The CANSURVIVOR Project: A Positive Approach to Survivorship. Development, Implementation and Evaluation of a Multidisciplinary, Biopsychosocial, Pilot Intervention to Meet Post-Treatment Cancer Survivors’ Needs

The population of Irish cancer survivors is ever-increasing due to the success of modern treatments and earlier detection of the disease. However, there is little evidence in Ireland regarding post-treatment survivors’ service needs. The major aims of this research were to profile a sample of post-treatment survivors, assess their quality of life and health service needs and develop a rehabilitation programme to address those needs. To develop such a programme, two exploratory studies were conducted. Study 1 was a qualitative study of survivors, their carers and health professionals (N = 56). It investigated the factors impacting on post-treatment quality of life from a number of perspectives. It found that cancer and its treatment impacts on the survivors’ quality of life in multiple life domains, that survivors need post-treatment services and that health professionals need to be educated regarding survivorship issues. Study 2 was a comprehensive survey and needs analysis of post-treatment breast, prostate, colorectal and lung cancer survivors (N = 262). It found that although most survivors recovered very well after cancer treatment, up to 26% had significant difficulties with quality of life functioning and symptoms and 33% had anxiety scores above the normal range. In terms of lifestyle, 35% had reduced their physical activity levels, 13% continued to smoke, 51% were overweight and the majority had a poor diet. These findings informed the development and implementation of Study 3 – a multidisciplinary and integrated pilot rehabilitation programme. This 8-week programme used Hope Therapy as a scaffold to support psychosocial, physical activity and dietary change (N = 38). This positive approach to enhancing quality of life and facilitating psychosocial adjustment and health behaviour change was successful in significantly impacting on quality of life, increasing hopeful thinking, physical activity levels, fitness, strength, vitamin C and fibre intake in the treatment group. Significant reductions in anxiety, weight, saturated fat and overall calories consumed were also found. A programme evaluation by participants and the delivery team endorsed the efficacy of the programme. This research represents the first step in developing a theory-based, positive, integrated, bio-psychosocial approach to adjustment after cancer. Recommendations for the future development of formal survivorship services in Ireland are made including the development and dissemination of high quality information about post-treatment issues to cancer survivors and health care professionals.