NCCN Guidelines Insights: Survivorship, Version 2.2019

Featured Updates to the NCCN Guidelines

Authors:
Tara SanftYale Cancer Center/Smilow Cancer Hospital;

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Crystal S. DenlingerFox Chase Cancer Center;

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Saro ArmenianCity of Hope National Medical Center;

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K. Scott BakerFred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance;

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Gregory BroderickMayo Clinic Cancer Center;

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Wendy Demark-WahnefriedO’Neal Comprehensive Cancer Center at UAB;

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Debra L. FriedmanVanderbilt-Ingram Cancer Center;

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Mindy GoldmanUCSF Helen Diller Family Comprehensive Cancer Center;

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Melissa HudsonSt. Jude Children's Research Hospital/The University of Tennessee Health Science Center;

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Nazanin KhakpourMoffitt Cancer Center;

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Divya KouraUC San Diego Moores Cancer Center;

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Robin M. LallyFred & Pamela Buffett Cancer Center;

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Terry S. LangbaumThe Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins;

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Allison L. McDonoughMassachusetts General Hospital Cancer Center;

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Michelle MeliskoUCSF Helen Diller Family Comprehensive Cancer Center;

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Kathi MooneyHuntsman Cancer Institute at the University of Utah;

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Halle C.F. MooreCase Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute;

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Javid J. MoslehiVanderbilt-Ingram Cancer Center;

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Tracey O’ConnorRoswell Park Comprehensive Cancer Center;

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Linda OverholserUniversity of Colorado Cancer Center;

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Electra D. PaskettThe Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute;

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Lindsay PetersonSiteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine;

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William PirlDana-Farber/Brigham and Women's Cancer Center;

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M. Alma RodriguezThe University of Texas MD Anderson Cancer Center;

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Kathryn J. RuddyMayo Clinic Cancer Center;

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Sophia SmithDuke Cancer Institute;

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Karen L. SyrjalaFred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance;

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Amye TevaarwerkUniversity of Wisconsin Carbone Cancer Center;

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Susan G. UrbaUniversity of Michigan Rogel Cancer Center;

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Phyllis ZeeRobert H. Lurie Comprehensive Cancer Center of Northwestern University; and

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Nicole R. McMillianNational Comprehensive Cancer Network.

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Deborah A. Freedman-CassNational Comprehensive Cancer Network.

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Volume/Issue:
Volume 17: Issue 7
Online Publication Date:
Jul 2019
DOI:
https://doi.org/10.6004/jnccn.2019.0034
Restricted access

The NCCN Guidelines for Survivorship provide screening, evaluation, and treatment recommendations for consequences of cancer and cancer treatment to aid healthcare professionals who work with survivors of adult-onset cancer. Guidance is also provided to help promote physical activity, weight management, and proper immunizations in survivors and to facilitate care coordination to ensure that all needs are addressed. These NCCN Insights summarize some of the topics discussed by the NCCN Survivorship Panel during the 2019 update of the guidelines, including the survivorship population addressed, ways to improve care coordination, and pain management.

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  • 1.

    Bluethmann SM, Mariotto AB, Rowland JH. Anticipating the “silver tsunami”: prevalence trajectories and comorbidity burden among older cancer survivors in the United States. Cancer Epidemiol Biomarkers Prev 2016;25:1029–1036.

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  • 2.

    Miller KD, Siegel RL, Lin CC, et al.. Cancer treatment and survivorship statistics, 2016. CA Cancer J Clin 2016;66:271–289.

  • 3.

    Centers for Disease Control and Prevention (CDC). Cancer survivors—United States, 2007. MMWR Morb Mortal Wkly Rep 2011;60:269–272.

  • 4.

    Nekhlyudov L, Aziz NM, Lerro C, et al.. Oncologists’ and primary care physicians’ awareness of late and long-term effects of chemotherapy: implications for care of the growing population of survivors. J Oncol Pract 2014;10:e29–36.

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  • 5.

    McCabe MS, Bhatia S, Oeffinger KC, et al.. American Society of Clinical Oncology statement: achieving high-quality cancer survivorship care. J Clin Oncol 2013;31:631–640.

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  • 6.

    El-Shami K, Oeffinger KC, Erb NL, et al.. American Cancer Society colorectal cancer survivorship care guidelines. CA Cancer J Clin 2015;65:428–455.

