Survivorship is the challenge faced daily by millions of Americans who have a history of cancer. Survivorship, however, is not just about long-term survival. Instead, it is about one’s quality of life from diagnosis onward. It is living with, through, and beyond cancer.

As detection and treatments have improved, many types of cancers have shifted from acute to chronic diseases, and some cancers are now highly curable. The statistics are positive, but numbers do not really tell very much about how persons with cancer survive—physically, psychologically, socially, economically or spiritually. They do not tell us how people with a cancer diagnosis learn to live with fear and uncertainty or how they manage to be hopeful.

• People hope differently. While hope is individualistic, your own hope strategies are impacted by how your family of origin and your present family use and maintain hope.
• Families tend to have similarities in the ways they hope, but family hope constellations are not mutually exclusive. For example, you may be religious and academic at the same time.
• Different types of hope constellations may lead to conflict between the person with cancer and family members or friends. It also can lead to conflict between the patient/family and the health care professionals who care for them, because health care professionals also hope in individual ways.
• Most people have never thought about “how” they hope. They just assume everyone hopes in the same manner that they themselves do.
• This does not refer simply to optimism or pessimism, but to the strategies people use to look forward and for maintaining a positive future outlook.
• Most health care professionals are not trained to do “hope assessments” or to recognize different hoping styles. They often think only in terms of “therapeutic” hope, and equate other hope with denial. This can have a negative impact on your interactions with them and can make you vulnerable to broken hope.
• It is important to think about your own hoping strategies and to be direct with family, friends and professional caregivers about what is most helpful to you with regard to using and maintaining hope. Never let anyone tell you that there is nothing further to hope for or that there is no hope. There is always something to hope for, and you, as an individual, have the right to determine for what, when and how you hope.