– by Mary McCabe – Director, Cancer Survivorship Initiative
Memorial Sloan Kettering Cancer Center
Since the 2005 publication of the Institute of Medicine (IOM) report ?From Cancer Patient to Cancer Survivor,? increasing attention has been focused on identifying and meeting the comprehensive needs of cancer survivors. The recommendations in the report made it clear that it is not sufficient to only monitor for disease recurrence and consider this quality follow-up care. The report called for the ?use of systematically developed evidence-based clinical practice guidelines, assessment tools and screening instruments to help identify and manage late effects of cancer and its treatment.?
More recently, the LIVESTRONG Foundation identified essential elements of survivorship care that include attention to medical, psychosocial, economic and spiritual issues. Although statements about domains of need are critical, specific guidance about how to identify and treat these issues are necessary to improve care. Fortunately, major cancer professional organizations, including the American Cancer Society (ACS), the American Society of Clinical Oncology (ASCO) and the National Cancer Center Network (NCCN), have taken this next important step by developing guidelines that will improve survivorship care in important ways.
First, they are developing guidelines using a systematic approach and second, they are instituting a process for ongoing updates based on new research results. Both the ASCO and NCCN are developing guidelines for the common symptoms experienced by cancer survivors. In 2013-2014, ASCO has published guidelines for anxiety and depression, fatigue, and neuropathy and NCCN has published guidelines for anxiety and depression, cognitive function, exercise, fatigue, immunizations, pain, sexual function and sleep disorders.
The ACS approach is to develop a comprehensive suite of survivorship information by disease. Their first excellent comprehensive guidelines for prostate cancer survivors was recently published. But this valuable information cannot remain within the publications and websites of these professional organizations. It needs to be disseminated, understood and used in order to improve care. The guidelines are intended to be used by patients, family members and caregivers along with professional health care providers.
So, take a look and begin to share this information, use this information and provide feedback about this information. Make these guidelines a topic of conversation among survivors and between survivors and clinicians. Spread the word by spreading the guidelines. Contribute to the ongoing improvement in survivorship care.