  • 7.

    Resnick MJ, Lacchetti C, Penson DF. Prostate cancer survivorship care guidelines: American Society of Clinical Oncology practice guideline endorsement. J Oncol Pract 2015;11:e445–449.

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  • 8.

    Runowicz CD, Leach CR, Henry NL, et al.. American Cancer Society/American Society of Clinical Oncology breast cancer survivorship care guideline. J Clin Oncol 2016;34:611–635.

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  • 9.

    Cohen EE, LaMonte SJ, Erb NL, et al.. American Cancer Society head and neck cancer survivorship care guideline. CA Cancer J Clin 2016;66:203–239.

  • 10.

    National Cancer Institute. Survivorship definitions. Available at: http://cancercontrol.cancer.gov/ocs/statistics/definitions.html. Accessed July 10, 2018.

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  • 11.

    Langbaum T, Smith TJ. Time to study metastatic-cancer survivorship. N Engl J Med 2019;380:1300–1302.

  • 12.

    Institute of Medicine and National Research Council. From Cancer Patient to Cancer Survivor: Lost in Transition. Committee on Cancer Survivorship: Improving Care and Quality of Life. Washington, DC: The National Academies Press; 2006.

  • 13.

    Earle CC, Ganz PA. Cancer survivorship care: don’t let the perfect be the enemy of the good. J Clin Oncol 2012;30:3764–3768.

  • 14.

    Heins M, Schellevis F, Rijken M, et al.. Determinants of increased primary health care use in cancer survivors. J Clin Oncol 2012;30:4155–4160.

  • 15.

    Snyder CF, Frick KD, Peairs KS, et al.. Comparing care for breast cancer survivors to non-cancer controls: a five-year longitudinal study. J Gen Intern Med 2009;24:469–474.

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  • 16.

    Luctkar-Flude M, Aiken A, McColl MA, et al.. Are primary care providers implementing evidence-based care for breast cancer survivors? Can Fam Physician 2015;61:978–984.

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  • 17.

    Potosky AL, Han PK, Rowland J, et al.. Differences between primary care physicians’ and oncologists’ knowledge, attitudes and practices regarding the care of cancer survivors. J Gen Intern Med 2011;26:1403–1410.

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  • 18.

    Virgo KS, Lerro CC, Klabunde CN, et al.. Barriers to breast and colorectal cancer survivorship care: perceptions of primary care physicians and medical oncologists in the United States. J Clin Oncol 2013;31:2322–2336.

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  • 19.

    Walter FM, Usher-Smith JA, Yadlapalli S, et al.. Caring for people living with, and beyond, cancer: an online survey of GPs in England. Br J Gen Pract 2015;65:e761–768.

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  • 20.

    Rubinstein EB, Miller WL, Hudson SV, et al.. Cancer survivorship care in advanced primary care practices: a qualitative study of challenges and opportunities. JAMA Intern Med 2017;177:1726–1732.

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  • 21.

    Hudson SV, Miller SM, Hemler J, et al.. Adult cancer survivors discuss follow-up in primary care: ‘not what I want, but maybe what I need’. Ann Fam Med 2012;10:418–427.

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  • 22.

    Mayer EL, Gropper AB, Neville BA, et al.. Breast cancer survivors’ perceptions of survivorship care options. J Clin Oncol 2012;30:158–163.

  • 23.

    Khan NF, Evans J, Rose PW. A qualitative study of unmet needs and interactions with primary care among cancer survivors. Br J Cancer 2011;105(Suppl 1)S46–51.

  • 24.

    Grunfeld E, Levine MN, Julian JA, et al.. Randomized trial of long-term follow-up for early-stage breast cancer: a comparison of family physician versus specialist care. J Clin Oncol 2006;24:848–855.

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  • 25.

    Wattchow DA, Weller DP, Esterman A, et al.. General practice vs surgical-based follow-up for patients with colon cancer: randomised controlled trial. Br J Cancer 2006;94:1116–1121.

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  • 26.

    Rechis R, Beckjord EB, Nutt S. Potential benefits of treatment summaries for survivors’ health and information needs: results from a LIVESTRONG survey. J Oncol Pract 2014;10:75–78.

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  • 27.

