With advances in treatment, supportive care, and early diagnosis, the prevalence of cancer is in- creasing. An individual is considered a cancer
survivor from the time of diagnosis to the end of his or
her life.1 Although many patients with cancer are cured,
they experience various short-term and long-term effects
of cancer treatment, a high risk of recurrence and second
cancer, anxiety, chronic pain, fatigue, depression, sexual
dysfunction, and infertility.1
As of January 1, 2014, there were about 14.5 million
cancer survivors in the U.S. The most common cancers
in this population include prostate (43%), colon and
rectal (9%), and melanoma (8%) in males; breast
(41%), uterine corpus (8%), and colon and rectal (8%)
in females.2 This estimate does not include noninva-sive cancers, but does include bladder, basal cell, and
squamous cell skin cancers. By January 1, 2024, the
population of cancer survivors is predicted to increase
to almost 19 million: 9.3 million males and 9.6 million females.1 Most of the cancer survivors (64%) were
diagnosed 5 or more years ago, and 15% were diagnosed 20 or more years ago. Nearly half (46%) of cancer survivors are aged ≥ 70 years, and only 5% are aged
< 40 years.2
Moye and colleagues reported that 524,052 (11%)
of veterans treated in 2007 were cancer survivors.3 The
most common types of cancers among these veterans
were prostate, skin (nonmelanoma), and colorectal can-
cers. Compared with the general population of can-
cer survivors in the SEER database, veteran survivors
were older.3 Because of the increasing prevalence of can-
cer survivors, greater attention is focused on long-term
complications of cancer treatment. Recent studies have
demonstrated that cancer survivors are less likely to re-
ceive general preventive care and care associated with
noncancer-related medical conditions than are individu-
als without cancer.4
SURVIVORSHIP CARE COMPONENTS
In 2005, the Institute of Medicine (IOM) published From
Cancer Patient to Cancer Survivor: Lost to Transition.5 The
report addresses 4 essential components of survivorship care: (1) prevention of recurrence, new cancers,
and other late effects; (2) surveillance for cancer spread,
recurrence, second cancers, and medical and psychosocial adverse events (AEs); (3) interventions for consequences of cancer and its treatment (medical problems,
symptoms, psychological distress experienced by cancer survivors and their caregivers, and concerns related
to employment, insurance, and disability); and (4) coordination between the specialist and primary care providers (PCPs) to ensure that all the survivors’ health needs
are met.5
Cancer Treatment Summary
To ensure better transition, the IOM recommended that
survivorship plans be made with a summary of treatment
provided by the primary oncologist who treated the patient, to improve communication among all health care
providers and between the providers and the patient.5
Updates on Cancer Survivorship
Care Planning
Anuradha Kunthur, MD; Zhifu Xiang, MD; Harjot Kaur, MD; Sarah Jewell, MD;
and Paulette Mehta, MD MPH
Cancer organizations have developed guides and tools to help build cancer
survivorship programs and survivorship care plans.
Dr. Kunthur, Dr. Xiang, and Dr. Mehta are staff hematology/oncologists,
all at the John L. McClellan Memorial Veterans Hospital in Little Rock, Arkansas. Dr. Kaur is a resident, Dr. Jewell is a hematology/oncology fellow,
Dr. Kunthur and Dr. Xiang are assistant professors of hematology/oncology,
and Dr. Mehta is a professor of hematology/oncology, all at the University of
Arkansas for Medical Sciences in Little Rock.
