【Cancer Survivorship 癌症生存】

【译文】癌症筛查和早检测的进展、治疗改进和支持性治疗共同提高了癌症生存率。到2040年,估计将有2600万癌症生存者,大多数处于60岁、70岁或80岁。几乎每个医疗工作者都会遇到癌症生存者。目前,癌症生存者的护理往往是事后想法,通常都是零零散散的,并没有很好融入癌症治疗的主流。此外,没有确定的癌症生存者最佳的照护模型。目前已有的一些模型,但其在改善生存结局有效性的数据很少。但癌症生存者面临着广泛的医疗和心理社会变化,变化需合理规划和妥善管理。癌症生存是从诊断开始,持续癌症生存者的整个生命期。这一整体定义鼓励临床医生把照护生存者视为癌症治疗的组成部分。生存者的定义包括家庭成员、朋友和照护者。包括这些人的主要原因是,大多数情况下,患者并非单独经受癌症。两个最紧迫的挑战是,满足不断增长的老年癌症生存者的需求,及照护儿童癌症生存者。

【原文】Advances in cancer screening and early detection, improvements in therapeutics, and supportive care all contribute to decreasing cancer mortality. There will be an estimated 26 million survivors in 2040, the majority of whom will be in their 60s, 70s, or 80s. Nearly every health care provider will encounter cancer survivors. At present, the care of cancer survivors is often an after thought, tends to be fragmentary, and is not well integrated into the mainstream of cancer care. Also, the best models for providing survivor care remain undefined. Some models exist, but there are scant data on their effectiveness in improving survivorship outcomes. But survivors face a wide range of medical and psyco-social changes that need to be planed for and properly managed. Survivorship starts at the time of diagnosis and lasts throughout the lifespan. This holistic definition encourages clinicians to think about the care of survivors as an integral part of the cancer care continuum. Included in the definition of survivors are family members, friends, and caregivers. The primary reason for including these persons is that in most cases cancer is not experienced alone. The two most pressing challenges are meeting the needs of the growing population of older cancer survivors and providing care for survivors of childhood cancer who have treatment-related cancers and coexisting medical conditions.