It is quite remarkable that in so short a period we have seen cancer change from the stigmatized deep secret when no survivor dared to reveal it and complaints to physicians were met with "You should just be glad you are alive." Today, survivors of cancer—all 10 million of them—are eager to share their story with others and oncologists have a new interest in the care of their patients AFTER cancer. It is most worthwhile that Dr. Feuerstein has chosen to put together a baseline state of the art of the science of cancer survivorship, because it is new, still in its infancy and the research will likely explode in the next decade. There is much to be grateful for to pediatric oncology which has led the way and embraced survivorship long ahead of the adult oncology world. Many lessons learned there about clinical care, management of long-term side effects, prevalence of second malignancies, and the most effective models for follow-up should guide some of the early research in adult survivors.

Survivorship research is now represented by a whole field of investigators and clinicians devoted to improving the lot of the survivor from many different perspectives. Several are key contributors to this useful book. This handbook outlines the prevalence, burden, common problems, secondary prevention, and global perspective toward a new clinical entity that is the result of the cancer success story.

There are many important questions to be answered about survivorship and this book sets the stage for new researchers and clinicians entering the field. The reviews of the literature in each area will be invaluable as researchers move forward. I predict that this will serve as a foundation for the explosion of research that will be designed to assist in assuring that survivors are able to live their full lives to the fullest.

Jimmie C. Holland, md Wayne E. Chapman Chair in Psychiatric Oncology Memorial Sloan-Kettering Cancer Center New York, NY 10022

April 2006

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