The cancer experience exists as a continuum, beginning with diagnosis and continuing through the phases of treatment toward long-term survival [1]. The term “cancer survivor” is used to describe any person diagnosed with cancer, including those currently fighting the disease or those who have become cancer-free. Treatments aim to remove all traces of the cancer from the body, prolong survival, and provide the highest possible quality of life. However, many survivors experience adverse long-term effects from the treatment, including physical and/or psychological symptoms. Supportive cancer care is designed to understand and treat these cancer-associated and cancer-induced symptoms to provide lasting physical and emotional well-being for survivors and their families at all stages of the illness [2]. Education, management, and continuous support are essential to reducing these adverse side effects of cancer and its treatments in order to enhance the quality of life for cancer patients and caregivers.

Cancer is a leading cause of disease, with an estimated 14.1 million new cancer cases occurring worldwide in 2012, according to the International Agency for Research on Cancer (IARC) [3]. Cancer is also a leading cause of death globally, with an estimated 8.2 million deaths in 2012 [3]. There were 32.6 million people alive worldwide at the end of 2012 with a cancer diagnosis in the previous 5 years, and the three most commonly diagnosed cancers were lung (13 %), breast (11.9 %), and colorectal cancers (9.7 %) [3, 4]. Predictions by GLOBOCAN 2012 calculate the new number of cancer cases per year to increase to 19.3 million in 2025 [3].

This trend of an increasing population of cancer survivors has been studied extensively in the United States. On January 1, 2014, nearly 14.5 million people were living with a history of cancer in the United States, and this number is predicted to reach 19 million by January 1, 2024 [5]. This estimate is calculated based on the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database and does not include basal cell or squamous cell skin cancers or carcinomas in situ of any site except the urinary bladder. The increase in the number of cancer survivors is attributed to the early detection and improved treatment for this disease in combination with an aging and growing population [5]. Of the total cancer survivors in the United States, 46 % are aged 70 years or older, whereas only 5 % are aged 40 years or younger. More than half of the cancer survivors (64 %) in the United States were diagnosed five or more years ago, and 15 % were diagnosed with cancer 20 or more years ago. Among males, the three most prevalent types of cancers are prostate cancer (43 %), colorectal cancer (9 %), and melanoma (8 %); among females, the three most prevalent cancers are breast cancer (41 %), uterine cancer (8 %), and colorectal cancer (8 %) [5]. The prevalence of cancer and its specific disease sites demonstrate the importance of understanding the unique characteristics and needs of each patient to provide supportive care resources throughout the many phases of cancer survivorship. The role of patient navigation throughout these phases of survivorship and the complexities of cancer care is the first topic explored in the next chapter, with special emphasis on the evolution of the patient navigation concept and its future potential as an organized and established discipline in the context of supportive cancer care.

An important factor to consider in the survival of cancer patients is comorbidity, a condition of having two or more diseases at the same time [6]. Observational studies suggest that cancer patients with comorbidities have poorer survival than patients without comorbidities [6]. When cancer patients have other medical conditions in addition to cancer, the healthcare provider must incorporate comorbidity measurements into the decision-making process to better quantify risk, predict outcomes, and identify treatment options for the patient. Research also suggests that comorbidity can have a considerable impact on cancer detection, stage at diagnosis, choice of treatment, and completion of treatment regimen [6].

According to the National Cancer Institute’s December 2013 Annual Report to the Nation on the Status of Cancer, the prevalence of comorbidities among the top four cancers (occurring in over half of patients aged 66 years or older) was 52.9 % for lung cancer, 40.7 % for colorectal cancer, 32.2 % for breast cancer, and 30.5 % for prostate cancer [7]. Based on Medicare claims reports, the fifteen new comorbidities identified in patients in the year prior to cancer diagnosis included acute myocardial infarction (heart attack), acquired immunodeficiency syndrome (AIDS), cerebrovascular disease (stroke), chronic renal failure (chronic kidney disease), cirrhosis/chronic hepatitis, congestive heart failure, chronic obstructive pulmonary disease (COPD, lung disease), dementia, diabetes, history of myocardial infarction (irreversible heart disease), liver disease, paralysis, rheumatologic disease (arthritis), ulcer disease, and vascular disease [7]. The most prevalent types of comorbidities among cancer patients were diabetes (16 %), COPD (15.5 %), congestive heart failure (9.7 %), and cerebrovascular disease (6 %) [7]. Depending on the level of severity (low, moderate, or severe) of the comorbidity condition, the cancer treatment may require modification to extend survival and/or maintain quality of life. The level of severity is calculated using scores from claims data and statistical models in the SEER-Medicare linked database [7].

Many different types of treatment have been researched and developed to eliminate cancer and/or ensure the highest possible level of physical and emotional well-being for the patient. When selecting a treatment and developing a treatment plan, it is most important to first discuss and identify the needs and the priorities of the patients and their families. Treatment options can involve surgery, radiation, therapy (chemotherapy, immunotherapy, targeted therapy), and bone marrow transplantation. Palliative and psychosocial care should also be incorporated into the active treatment plan to help minimize pain, symptoms, and stress for patients. From the moment of diagnosis, physical and emotional symptoms begin to negatively affect patients; therefore, it is crucial that discussions on supportive and palliative care occur as early as possible in the course of disease. In 2007, a study of 51 ambulatory patients with advanced non-small cell lung cancer (NSCLC) demonstrated the feasibility of integrating early palliative care with oncology care [8]; in 2012, a study of 151 patients with metastatic NSCLC demonstrated that early palliative care optimized the timing of chemotherapy treatment and hospice care transitions [9], lending support to the positive impact of the services provided by a palliative care team. Chapter 5 of this book examines Palliative Care as an essential part of quality care in cancer survivorship.

Unfortunately, there are many common side effects associated with cancer treatment, and these side effects can vary from being acute and short lived to being chronic and persistent. Even after treatment has ended, late effects can arise months or years later, thus affecting both short-term and long-term quality of life. For example, chemotherapy drugs such as vincristine, taxanes, and platinum-based drugs can damage sensory nerve cells and induce weakness, numbness, and pain in the hands and feet of the patient [10]; this condition is termed peripheral neuropathy, and it requires ongoing medical attention because the extent of the damage is dose dependent and may take months or years, if ever, to resolve. Chapters 7 and 8 of this book explore the Fundamentals of Pain Management as well as the Management of Breakthrough Pain, respectively.

The management of the physical and psychological symptoms related to cancer and its treatment is crucial for maintaining quality cancer care and meeting the needs of cancer survivors and families. The eleven most common side effects of cancer and its treatment are bone density loss (osteoporosis and osteopenia), cardiotoxicity (heart damage), cognitive (mental) deficits, emotional distress, fatigue, fear of cancer recurrence, infertility, lymphedema, pain, pulmonary (lung) dysfunction, and sexual dysfunction [11]. Coordination of supportive care for physical and psychological side effects is a key aspect in developing a treatment plan. This book features many chapters on the management of specific adverse effects of cancer and its treatment. Chapter 3 delves into Psychosocial Oncology as an interdisciplinary specialty of understanding and treating the complex emotional stress and psychological issues associated with the cancer experience. Chapter 4 focuses on the Management of Depression, Chaps. 9 and 10 explore Delayed Nausea/Emesis and Fatigue respectively, and Chap. 11 investigates Cognitive Function in the Cancer Survivor. In regard to lifestyle management, Chap. 13 builds upon the foundation of patient-centered care to address Nutrition and the Cancer Survivor, and Chap. 14 focuses on the current research and future directions for the symptom management of Weight Gain.