National Cancer Survivorship Month: What is a Survivorship Program?
By Sharon Salenius
With the development of improved treatments, earlier diagnosis through screening, and better imaging technologies, there are more and more people surviving a cancer diagnosis every year. Who exactly is a cancer survivor? A cancer survivor is anyone who has had a diagnosis of cancer. This can include people who are under treatment for cancer, those who have finished treatment and are cancer-free, and those who are living with cancer as a chronic disease.
Many cancer patients celebrate when their active treatment ends. The end of treatment was once considered to be the end of a patient’s cancer “journey”, but it has become apparent that a cancer diagnosis can continue to affect patients long after their active treatment ends, even when they are cancer-free, in expected and unexpected ways.
In 2005, the Institute of Medicine (now the National Academy of Medicine) issued a report entitled “From Cancer Patient to Cancer Survivor: Lost in Translation”. The report issued a number of recommendations to improve the quality of life for patient following a cancer diagnosis. For example, many patients worry about the cancer returning, or feel stress that they aren’t seeing their medical team as frequently. Often, they have to deal with long-term side effects of treatment, sexual and fertility problems, relationship changes, and work-related issues.
Many clinics subsequently organized survivorship programs and offered them to their patients to help them through such issues. What does a survivorship program consist of? While they vary from clinic to clinic, there are some specific guidelines. According to the NCCN1, the essential components of a survivorship program are:
- Monitoring for any return or spread of the cancer, and screening for new cancers
- Monitoring long-term effects of cancer, including psychological, social, and physical effects
- Prevention and detection of late effects of cancer and therapy
- Evaluation and management of cancer-related symptoms with referrals for management
- Coordination of care between primary care providers and specialists to ensure that all of the survivor’s health needs are met
- Planning for ongoing survivorship care:
- Information on treatment received including all surgeries, radiation therapy, and systemic therapies
- Information regarding follow-up care, surveillance, and screening recommendations
- Information on post-treatment needs, including information on acute, late, and long-term treatment-related side effects and health risks when
- Delineation of roles of all health care providers (including oncologists, primary care physicians [PCPs], and subspecialists) in long-term survivorship care with coordinated timing of care and transfer of care as appropriate
- Promotion of adherence to healthy behavior recommendations
- Periodic assessment of ongoing needs and identification of appropriate resources
Many clinics go above and beyond these recommendations, and some offer programs specific to the type of cancer or for specific age groups such as children. If you are not offered a survivorship program in your treatment clinic, you may ask your health care provider to refer to you a center that offers such a program. Survivorship programs have been found to be helpful to cancer survivors and as technology continues to improve, it is expected that their use will increase.