More survive cancer, and more live with complications

While cancer was once treated as a death sentence, more people are surviving today.

That’s undeniably great news, but many of those survivors are living with serious health complications and limitations.

Researchers have found that the number of cancer survivors with some kind of functional limitation has more than doubled over the past 20 years. The findings were published in Jama Oncology last month.

The number of cancer survivors with functional limitations rose from 3.6 million in 1999 to 8.2 million in 2018, researchers found.

In addition, the percentage of survivors with some kind of limitation is rising. In 2018, 70% of survivors had some degree of limitation, up from 57% in 1999, according to the study.

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Researchers from Johns Hopkins Medicine, the Dell Medical School and the University of Minnesota conducted the study. S.M. Qasim Hussaini, a cancer researcher at Johns Hopkins Medicine and a co-author of the study, said in a news release that the findings suggest the need for more work to help survivors live better lives.

"The fact that we are saving more lives from cancer is worth celebrating, but it also warrants a shift toward understanding and improving the quality of life for those who survive," Hussaini said in the statement. 

"Overall, our study calls for urgent action to address the burden of cancer and its treatment on physical, psychosocial and cognitive function," Hussaini said.

Researchers suggest the increases in functional limitations reflect more than age, because the greatest increases in limitations came among those under the age of 65. The rate of limitations between those 55 and 64 years of age rose 17% from 1999 to 2018.

Hispanic and Black cancer survivors experienced greater increases in functional limitations. Among Hispanic survivors, the rate of limitations rose from about 40% to 65%, an increase of 25%. Roughly three out of four Black survivors (76.5%) had functional limitations in 2018, compared to 57% in 1999.

• Read more: Black, Latinx patients had greater delays in cancer care in pandemic

Researchers said the spike among Black and Hispanic patients suggest that they are receiving better treatment for their cancer and are more likely to survive. The findings also suggest it’s possible that Black and Hispanic patients aren’t getting sufficient access to “quality survivorship care,” the authors wrote.

The researchers said the study illuminates the need for better treatments to ensure patients don’t just survive cancer but have the best chance for a full life.

“Given a growing population of cancer survivors, our findings suggest an urgent need for care teams to understand and address function, for researchers to evaluate function as a core outcome in trials, and for health systems and policy makers to reimagine survivorship care, recognizing the burden of cancer and its treatment on physical, psychosocial, and cognitive function,” the authors wrote.

The American Cancer Society reported a drop in cancer deaths earlier this year, but there continues to be disparities among women and minority groups.

Some healthcare researchers have feared that cancer rates could rise due to some people delaying screenings in the COVID-19 pandemic. An Epic analysis found there has not yet been an increase in the rates of breast cancer, cervical cancer and colon cancer.

Christopher Alban, a clinical informaticist at Epic Systems Corp., told Chief Healthcare Executive® in a March interview that the findings offer “cautious optimism,” but said researchers will need to continue monitoring to determine the long-term impact of the pandemic on cancer rates.

“Don't go throwing a parade yet,” Alban said. “We've got to keep monitoring, and watching.”