Originally published September 1, 2021
Deborah K. Mayer, PhD, RN, AOCN, FAAN
Although it is difficult to measure how many cancers have been prevented since 1971, we do know that there are now more than 17 million people alive in the United States with a history of cancer, as compared with 3 million people in 1971, representing an increase from about 1% to more than 5% of the American population. This fact is one of the greatest testaments to the impact of the National Cancer Act.
In the early days after the Act was passed in 1971, the National Cancer Institute (NCI) funded cancer rehabilitation programs focused on mitigating the functional, physical, emotional, social, and vocational impacts of cancer and its treatment. This shifted over time to the concept of survivorship with the publication of an article by Fitzhugh Mullan in The New England Journal of Medicine. Mullan, a young physician diagnosed with cancer, who described seasons of survival. He stated, “it did not occur to me while I was acutely ill for some time afterward that the simple concepts of sickness and cure were insufficient to describe what was happening to me. As with most cancer patients, the quality of my life during this period was severely compromised, and the possibility of death was always present. I was in fact, surviving, struggling physically and mentally with the cancer, the therapy and the large-scale disruption to my life.” Mullan then went on to describe acute, extended, and permanent phases of survival.