    Majhail NS, Murphy E, Laud P, et al.. Randomized controlled trial of individualized treatment summary and survivorship care plans for hematopoietic cell transplantation survivors. Haematologica 2019;104:1084–1092.

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  • 28.

    Grunfeld E, Julian JA, Pond G, et al.. Evaluating survivorship care plans: results of a randomized, clinical trial of patients with breast cancer. J Clin Oncol 2011;29:4755–4762.

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  • 29.

    Boekhout AH, Maunsell E, Pond GR, et al.. A survivorship care plan for breast cancer survivors: extended results of a randomized clinical trial. J Cancer Surviv 2015;9:683–691.

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  • 30.

    Jefford M, Schofield P, Emery J. Improving survivorship care. J Clin Oncol 2012;30:1391–1392.

  • 31.

    Smith TJ, Snyder C. Is it time for (survivorship care) plan B? J Clin Oncol 2011;29:4740–4742.

  • 32.

    Stricker CT, Jacobs LA, Palmer SC. Survivorship care plans: an argument for evidence over common sense. J Clin Oncol 2012;30:1392–1393.

  • 33.

    Jefford M, Gough K, Drosdowsky A, et al.. A randomized controlled trial of a nurse-led supportive care package (SurvivorCare) for survivors of colorectal cancer. Oncologist 2016;21:1014–1023.

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  • 34.

    Nicolaije KA, Ezendam NP, Vos MC, et al.. Impact of an automatically generated cancer survivorship care plan on patient-reported outcomes in routine clinical practice: longitudinal outcomes of a pragmatic, cluster randomized trial. J Clin Oncol 2015;33:3550–3559.

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  • 35.

    Maly RC, Liang LJ, Liu Y, et al.. Randomized controlled trial of survivorship care plans among low-income, predominantly Latina breast cancer survivors. J Clin Oncol 2017;35:1814–1821.

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  • 36.

    Jacobsen PB, DeRosa AP, Henderson TO, et al.. Systematic review of the impact of cancer survivorship care plans on health outcomes and health care delivery. J Clin Oncol 2018;36:2088–2100.

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  • 37.

    Blanch-Hartigan D, Forsythe LP, Alfano CM, et al.. Provision and discussion of survivorship care plans among cancer survivors: results of a nationally representative survey of oncologists and primary care physicians. J Clin Oncol 2014;32:1578–1585.

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  • 38.

    American College of Surgeons Commission on Cancer. Cancer program standards: ensuring patient-centered care. Available at: https://www.facs.org/quality-programs/cancer/coc/standards. Accessed July 10, 2018.

  • 39.

    Pachman DR, Barton DL, Swetz KM, et al.. Troublesome symptoms in cancer survivors: fatigue, insomnia, neuropathy, and pain. J Clin Oncol 2012;30:3687–3696.

  • 40.

    Paice JA, Ferrell B. The management of cancer pain. CA Cancer J Clin 2011;61:157–182.

  • 41.

    Raphael J, Hester J, Ahmedzai S, et al.. Cancer pain: part 2: physical, interventional and complimentary therapies; management in the community; acute, treatment-related and complex cancer pain: a perspective from the British Pain Society endorsed by the UK Association of Palliative Medicine and the Royal College of General Practitioners. Pain Med 2010;11:872–896.

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  • 42.

    van den Beuken-van Everdingen MH, de Rijke JM, Kessels AG, et al.. Prevalence of pain in patients with cancer: a systematic review of the past 40 years. Ann Oncol 2007;18:1437–1449.

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  • 43.

    Meretoja TJ, Leidenius MHK, Tasmuth T, et al.. Pain at 12 months after surgery for breast cancer. JAMA 2014;311:90–92.

  • 44.

    Greco MT, Roberto A, Corli O, et al.. Quality of cancer pain management: an update of a systematic review of undertreatment of patients with cancer. J Clin Oncol 2014;32:4149–4154.

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  • 45.

    Improving the quality of pain management through measurement and action. Available at: https://www.npcnow.org/system/files/research/download/Improving-the-Quality-of-Pain-Management-Through-Measurement-and-Action.pdf. Accessed April 26, 2019.

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    Sun V, Borneman T, Piper B, et al.. Barriers to pain assessment and management in cancer survivorship. J Cancer Surviv 2008;2:65–71.

