The Internet as a Route to Health Information, Support, and Healthcare for Cancer Survivors

Abstract

W ith advances in detection and increasingly sophisticated treatments, twothirds of people who are diagnosed with cancer will become long-term survivors. 1 This means that most cancer survivors will live .5 years after their diagnosis. 1 In fact, it is estimated that there are .16.9 million cancer survivors alive in the United States today, and that number is expected to grow to $22.2 million by 2030 with the growth and aging of our population. 2 The growing number of cancer survivors represents both a success and a challenge, which will require innovative models of care and support. 3 This includes internet use. 4 As explained by Young Adult Cancer Canada, "it takes longer to recover from cancer than to treat it" (Karine Chalifour, BSW, Young Adult Cancer Canada, personal email communication, October 2020). After treatment, cancer survivors must cope with multiple physical, functional, and psychosocial challenges that can diminish their ability to participate fully in work and life and reduce their overall quality of life. 5-7 Many of these supportive care issues are neglected or not adequately addressed because of the fractured nature of care delivery, the lack of survivorship programs or processes or incentives to permit their timely management, 3,8,9 or the patient's location. 10 As a result, many patients with cancer report being dissatisfied with the information and support they receive from health professionals, 11 and struggle with high levels of unmet supportive care needs. 12 The internet offers a convenient and cost-effective way for cancer survivors to access personally tailored health information and support. 13-15 Relevant information from credible health websites can dispel fears, enhance feelings of control, promote self-care, and decrease anxiety, 13,14 and emotional support from online groups can buffer distress by normalizing experiences, thereby lessening negative appraisals of events and promoting coping efforts. 15 Nationally representative, up-to-date data on the prevalence of internet use is needed to inform patient education and supportive care services for cancer survivors. In this issue of JNCCN, using 2013-2018 data from the National Health Interview Survey, Dee et al 4 report on a cross-sectional analysis of general and health-related internet use among cancer survivors in the United States. In this study, more than two-thirds of respondents were internet users, with internet usage increasing over the 5-year period studied. Among this sample of 12,970 adult survivors, general internet use increased from 63.2% to 70.8%, and healthspecific internet use increased from 48.9% to 52.2% between 2013 and 2018. Other population-based studies using data from the Health Information National Trends Survey have reported similar internet use rates among cancer survivors in the United States. 16 Although the internet has the potential to reduce healthcare inequalities by providing individuals with access to information and support that might otherwise be inaccessible, 10 experts have concerns that i...

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“What We Want Is More Access…”: Experiences of Supportive Cancer Care and Strategies for Advancement in a Canadian Provincial Cancer Care Organization

“…Suggestions provided by participants to improve integration and coordination included centralizing information about supportive care services, developing virtual/online/telehealth supportive care programming to minimize the need to travel/commute to the cancer centre to access in-person programming, having dedicated professional patient navigators/coaches, and a “one-stop-shop” to access supportive care. These strategies have already been implemented/tested in various ways at different cancer care institutions [ 20 , 21 , 22 , 23 , 24 ]. For example, centralizing information about supportive care services has been developed using eHealth (i.e., web-based Internet search engines or smartphone applications) [ 24 , 25 ].…”

Factors associated with internet use and health information technology use among older people with multi-morbidity in the United States: findings from the National Health Interview Survey 2018

“…Healthy People 2030 highlights the desire to increase the use of patient portals, particularly the proportion of persons who use health information technology (HIT) to track health care data or communicate with providers, and the proportion of persons who have access to quality (reliable and easy to use) digital health tools and information [ 12 ]. The Internet is and will continue to be a major source for people to receive health information as it plays an increasingly important role in health care and as individuals become more aware and receptive to new technologies such as the Internet [ 13 ]. Studies have shown that greater participation in the Internet and social media may be related to the improvement of health behaviors and health conditions, indicating the growing important of the Internet in health maintenance [ 14 ].…”