Survivorship research for people with metastatic or advanced cancer: A time for action

Background
Over recent decades, survival outcomes for people diagnosed with cancer have changed dramatically, with approximately 20% improvement in five-year relative survival rates in high-income countries including the United States and Australia. Regardless of regions, there is a decrease in overall cancer mortality rate of about 1% per year. Likewise, the cancer disease trajectory has changed. The traditional linear cancer trajectory in which a patient moves from cancer diagnosis through to a binary outcome (cure or death)—is no longer applicable and does not adequately describe the complexity of experience for many people. Indeed, the availability of targeted therapies and immunotherapies has meant that people diagnosed with cancers once rapidly fatal in the advanced or metastatic stages, such as prostate, breast, ovarian, melanoma, myeloma, and non-small cell lung cancer, are now being treated over relatively long periods of time with treatments that slow the progression of their cancer, prolong life and control cancer symptoms.1However, despite the ability of these novel therapies to extend life, most patients with an advanced or metastatic cancer diagnosis will never be cured. For these patients, cancer is often a chronic and complex illness that is, often unpredictable and requires ongoing monitoring, treatment, care, and support.