As cancer diagnosis and treatment continues to improve and cancer survival rates continue to increase, the issues and needs of long-term survivors demand special attention. Our review suggests that long-term survivors of cancer have ongoing issues and concerns associated with diagnosis and treatment. We find that most studies looking at long-term cancer survivors' focus on a narrow view of QOL, often focusing primarily on physical domain issues. We argue that a broader view should be considered; one that examines the four interconnected domains of physical, social, psychological, and spiritual QOL. Although it is true that physical outcomes are important, the psychological, social, and spiritual responses to physical symptoms are equally important and will vary among individuals. A more complete understanding of the long-term impact of a cancer diagnosis and treatment requires inquiry in these additional domains. In addition, few if any of the studies reviewed explored positive outcomes of the cancer experience. There is a clear need to focus on positive aspects of cancer survivorship as well as the negative.

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