LIVING WITH CANCER AND OTHER CHRONIC CONDITIONS

Most people can attest to the disruptive influence an illness can have on their ability to participate in day-to-day activities.  When we are ill, school, employment, and leisure activities are replaced by periods of lessened activity and even periods of bed rest or hospitalization.  When an illness is chronic, the effect of being ill may extend over long periods, perhaps even an entire lifetime.  People with chronic illness must eventually find a balance between day-to-day function and the continuous presence of their condition.  Cancer is usually a chronic illness.

In spite of our understanding of its relationship to human health and our ceaseless attempts to prevent and cure it, progress in “the war on cancer” has been relatively limited.  In this regard, cancer is clearly an “expensive” condition, both in terms of its human consequences and its monetary costs.  It is estimated that 1,334,100 people developed cancer in 2003 and that, since 1990, nearly 17 million new cases of cancer have developed in this country.  Once diagnosed, approximately 62% (adjusted for other causes of death) of this group will be alive 5 years later.  The 5-year period that defines relative survivability encompasses “persons who are living 5 years after diagnosis, whether disease free, in remission, or under treatment with evidence of cancer.  Understandably, the use of the term cured is guarded since an initially diagnosed case of cancer can impact on survivability beyond the end of the 5-year time period.  Regardless of survivability, for those who develop cancer, the physical, emotional, and social costs will be substantial.

No single explanation can be given for why progress in eliminating cancer has been so limited.  It is a combination of factors, including the aging of the population, continued use of tobacco, the high-fat American diet, the continuing urbanization and pollution of our environment, the lack of health insurance for an estimated 41.2 million Americans to pay for early diagnosis and proper treatment, or simply our recognition of cancer’s true role in deaths once ascribed to other causes.  Regardless, we continue to be challenged to control this array of abnormal conditions that we collectively call cancer.  There is, however, increasing optimism that with new pharmacological agents and the completion of the Human Genome Project real progress will finally be made.