Washington – The nation’s 10 million cancer survivors require customized follow-up for years that too few now receive, says a major study that calls for oncologists to create a “survivorship plan” to guide every patient’s future health care.
Half of all men and one-third of women in the U.S. will develop cancer in their lifetimes. Thanks to advances in early detection and treatment, the number who survive has more than tripled over the past 30 years.
When active treatment ends, these people’s special needs may be just beginning, said the study, released Monday.
Yet the legacy of physical, psychological and social consequences has largely been ignored by doctors, researchers and even patient-advocacy groups, leaving survivors too often unaware of simmering health risks or struggling to manage them on their own, said the report by the Institute of Medicine.
“There is currently no organized system to link oncology care to primary care,” explained Dr. Sheldon Greenfield of the University of California, Irvine, who led the study for the institute, an arm of the National Academy of Sciences.
“You fall off a cliff when your treatment ends,” agreed report co-author Ellen Stovall, president of the National Coalition for Cancer Survivorship, who speaks from personal experience as a two-time survivor.
Busy oncologists’ priority is to treat patients, and they may have little time for the survivor, while physicians who don’t specialize in cancer care may not know what needs survivors have.
Survivors are at risk of their initial cancer returning or a new one forming, and may need not just screening to detect that but also help handling the inevitable fear.
Some work is beginning to try to provide survivor care, sparked by the pediatric cancer community. The Children’s Oncology Group, a leading research group, developed long- term follow-up guidelines that say every child cancer survivor should be given an explicit treatment record – complete with physicians’ addresses and doses of every drug – to provide to every doctor who treats them in the future.
