Preface

"You have cancer," these words almost always cause devastation in the lives of their recipients. Feelings of uncertainty and loss of control over one's life are common reactions. Over time, cancer patients face several challenges that disrupt their quality of life. Examples include: making sense of complex medical information; making difficult treatment decisions; dealing with treatment side effects; living with the fear of recurrence; and for some, facing the possibility of impending death. Thus, in addition to prolonging survival, a key goal of cancer care is to minimize the impact of the disease and treatment on patients' functioning and well-being.

Cancer survivors are all those patients who have ever been diagnosed with cancer. The term "survivor" connotes that patients have been through a harrowing experience. Newly-diagnosed patients are included because this experience begins with the moment of diagnosis. From that time quality of life is almost constantly at peril because of uncertainties and side effects associated with diagnostic and treatment procedures, chronic pain, frequent hospitalizations, disfigurement, depression, and bodily dysfunctions. The spectrum of threats is wide, and so is the potential to address these threats.

In this book, authors present a variety of interventions ranging from the effect of cancer and its treatment on physical appearance and function, expectations regarding survival, mood, sexuality, fertility, and immune function, and describe lifestyle interventions to mitigate these effects and solutions for specific symptoms such as alopecia and lymphedema.

> **Assoc. Prof. Dr. Ravinder Mohan**  Full-time Clinical Faculty, Department of Family and Community Medicine, Eastern Virginia Medical School, Norfolk, Virginia, USA

**1** 

*UK* 

**Living With and Beyond Cancer:** 

Neel Bhuva, Sonia P. Li and Jane Maher

*Mount Vernon Cancer Centre, Northwood, Middlesex,* 

**UK % ENGLAND** 

0.8 38.7 60.5

*'An illness in stages, a very long flight of steps that led assuredly to death, but whose every step represented a unique apprenticeship. It was a disease that gave death time to live and its victims time* 

The incidence of cancer is increasing with most current published statistics suggesting that approximately 300,000 new cases are being diagnosed annually in the UK. 1 in 3 will develop cancer during their lifetime. However, despite the incidence of cancer rising by almost 25% in the last 30 years, mortality rates have fallen by almost 20% in the same time period. In the UK, the overall cancer mortality rate in 2008 stood at just over 150,000 (Cancer Research UK, 2010). At present it is thought that two million people have cancer in the UK and as survival rates continue on an upward trend, this figure will only continue to rise (Table 1, Figures 1 and 2). This means that more and more people are living with or beyond a diagnosis of cancer especially with improving cure rates. Cancer is no longer a death

Total 2,000,000 100 1,670,000 Male 800,000 40 670,000 Female 1,200,000 60 1,000,000

Breast 550,000 28 460,000 Colorectal 250,000 12 210,000 Prostate 215,000 11 180,000 Lung 65,000 3 54,000 Other 920,000 46 766,000 *Kings College London, MacMillan Cancer Support and National Cancer Intelligence Network,Cancer Prevalence* 

Table 1. Number of people living in the UK and England who have had a cancer diagnosis

*to die, time to discover time, and in the end to discover life.' Hervé Guilbert* 

16,000 774,000 1,210,000

sentence for an increasing number of patients.

**1. Introduction** 

Age 0-17 18-64 65+

*in the UK, 2008* 

**New Challenges** 

13,000 645,000 1,010,000
