Cancer Survivorship Program

SCI Spotlight

As early cancer detection and therapeutics improve, more people are living longer with cancer. The National Institute of Health (NIH) estimates there are 18.1 million cancer survivors in the United States. This number is projected to grow to 26 million people by 2040. For many, their cancer will be cured or managed like a chronic disease.

The term “cancer survivor” references “every person diagnosed with cancer from the moment of diagnosis through the balance of their life. This includes survivors living with cancer and those free of cancer,” states Stanford Cancer Institute (SCI) member and the director of the Stanford Cancer Survivorship Program Lidia Schapira, MD, FASCO. A cancer diagnosis can have long-lasting impacts on a survivor’s health. “By that, we mean all domains of health and wellbeing, including physical and mental health, health behaviors, professional and personal identity, sexuality, and financial standing,” continues Schapira.

The Stanford Cancer Survivorship Program’s mission is to improve the experience and health outcomes of people living with and beyond cancer by advancing survivorship research and access to clinical services and educating healthcare professionals in the science of survivorship care. The program has expanded services for patients across the cancer center, primary care, and psychiatry. Additionally, they have worked alongside Stanford Medicine Children’s Health to help facilitate the transition of care for adult survivors of childhood cancers. The program has also trained clinicians by increasing their skill set to care for cancer survivors, helping to expand the workforce to care for this ever-growing population.

Mindset research

Survivorship research is essential to identify the needs of people living with and after cancer and to find new ways to meet those needs. This research focuses on the restoration of the physical, psychological, and social health of individuals as they navigate beyond the initial diagnosis and treatment of their cancer. Unfortunately, post-traumatic stress disorder (PTSD), depression, and anxiety, including fear of cancer recurrence, are commonplace among cancer survivors. 

Working alongside SCI member Alia Crum’s, PhD, Mind-Body Lab, the Stanford Cancer Survivorship Program has studied and tested mindset interventions designed to prevent psychosocial morbidity for the past six years. Their research was published in Trends in Cancer in 2019. Mindsets are core assumptions about how the world works. Schapira explains that they guide people through a complex and uncertain reality in ways that create meaning (e.g., why is this happening?), make predictions (e.g., what will happen next?), and motivate action (e.g., what should I do?). Mindsets are a critical but relatively understudied variable that can influence mental and physical health in patients with cancer and can impact how a person experiences their diagnosis and treatment. Mindsets are an especially good target for interventions because they can be changed, and these changes afford significant downstream impacts. 

The team hypothesized that mindsets constituted a promising new target for improving whole-person health. They are currently testing a novel 2.5-hour mobile health mindset intervention in 360 newly diagnosed cancer patients. The research has shown positive benefits  to survivors’ physical, emotional, social, and functional quality of life  and they are now applying for external funding to expand upon this research.

“We built a transdisciplinary and multidisciplinary research platform leveraging the expertise of scientists at Stanford, and we have included multiple stakeholders, including cancer survivors, in the design of every project,” states Schapira. “Our vision is to give people living with cancer the tools they need to manage their illness with confidence.”

Photo: Annie Spratt on Unsplash
February 2023