Cancer Survivorship Care The Focus of Upcoming ASCO Guidelines

When cancer patients finish treatment as well as any requisite follow-ups with their oncologists, from there on they are typically on their own. And, as recent studies have pointed out, today's primary care physicians (PCPs) are woefully disconnected to the kinds of individualized attention needed to be paid to their post-cancer patients.

In an effort to address this, the American Society of Clinical Oncology (ASCO) has published its goals to improve the lives of cancer survivors through care coordination and the creation of treatment guidelines. Their lengthy statement was published in the Journal of Clinical Oncology, and the authors noted that:

"PCPs are often unfamiliar with the consequences of cancer and its treatment and seldom receive explicit survivor care guidance about potential treatment effects from oncologists."

Specifically, these patients aren't getting the care they need, and there are no coordinated, national guidelines in place to make it easier. ASCO president Sandra Swain, MD, said the group will issue consensus-based guidelines for long-term clinical management of these patients following the completion of their primary cancer therapy, which should include:

• Which patients need screening
• What methods (CT, CBC, etc.) would be appropriate
• How often and for how long such screening should be necessary

"We can't let these patients, who are living examples of the progress we have achieved in cancer, fall through the cracks," Swain said. "ASCO's statement provides a roadmap for closing the gap in survivor care."

Aims of the strategy presented by the ASCO included addressing the following:

• The increased risk for cardiovascular disease, diabetes, and other chronic diseases
• The psychosocial needs of each patient
• Dealing with fertility planning for those patients still in reproductive years
• Being on the lookout for persistent and late-occurring side effects of both cancer and cancer treatment
• Screening guidelines and symptoms of recurrence or second primary cancers
• Lifestyle guidance
• The creation of a way to integrate treatment planning into the electronic health records

Other aspects of the strategy outlined included:

• Better health professional education and training
• Improving patient education and self-advocacy
• Supporting further research into cancer survivorship
• Promoting policy changes that will contribute to easier access to appropriate healthcare services

The guidelines will target oncologists, PCPs, nurse practitioners, and other health professionals.

Source: McCabe MS, et al "American society of clinical oncology statement: achieving high-quality cancer survivorship care" J Clin Oncol 2013; DOI: 10.1200/JCO.2012.46.6854.