Advancing Cancer Survivorship in a Country with 1.35 Billion People: The China Lymphoma Project.

Rates of lymphoma are rising rapidly and lymphoma is now the ninth most common cancer among Chinese males. The China Lymphoma Project was founded to increase awareness of lymphoma in China, including the survivability of the disease and the availability of potentially life-saving treatments, and to provide social support for men, women, and children in China who are living with the disease. The project is working with China government officials, several of the top cancer hospitals in China and the U.S., internationally known oncologists and cancer researchers, pharmaceutical and biotech companies in China and the U.S., healthcare and environmental companies, the Confucius Institute at San Diego State University, and the Asian Heritage Society. Advances in e-Health are being utilized to provide patient education and social support. The project will provide free e-books that profile lymphoma survivors (e.g., Kai-Fu Lee, creator of Google China), new videos, websites, pamphlets, blogs, video logs (vlogs), peer-to-peer counseling and support, and information about the latest treatments and oncology clinical trials.


Introduction
The Peoples Republic of China is the world's most populous country and the second largest country by land area. In recent decades, cancer incidence and mortality have increased in China due to exposure to occupational carcinogens and environmental pollution associated with rapid industrialization and lifestyle factors such as cigarette smoking and westernization of diet. Each year, China accounts for more than 3 million newly diagnosed This is an Open access article distributed under the terms of Creative Commons Attribution 4.0 International License. cancer cases, 21.8 percent of the world's total [1] . Although the most common forms of cancer in China include cancer of the lung, breast (women), liver, stomach, and esophagus, rates of lymphoma are rising rapidly [2] . Lymphoma (Hodgkin's and non-Hodgkin's lymphoma) is now the ninth most common cancer among Chinese males on the mainland [2] . Researchers have reported an especially rapid increase in the disease among China's young people in major urban areas.
The China Lymphoma Project was founded by one of the authors (J.R.) who is a journalist (Newsweek, International Business Times, New York Times), singer-songwriter, cancer patient advocate, and 19-year survivor of stage IV non-Hodgkin's lymphoma. The project's goal is to increase awareness of lymphoma in China, including the survivability of the disease and the availability of potentially life-saving treatments, and to provide health educational information and social support for men, women, and children in China who are living with the disease.
The social support received by cancer patients can include informational support (the provision of advice, guidance, suggestions, or useful information), companionship support, and emotional support (the offering of empathy, concern, acceptance, encouragement, or caring) [3] . Emotional support can come from family and close friends, health care providers, and fellow cancer patients [4] . Sources of support include online patient support groups, blogs, and social media.
In a country as large as China, the provision of health education and social support for cancer patients requires leveraging recent advances in e-Health and mobile health (m-Health) technologies such as smartphone applications for patient education, diagnosis and disease management, and participation in randomized clinical trials of new treatments [5,6] . Smartphone apps can have a variety of features including visually-engaging design, video and audio capabilities, unrestricted text capabilities, access without cellular or Internet connection, optimized to smartphone screen size, content sharable via social media, and tracking progress anywhere and anytime [7] . Health applications related to cancer diagnosis and treatment, telemedicine, and oncology clinical trials hold promise for cancer treatment and survivorship [5,6,8] .
The China Lymphoma Project is working with China government officials, several of the top cancer hospitals in China and the U.S., internationally known oncologists and lymphoma researchers, pharmaceutical and biotech companies in China and the U.S. healthcare and environmental companies, and highly-regarded nonprofit organizations. The latter include the Confucius Institute at San Diego State University and the Asian Heritage Society, an educational and philanthropic nonprofit organization based in San Diego.(figure 1) The project will provide free e-books that profile lymphoma survivors (for example, Kai-Fu Lee, creator of Google China), new videos, websites, pamphlets, blogs, video logs (vlogs), peer-to-peer counseling, and information about the latest treatments and oncology clinical trials. The latter include phase I/II and phase III trials of a new generation of less toxic, more effective treatments for lymphoma. Chinese lymphoma patients and their families will be provided with hope and information, two essential tools they need to fight cancer.