Survivorship

Creating a Survivorship Plan

Many cancer advocacy organizations recommend a survivorship care plan for all cancer survivors, whether you are disease-free or living with chronic or metastatic cancer. Ideally, your survivorship care plan starts at the time of your diagnosis. This means making your life goals known to your treatment team so they can consider them in the treatment planning process. For example, if you are in your thirties, newly married and hope to have a family, fertility preservation should be explored before you start the therapies you will take to treat the cancer or prevent recurrence.

If the follow-up care plan you received does not include recommendations for survivorship care, your doctor, nurse navigator or case worker can help you make one. The information on this page should be included in your plan. Download these tools to help you get started:

  • Survivorship Diagnosis Care Summary
  • Follow-up Care Plan

Your Medical History

This information may include diseases, conditions or disorders; surgeries and treatments; hospitalizations; pregnancies; major accidents or injuries; past and present pain issues; lab reports and test results; immunizations; past and current medications; and ongoing health conditions. Include your family medical history.

List of Health Care Team Members with Contact Information

Include each person’s role, from primary care physician and medical, surgical and radiation oncologists to your follow-up care physician.

Diagnosis

Make sure it includes cancer type, subtype and tumor site(s); stage or classification; date of diagnosis; diagnostic test results and pathology reports; and, if applicable, tumor grade, molecular biomarkers present, genetic test results, hormonal status and a summary of second/ third opinions. (Review this information with your doctor, nurse practitioner or nurse navigator to ensure you have recorded it correctly. It is easy to confuse stage and grade.)

Treatment Summary, including Dates

  • Hospital stays: Reasons, medications, recovery time and any complications.
  • Surgeries: Types, inpatient or outpatient, recovery times and any complications.
  • Radiation therapy: Type, site(s) and total amount of radiation.
  • Drug therapies: Type, drug names, dosages, duration, side effects and responses.
  • Supportive care (palliative care): Symptom management, medications (such as for anxiety, nausea, etc.), pain management, counseling or other support services for you and/or your loved ones.
  • Additional services: Physical or occupational therapy, fertility preservation, nutritional counseling, etc.

Follow-up Care Plan

  • Follow-up appointment schedule for ongoing monitoring.
  • Maintenance medications or therapies, including type, dosage, frequency and duration.
  • Referral(s) for cancer rehabilitation services, such as physical or occupational therapy, speech therapy, a lymphedema specialist or others.
  • Information about your risk of a recurrence; a second cancer (see Table 1), long-term treatment-related side effects and late effects (see Late Effects).
  • Recommended screening guidelines for other types of cancer (see Table 2), and ask your doctor how they apply to you.

Table 1. Potential Second Cancers Among Adult Survivors

Primary Cancer Commonly Associated Second Cancers*
Bladder Lung, Bladder*, Renal Pelvis/Ureter, Pancreas, Larynx, Prostate
Breast Breast (female, opposite side)*, Colon, Esophagus, Ovarian, Stomach, Thyroid, Uterine
Colon Colon*, Anal, Bile Duct, Kidney, Rectal, Small Intestine, Stomach
Hodgkin Lymphoma Leukemia, Breast (female), Lip and Tongue, Lung, Non-Hodgkin Lymphoma, Salivary Gland, Thyroid
Testicular

Testicular, Bladder, Kidney, Pancreas, Rectal, Thyroid

Melanoma** Melanoma*, Other Skin Cancers, Salivary Gland, Small Intestine, Breast (female), Prostate, Kidney
*Second primary cancer diagnosis in the same organ or site.
**Learn how to detect a melanoma at patientresource.com/ABCDErule.aspx

Table 2. Recommended Guidelines For Cancer Screenings

Cancer Type Screening Test Age Frequency
Breast cancer Breast self-exam (BSE) 20+ (women) Regularly
Clinical breast exam (CBE) 40+ (women)* Yearly
Mammogram 40+ (women)* Yearly
Cervical cancer Pap test 21 to 29 (women) Every 3 years
Pap test + human papillomavirus (HPV) test 30 to 65 (women) Every 5 years
Colorectal cancer Colonoscopy 45+ (men and women) Every 10 years
Lung cancer** Low-dose computed tomography (LDCT) of the chest 55 to 74 (men and women)* Yearly
Prostate cancer Prostate-specific antigen (PSA) blood test with or without a digital rectal exam (DRE) 50*** to 70 (men) Varies based on PSA level
*If you are healthy and expect to live another 10+ years, continue screening.
** Only if you meet all criteria: in relatively good health; smoking history of 30 (or more) pack-years (number of packs of cigarettes smoked daily multiplied by years of smoking; and smoke currently or quit within the last 15 years.
***Ask your doctor about starting screening at age 40 if your father or brother had prostate cancer before age 65 or if you are African-American.

Health, Wellness and Lifestyle Recommendations

These recommendations may include good nutrition habits, getting to or maintaining a healthy weight, improving fitness and increasing strength, and healthy lifestyle changes such as smoking cessation and stress management, with contact information for specialists to guide you.

Your Life Goals

These life goals were previously identified and shared with your treatment team. Determine if you are still on track for accomplishing them. Create a plan for how to achieve them. Also consider adding some new goals (see Life After Cancer).

Survivorship Support and Community Resources

The resources should include your cancer center; survivorship clinics, support groups, cancer advocacy organizations and other local or area resources; survivor phone buddies and peer-to-peer matching; and online survivorship support groups and communities.

Additional Resources

 

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