Managing Your Health is Easier When You Have a Plan
Just as you needed a treatment plan, you also need a survivorship care plan once therapy is finished or as you continue with maintenance therapy. By working together with your doctor, you can map out the level of care you will need, develop a follow-up schedule and learn about recommendations for living the best life possible.
Following are the common parts of a survivorship care plan. Your plan will be customized for you, taking into consideration your diagnosis and treatment history, age and other health conditions, as well as your expectations for the future.
This information may include your diagnosis and other diseases 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. It also may include your family medical history.
Your diagnosis should include the 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.
Your treatment summary should include the following:
- Hospital stays: Reasons, medications, recovery time and complications.
- Surgeries: Types, inpatient or outpatient, recovery times and 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 or nausea), 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
This part of the plan will outline your follow-up care:
- Follow-up appointment schedule for ongoing monitoring.
- Maintenance medications or therapies, including type, dosage, frequency and duration.
- Referral(s) for cancer rehabilitation, such as physical or occupational therapy, speech therapy, a lymphedema specialist or others.
- Information about your risk of a recurrence, long-term treatment-related side effects and late effects, and a second cancer (see Table 1).
- Recommended screening guidelines for other types of cancer (see Table 2). 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, Bladder, Kidney, Pancreas, Rectal, Thyroid
|Melanoma**||Melanoma*, Other Skin Cancers, Salivary Gland, Small Intestine, Breast (female), Prostate, Kidney|
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|
|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|
Note the health care team members you will see for follow-up care, and include their contact information.
Health, Wellness and Lifestyle Recommendations
These recommendations may include good nutrition habits, getting to or maintaining a healthy weight, improving fitness and increasing strength. Healthy lifestyle changes such as stopping smoking and managing stress are important to discuss.
Also ask your doctor about getting vaccinations, such as those for COVID-19, shingles or influenza. What is recommended for one person may not be appropriate for another, so be sure the doctor you talk with is familiar with your medical history and current treatments.
You may have already shared these goals with your medical team when planning treatment. Now is also a good time to change them or add new ones that better fit in with where you are now.
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. Download a blank Survivorship Care Plan