title: Beyond treatment - Psychosocial and behavioural issues in cancer survivorship research and practice.
abstract: The population of cancer survivors has grown steadily over the past several decades. Surviving cancer, however, is not synonymous with a life free of problems related to the disease and its treatment. In this paper we provide a brief overview of selected physical and psychosocial health problems prevalent among cancer survivors, namely pain, fatigue, psychological distress and work participation. We also address issues surrounding self-management and e-Health interventions for cancer survivors, and programmes to encourage survivors to adopt healthier lifestyles. Finally, we discuss approaches to assessing health-related quality of life in cancer survivors, and the use of cancer registries in conducting psychosocial survivorship research. We highlight research and practice priorities in each of these areas. While the priorities vary per topic, common themes that emerged included: (1) Symptoms should not be viewed in isolation, but rather as part of a cluster of interrelated symptoms. This has implications for both understanding the aetiology of symptoms and for their treatment; (2) Psychosocial interventions need to be evidence-based, and where possible should be tailored to the needs of the individual cancer survivor. Relatively low cost interventions with self-management and e-Health elements may be appropriate for the majority of survivors, with resource intensive interventions being reserved for those most in need; (3) More effort should be devoted to disseminating and implementing interventions in practice, and to evaluating their cost-effectiveness; and (4) Greater attention should be paid to the needs of vulnerable and high-risk populations of survivors, including the socioeconomically disadvantaged and the elderly.
authors.affiliation: Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
authors.forename: Neil K
authors.initials: NK
authors.lastname: Aaronson
authors.affiliation: O.U. Anesthesiology, Intensive Care, Pain and Palliative Care, Experimental Unit of Psycho-Oncology, National Cancer Research Center 'Giovanni Paolo II', Bari, Italy.
authors.forename: Vittorio
authors.initials: V
authors.lastname: Mattioli
authors.affiliation: Palliative Medicine, Division of Population Health Sciences and Education, St. George's University of London, London, United Kingdom.
authors.forename: Ollie
authors.initials: O
authors.lastname: Minton
authors.affiliation: Department of Psychosocial Oncology, Clinic for Tumor Biology, University of Freiburg, Freiburg, Germany.
authors.forename: Joachim
authors.initials: J
authors.lastname: Weis
authors.affiliation: Cancer Late Effects Research, Oncology, Finsencenteret, RIgshospitalet, University of Copenhagen & Danish Cancer Society Research Centre, Copenhagen, Denmark.
authors.forename: Christoffer
authors.initials: C
authors.lastname: Johansen
authors.affiliation: Unit of Survivorship Research, The Danish Cancer Society Research Centre, Copenhagen, Denmark.
authors.forename: Susanne O
authors.initials: SO
authors.lastname: Dalton
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, VU University Medical Center and Department of Clinical Psychology, VU University, Amsterdam, The Netherlands.
authors.forename: Irma M
authors.initials: IM
authors.lastname: Verdonck-de Leeuw
authors.affiliation: Behavioral Research Center, Intramural Research Department, American Cancer Society, Atlanta, GA, USA.
authors.forename: Kevin D
authors.initials: KD
authors.lastname: Stein
authors.affiliation: Office of Cancer Survivorship, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health (NIH)/Department of Health and Human Services (DHHS), Bethesda, MD, USA.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Alfano
authors.affiliation: Section of Psychosocial Oncology, Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany.
authors.forename: Anja
authors.initials: A
authors.lastname: Mehnert
authors.affiliation: Coronel Institute of Occupational Health, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Angela
authors.initials: A
authors.lastname: de Boer
authors.affiliation: Centre of Research on Psychology in Somatic Diseases (CoRPS), Tilburg University, Comprehensive Cancer Centre of the Netherlands, Eindhoven, The Netherlands.
authors.forename: Lonneke V
authors.initials: LV
authors.lastname: van de Poll-Franse
keywords: Behavioural; Cancer; Psychosocial; Survivorship