The adult cancer survivor: psychosocial consequences of cure.

This article has summarized the psychosocial sequelae identified for the adult cancer survivor. The themes that have been identified relate to loss, compromise, and uncertainty. There is, as yet, no evidence of increased psychopathology in this population. Research on this subject is sparse and difficult to interpret. Consistent definitions of survival across studies is needed in order to compare findings. Although no specific length of time is precise for a given individual, information does exist that would assist in defining long-term survival for a given disease. The use of sensitive measures and appropriate comparison groups is an important consideration in future studies. Instruments that measure psychopathology have often been used; however, these instruments appear not to be sensitive to the more subtle levels of psychological distress and problems associated with long-term survival. Schipper and Levitt have emphasized the need for more discriminating tools. Spitzer and colleagues propose the use of in-depth psychological interviews as optimal in this regard. Comparison groups have varied from neighbors, friends, college students, psychiatric patients, and national surveys. In addition to a lack of consistency among these groups, questions have been raised in the literature as to what degree these groups represent the general population. Schipper and Levitt suggest that patients might best be used as their own controls and followed over time. Through increased understanding, strategies for prevention and intervention can be designed. An editorial in the newsletter for the National Coalition for Cancer Survivorship states, "the strength of the survivorship movement can be measured, in part, by the fact that these activities have developed independently, without coordination.(ABSTRACT TRUNCATED AT 250 WORDS)