The Survivorship Report highlights many opportunities to meaningfully improve cancer survivorship care in Ontario.
For example, when appropriate, some cancer survivors may benefit from having their care transitioned from their Regional Cancer Centre specialists to a setting closer to their home that better meets their needs. For some people, this might be with their primary care provider or a survivorship clinic that links the Regional Cancer Centre to primary care. This would offer safe and effective post-treatment care as well as ensuring a streamlined path back to specialist care if required. Integrating survivorship care with primary care is not only more convenient and beneficial for cancer survivors, it also opens up specialists’ capacity to help patients requiring active treatment.
In partnership with our many stakeholders across the oncology, primary care and community sectors, we look forward to building upon the learnings highlighted in the Survivorship Report. Together, we can work to develop system-wide standards that will meaningfully improve cancer survivorship care in Ontario.
Read the Survivorship Report