Cancer Survivorship, at What Cost?

Sunday 4th of June is World Cancer Survivor Day 2023, a day dedicated to those who have survived a cancer diagnosis.  But importantly, the day is also designed to raise awareness of the often-overlooked challenges that this survivorship brings.

Our VP of Oncology, Dr Allan Jordan, explores further.





The discovery and development of novel cancer therapies have been the primary theme of my career for at least the past two decades. I’ve been fortunate to see several compounds I’ve been involved in enter clinical trials, offering potential benefits to patients and the chance that they, too, might become cancer survivors. Several of these patients, and members of their families, have become colleagues and friends along the way and sharing their journey is a huge motivator to continue the pursuit of even better treatment options.

But that shared journey has also highlighted another side to our novel medicines.  One that we frequently overlook in our research activities but is no less critical to the benefit we strive to deliver.  And that is the impact of our therapies, and of the disease itself, on those who are fortunate enough to beat their cancer.  Indeed, cancer survivorship brings a host of challenges which we frequently overlook, but which overshadow the successes we celebrate.

Our treatments are not kind.  Radiotherapy – still our best option for truly “curative” treatment, can lead to long-term chronic toxicity in adjacent organs, often leading to challenges in eating and digestion.  Combination chemotherapy which, despite significant advances in more targeted and personalised therapies, remains our go-to first line of therapy in most cases, can itself lead to treatment-induced secondary cancers, significant neurological damage and chronic pain, muscle wasting and a multitude of other day-to-day challenges.  And even these targeted therapeutics, aligned to a specific patient’s tumour and designed to exploit a tumour-specific weakness, are frequently not without side effects, both in the short and long term…

Survivorship, yes.  But at what cost to quality of life?

So how do we change this?  Days like Cancer Survivor’s Day are important to raise awareness of these hidden costs of cancer therapeutics and remind us that we remain some way away from the cancer “magic bullet”.  That awareness can help us as we consider the impacts and side effects of our novel therapies, not just during the clinical evaluation, but also after our therapy has (hopefully) done its job and our patients move forward with their lives.

But also, it reminds us that novel cancer therapeutics are not just about the destruction of rogue cancer cells.  A more holistic approach to quality of life remains important, and as a community, we do need to connect more widely with patient advocacy and support groups (such as Macmillan and Marie Curie in the UK, or the American Cancer Society in the USA), to truly understand the challenges our patients face once their treatments end. These conversations clearly highlight the urgent need to drive toward better therapeutic options for conditions such as neuropathic pain, cachexia, nausea, fatigue, and cognitive decline. This would offer significant benefits and improved quality of life to our cancer survivors.

Delivering these therapies and delivering an improved and enhanced quality of life for our survivors, would make an equally significant contribution to delivering better outcomes for cancer patients.  Perhaps it is time for us all to think a little further beyond killing cancer cells, and help deliver that more meaningful survivorship?