Survivorship

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.

Medical History

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

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.

Contact information

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.

Life Goals

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

 

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