Cancer: Thriving and Surviving (CTS) Program

The teaching process makes this program effective. Classes are highly participatory. Mutual support and success builds participants’ confidence in their ability to manage their health and maintain active and fulfilling lives.


  • Small group workshop
  • 2 1/2 hours per session
  • 1 session per week for 6 weeks
  • It is the process in which the program is taught that makes it effective. Classes are highly participative, where mutual support and success build the participants’ confidence in their ability to manage their health and maintain active and fulfilling lives.
  • A Spanish translation of the program is also available.


  • Community settings such as senior centers, churches, libraries and hospitals.
  • Special attention should be given to making the location accessible to all.
  • A room large enough for all participants to gather comfortably, plus space for 2 leaders and their materials.


  • People who are managing cancer or are in remission
  • 12-16 participants per workshop

Participant Materials


  • 2 trained leaders, one or both of whom are are themselves cancer survivors.
  • Must be trained by certified Master Trainers, or must be Master Trainers themselves.

Subjects Taught

(Note: Participants make weekly action plans, share experiences, and help each other solve problems they encounter in creating and carrying out their self-management program. Physicians and other health professionals both at Stanford and in the community have reviewed all materials in the workshop.)

  • Techniques to deal with problems such as frustration, fatigue, pain, isolation, poor sleep and living with uncertainty
  • Appropriate exercise for regaining and maintaining flexibility, and endurance
  • Making decisions about treatment and complementary therapies
  • Communicating effectively with family, friends, and health professionals
  • Nutrition
  • Setting priorities
  • Relationships

Cáncer: Triunfando y Sobreviviendo

This program is a Spanish translation of Cancer: Thriving and Surviving

Frequently Asked Questions

Does the Program replace existing programs and treatments?

The program will not conflict with existing programs or treatment. It is designed to enhance regular treatment. The program gives participants the skills to coordinate all the things needed to manage their health, as well as to help them keep active in their lives and relationships.

How was the Program developed and evaluated?

The Cancer: Thriving and Surviving (CTS) Workshop was originally adapted from the Chronic Disease Self-Management Program (CDSMP), at the Macmillan Cancer Support Trust in the United Kingdom.  It was tested for effectiveness in the UK and in the USA.  The primary developers of the current program are Kate Lorig, DrPH, and Diana Laurent, MPH, at Stanford, and Richard (Rick) Seidel, PhD, LCP, at Virginia Tech Carilion School of Medicine.

How can my facility offer the Program?

Web-based cross-training is available through SMRC for those already trained in the Chronic Disease Self-Management Program (CDSMP). Because the program shares many of the basic techniques with the CDSMP, those new to our self-management programs must take in-person training for the CDSMP before being cross-trained in the CTS program. Training locations, dates and application can be found in the "Training" section of this website.


Outcome data reported in (more citations in Bibliography):

Risendal BC, Dwyer A, Lorig K, Coombs L, Kellar-Guenther Y, Warren L, Franco A, Ory MG. Adaptation of the chronic disease self-management program for cancer survivors: feasibility, acceptability, and lessons for implementation. J Cancer Educ. 2014 Dec;29(4):762-71. doi:

Risendal BC, Dwyer A, Seidel RW, Lorig K, Coombs L, Ory MG. Meeting the challenge of cancer survivorship in public health: results from the evaluation of the chronic disease self-management program for cancer survivors. Psycho-Oncology. 2015 Apr 10 (ePub). doi: 10.1002/pon.3783