The Science of Survivorship from a Personal Perspective

NCI is dedicated to science at the highest level: research that leads to effective interventions with reduced toxicity; diagnosis at earlier, more treatable stages; and prevention strategies based on a molecular understanding of carcinogenesis and targeted interventions. But our mission to reduce the burden of cancer doesn't end there. A vital component of NCI's research focuses on America's growing population of cancer survivors, who now number more than 10 million, up from only 3 million in 1971.

For a great many patients, cancer's effects continue long after treatment is completed. Consequently, NCI's survivorship science, under the leadership of the Office of Cancer Survivorship (OCS), seeks to understand, for example, why two patients with strikingly similar tumors may face starkly different possibilities of future disease recurrence. We also track and study the experiences of former patients in order to obtain deeper knowledge about the posttreatment effects of cancer drugs and devices. And we seek answers about how patients can better cope with the emotional and financial pressures that may result from successful treatment.

This special issue of the NCI Cancer Bulletin on cancer survivorship marks the 10th anniversary of OCS, a founding that owes a great debt to a landmark report developed under the leadership of the National Coalition for Cancer Survivorship. That 1996 paper, Imperatives for Quality Cancer Care: Access, Advocacy, Action & Accountability, called for research on a range of issues, including quality of life and outcomes; the impact and burden of cancer care on caregivers; case management; the effects of cancer on childbearing; and differences in survivorship based on culture and ethnicity.

In its first decade, OCS has blossomed from a fledgling program to a source of solid science that today administers more than 125 research grants and conducts important symposia for the cancer community, such as its recent 3-day conference, "Cancer Survivorship: Embracing the Future," cosponsored by the American Cancer Society (ACS) and the Lance Armstrong Foundation.

Events like this conference remind us that cancer alters not just the lives of patients, but of parents, children, friends, loved ones, and caregivers, all of whom are included in NCI's definition of "survivor." Indeed, for many of our colleagues at NCI, cancer is a personal - as well as a professional - issue, because they are themselves survivors. In honor of loved ones, in tribute to former patients, or in testament to their own cancer battles, a number of NCI staff members have volunteered the photographs you see at the top of this page and the pages that follow. Together we mark a first decade of NCI's OCS, and we look forward to every scientific discovery and new kernel of knowledge OCS will produce in the years ahead.

Dr. John E. Niederhuber
Director, National Cancer Institute