Cancer shifts to chronic disease, so living well matters

1 December 2020

Improved survival means cancer is increasingly a chronic disease, and a lot of people are living well with it, new research from The Australian National University (ANU) shows.

The study, the largest of its kind in the world, has looked at data from more than 22,000 people with cancer compared to 244,000 people without cancer, analysing levels of physical disability, psychological distress and quality of life.

However, the researchers warn their findings show "underserved cancers", like lung cancer, are more challenging for survivors.

"There are more than one million people living with cancer in Australia and average five-year survival rates sit at 68 per cent," study lead, Professor Emily Banks, said.     

"We started this project in collaboration with cancer survivors to understand more about what it is like to live with cancer.

"The good news is that for the most common cancer types - such as breast, prostate, bowel cancer, and melanoma - the outcomes are looking really good.

"Overall, we found that once patients with the most common cancers were through the initial period of diagnosis and treatment, their quality of life and levels of psychological distress were similar to people in the community without cancer.

"These findings should shift the general mindset about cancer, as it is increasingly becoming a chronic disease. It is good for people to know they may not have to quit their job and may continue to have a good quality life."

The study looked at cancer survivors from rural and urban areas, people with early and late stage cancer, and people who have been recently diagnosed along with people diagnosed up to 12 years ago.

Although the researchers say the cancer experience is diverse, the findings map a broad spectrum of different cancers and how they relate to quality of life.

"Certain cancers, especially those with worse survival, have a much more challenging profile," Professor Banks said.  

"People with multiple myeloma, leukaemias and lymphomas do tend to have higher levels of physical disability than people without cancer and their overall profile is much worse.

"People with more advanced cancer also tend to have worse outcomes.

"We found that, on average, all cancer survivors in the community were 30 per cent more likely to be living with significant physical disability than people without cancer. They also had reduced quality of life and had slightly more psychological distress."

A new report based on the study's findings authored by ANU Fellow, Dr Grace Joshy, has just been published in BMC Medicine.

Dr Joshy says the study's findings show there is "no one-size-fits-all approach" for cancer care.

"This study shows us the majority of people are surviving well with cancer, but there are underserved cancer groups," Dr Joshy said.

"For example, things seems to be working well for some cancer types, such as breast or bowel cancer. There are likely to be lessons from these for cancers like multiple myeloma and lung cancer."  

An investigator on the project, and cancer survivor John Stubbs, said: "As a person with cancer the one thing I didn't think about was the possibility of long-term emotional and other effects. Even with a cure, the trauma can hit years later.

"It is great that we now have this study to guide us, bringing together the experiences of tens of thousands of Australians, with and without cancer."