As survivorship increases, more cancer patients will be living with cancer for longer periods of time. This may affect your view of the disease and your treatment plans. Often, this can be a positive thing. For example, HIV, once a fatal disease, is now considered chronic because treatments exist that extend the life expectancy of individuals who are HIV positive.
According to most definitions, cancer is a chronic disease because it meets the requirements established by most health authorities: it is an ongoing condition that can recur, requires medical attention/treatment, and affects activities of daily living. Often, there is no cure.
Not all cancers can be categorized as chronic, but those that are ongoing and can be watched and treated do become classified as chronic. Cancers such as ovarian, chronic leukemias, some lymphomas, and even some cancers that have spread or come back like metastatic breast or prostate also become chronic cancers.
While living with a chronic disease of any type can be difficult, the outlook for cancer patients living with chronic cancer is much better than it was years ago.
Chronic Disease Definition
While there is much overlap in the definition of chronic disease, there are still variations in these definitions among the world’s organizations that track disease statistics and provide information to those living with chronic disease. Each organization has their own definition when deciding how to categorize chronic disease.
World Health Organization
The WHO defines chronic diseases as non-communicable diseases that endure for long durations. They are the result of a combination of genetic, physiological, environmental, and behavioral factors. By this definition, the WHO considers cancer to be a chronic disease.
Centers for Disease Control and Prevention (CDC)
The CDC defines chronic disease broadly as any condition that lasts one year or more and requires ongoing medical attention or limits activities of daily life or both. In the U.S., heart disease, cancer, and diabetes are some of the most common chronic diseases.
American Cancer Society
The American Cancer Society views cancer as a chronic disease when the cancer can be controlled with treatment, becomes stable, or reaches remission. Often, when cancer is considered chronic it will move from remission to recurrence and progression and back to remission.
Cancer then becomes a chronic condition that can be controlled with treatment. These treatments may include surgery, chemotherapy, or radiation and are decided between patient and healthcare provider. When making these decisions, quality of life and probability of success are taken into consideration.
U.S. National Center for Health Statistics
The U.S. National Center for Health Statistics defines a chronic disease as a disease that lasts three months or longer. As such, cancer is considered a chronic disease.
Types of Cancer That Can Become Chronic
As treatments for cancer improve and survival rates increase more patients with cancer are living in the chronic phase of the disease. After an initial diagnosis of cancer, you may undergo treatment to control, stop, or remove the cancer. When these treatments are complete, you may go into remission or reach a stable state where the cancer isn’t spreading and can be monitored or treated.
At this point, you may consider your cancer as chronic. Much like patients who live with diabetes or heart disease, you will have a treatment and monitoring plan for the cancer. While you may never be fully cured, you may live a long life with the disease.
The most common types of chronic cancer are ovarian, breast, prostate and certain blood cancers. However, that is not to say that other cancers can’t be considered chronic. Living with cancer can be looked at as a continuum from diagnosis, to treatment, to ongoing observation and more treatment, to a final terminal phase. When cancer is considered chronic you are in a state where your cancer is either stable or controlled.
Treatment of Chronic Cancer
As treatments have improved over the years, many people are living prolonged lives with cancer. A cancer diagnosis is no longer immediately considered a terminal illness, instead, many cancers can be considered chronic. In these cases, treatment should be looked at as a way to prolong and maintain quality of life.
If you look at cancer as a chronic disease you can view it as something that is manageable. The treatment of chronic cancer is varied based on individual goals and probable outcomes. The primary goal of treating chronic cancer is to manage the disease in a way that minimizes the negative effects on your life.
When you can look at cancer in much the same way an asthma patient looks at their disease—that there is no cure, but a way to manage the symptoms—you may be able to adapt a more positive outlook. When faced with a diagnosis that has no cure, learning to manage it in the long term can help you cope with uncertainty.
Treatment for chronic cancer is much the same as treatment for all cancers. The goal here is to minimize symptoms and improve quality and length of life. Depending on your specific cancer diagnosis, you may receive one or more of the following treatments, either concurrently, in succession, or spread out over time.
Surgery
Surgery is used to remove cancer from your body. This is often used on tumors or masses that can be easily taken out of the body. It can also be used to remove parts of tumors in order to make other treatment more effective. Sometimes surgery is used as a palliative treatment to remove tumors that are causing pain or pressure.
Radiation Therapy
Radiation therapy is used to shrink tumors and kill cancer cells. It can also slow growth by damaging the DNA of cancer cells. There is a lifetime limit to radiation therapy for each part of the body and this will be considered when developing your treatment plan.
Chemotherapy
Chemotherapy is a drug-based treatment that works by stopping or slowing the growth of cancer cells. It can shrink tumors before surgery or radiation therapy, destroy cancer cells that remain after surgery or radiation, and kill cancer cells that have returned.
Immunotherapy
Immunotherapy can help your immune system fight cancer. It is a biological therapy that boosts your own immune system’s ability to destroy cancer cells.
Hormone Therapy
Hormone therapy slows or stops the growth of cancers that use hormones to grow such as breast cancer and prostate cancer. This therapy is used to prevent or ease symptoms in people with prostate cancer and can slow or stop cancer’s growth. It can also lessen the chance that the cancer will return.
Stem Cell Transplants
Stem cell transplants do not work by destroying cancer directly, instead they recover your ability to produce stem cells that may have been destroyed by chemotherapy or radiation treatments. However, in the case of multiple myeloma and some types of leukemia, a stem cell transplant can work to destroy the cancer itself.
Whatever treatment plan you and your healthcare provider decide upon, remember that your cancer is a chronic disease and you’re not necessarily looking to eliminate it fully, but to live with it in a way that keeps your quality of life high.
