The annual publication Cancer Statistics is, as the name would suggest, largely a dry compilation of data.

But behind every number is a story, few more compelling and complex than a number tucked away quietly on Page 63 of the report: 695,049.
That is the number of people who had been diagnosed with cancer in the previous 10 years and were still alive on Jan. 1, 2005.
- An astonishing fact
It is astonishing to think that the number of cancer survivors in Canada today is equivalent to the population of a large city.
- 145,692 women overcame breast cancer
Among this army of cancer survivors are 145,692 women who have battled breast cancer; 135,061 men who overcame prostate cancer; 91,934 people who survived colorectal cancer, and even 38,875 people successfully treated for lung cancer.
There is no geographic breakdown of survivorship, but there should be. One of the dirty little secrets in Canada's health-care system is that the quality of treatment and care can vary markedly.
In the cancer field, there is an unofficial postal-code lottery, in which patients in less populous, poorer areas of the country, such as the Atlantic region and the Far North, get short shrift.
The Canadian Strategy for Cancer Control was created, in part, to address this disparity.
- Ambitious strategy goals
The ambitious strategy aims to reduce the burden of cancer by preventing disease, detecting it early and ensuring that those stricken by it receive the best possible care, regardless of where they live.
The survivorship numbers remind us of the importance of this strategy. The numbers are growing annually. This year, an estimated 171,000 will be diagnosed with cancer and 75,300 will die of cancer.
Over all, the numbers are a testament to the fact that diagnosis and treatment have improved. People are living longer after a cancer diagnosis in part because they are being diagnosed earlier.
- Thanks to early detection
But thanks to early detection, an increasing number of cancer patients are being cured. However, we should not fall into the trap of thinking that because the proliferation of cancerous cells has been stopped, a person can forget they had cancer.
Nor can the health system behave as if the initial medical treatment of cancer is all that needs to be done. On the contrary, it is often just the beginning of a health-care journey.
It is true that many, according to the stats - individuals who survive cancer will live productive and rewarding lives for many years after their diagnosis. Survivors make symbolic gestures such as dragon-boat racing and running for the cure, but they also work, volunteer and raise their families.
- Cancer experience
But the cancer experience is never easy. The words ""you have cancer"" strike like a mace. Then treatment and survival present physical, emotional and spiritual challenges that can last years, even decades.
Generally speaking, cancer treatments are not as disfiguring or debilitating as they used to be, but they are still no walk in the park.
- Treatment
Treatment - which can consist of surgery, radiation, chemotherapy or some combination thereof - can last a year and sometimes much more.
Last week, The Globe and Mail featured the story of Shawn Sajkowski, who was diagnosed with non-Hodgkin's lymphoma at age 25.
His treatment lasted six years and included three relapses, 19 rounds of chemotherapy and an arduous stem-cell transplant.
Mr. Sajkowski also missed 20 months of work, had to move back home with his parents, and his long-term relationship collapsed under the strain. His story reminds us that cancer's tentacles reach far beyond the body.
- Financial impact
The financial impact can be staggering, especially for a person with cancer who does not have a job with a good short-term disability plan and extensive drug benefits.
It can be even worse for parents of children with cancer, who often leave their jobs to be full-time caregivers, and see debt pile up that adds to their stress.
One of the biggest financial hardships is created by the lack of universal drug coverage under our current medicare scheme.
Cancer drugs are covered when a patient is treated in hospital, but in many cases they have to be paid for privately (by private insurance or out of pocket) afterward.
- Drug coverage challenges
Drug coverage is particularly poor in the Atlantic provinces, putting cancer patients there at a distinct disadvantage. The health system we have now, with its silos and its illogical disconnect with the social welfare system, is not equipped to deal with cancer survivors after a diagnosis.
When oncology treatment stops, cancer survivors still have financial needs, mental-health challenges (depression is common), may require rehabilitation (especially if they have lost a limb or eyesight) and they need regular medical monitoring.
For some, cancer poses life-long problems, while for others it can be episodic.Treatments can leave survivors infertile or cause secondary illnesses such as heart disease.
Cancer survivors also have a high likelihood of developing a second cancer, often more aggressive than the first, a reality that can hang over their heads like the sword of Damocles.
Yet, it is hard to find a family doctor in many parts of Canada. And general practitioners are not necessarily well versed in the needs of long-time cancer survivors.
Survivors themselves have responded by creating all manner of support groups. But this does not replace the need for a human resources strategy.
Simply put, Canada's health system is not prepared to deal with the large and ever-growing number of people living with cancer and other chronic illnesses.
The number 695,049 should give us pause. But counting cancer survivors is not enough. They need to be monitored and cared for properly.
And with 40 per cent of Canadian women and 45 per cent of men expected to develop cancer during their lifetimes, it is a challenge all of us should demand be met.
(Source: theglobeandmail.com)