  • 47.

    Key findings summary: opioid access research project. Available at: https://www.fightcancer.org/sites/default/files/ACS%20CAN%20PQLC%20Opioid%20Research%20Project%20Key%20Findings%20Summary%20Memo%20FINAL.pdf. Accessed April 26, 2019.

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    Nucynta [package insert]. Newark, CA: Depomed, Inc.; 2018.

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    Schwartz S, Etropolski M, Shapiro DY, et al.. Safety and efficacy of tapentadol ER in patients with painful diabetic peripheral neuropathy: results of a randomized-withdrawal, placebo-controlled trial. Curr Med Res Opin 2011;27:151–162.

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    Vinik AI, Shapiro DY, Rauschkolb C, et al.. A randomized withdrawal, placebo-controlled study evaluating the efficacy and tolerability of tapentadol extended release in patients with chronic painful diabetic peripheral neuropathy. Diabetes Care 2014;37:2302–2309.

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  • 52.

    Imanaka K, Tominaga Y, Etropolski M, et al.. Efficacy and safety of oral tapentadol extended release in Japanese and Korean patients with moderate to severe, chronic malignant tumor-related pain. Curr Med Res Opin 2013;29:1399–1409.

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    Kress HG, Koch ED, Kosturski H, et al.. Tapentadol prolonged release for managing moderate to severe, chronic malignant tumor-related pain. Pain Physician 2014;17:329–343.

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  • 54.

    Argoff CE. Topical analgesics in the management of acute and chronic pain. Mayo Clin Proc 2013;88:195–205.

  • 55.

    Barros GA, Miot HA, Braz AM, et al.. Topical (S)-ketamine for pain management of postherpetic neuralgia. An Bras Dermatol 2012;87:504–505.

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    Hempenstall K, Nurmikko TJ, Johnson RW, et al.. Analgesic therapy in postherpetic neuralgia: a quantitative systematic review. PLoS Med 2005;2:e164.

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    Ho KY, Huh BK, White WD, et al.. Topical amitriptyline versus lidocaine in the treatment of neuropathic pain. Clin J Pain 2008;24:51–55.

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    Lin PL, Fan SZ, Huang CH, et al.. Analgesic effect of lidocaine patch 5% in the treatment of acute herpes zoster: a double-blind and vehicle-controlled study. Reg Anesth Pain Med 2008;33:320–325.

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    Lynch ME, Clark AJ, Sawynok J, et al.. Topical amitriptyline and ketamine in neuropathic pain syndromes: an open-label study. J Pain 2005;6:644–649.

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    Gewandter JS, Mohile SG, Heckler CE, et al.. A phase III randomized, placebo-controlled study of topical amitriptyline and ketamine for chemotherapy-induced peripheral neuropathy (CIPN): a University of Rochester CCOP study of 462 cancer survivors. Support Care Cancer 2014;22:1807–1814.

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    Barton DL, Wos EJ, Qin R, et al.. A double-blind, placebo-controlled trial of a topical treatment for chemotherapy-induced peripheral neuropathy: NCCTG trial N06CA. Support Care Cancer 2011;19:833–841.

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  • 64.

    Derry S, Wiffen PJ, Moore RA, et al.. Topical lidocaine for neuropathic pain in adults. Cochrane Database Syst Rev 2014:CD010958.

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    Tam E, Furlan AD. Transdermal lidocaine and ketamine for neuropathic pain: a study of effectiveness and tolerability. Open Neurol J 2012;6:58–64.

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    Hurlow A, Bennett MI, Robb KA, et al.. Transcutaneous electric nerve stimulation (TENS) for cancer pain in adults. Cochrane Database Syst Rev 2012;3:CD006276.

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    Johnson MI, Bjordal JM. Transcutaneous electrical nerve stimulation for the management of painful conditions: focus on neuropathic pain. Expert Rev Neurother 2011;11:735–753.

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    Coyne PJ, Wan W, Dodson P, et al.. A trial of scrambler therapy in the treatment of cancer pain syndromes and chronic chemotherapy-induced peripheral neuropathy. J Pain Palliat Care Pharmacother 2013;27:359–364.

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    Pachman DR, Weisbrod BL, Seisler DK, et al.. Pilot evaluation of scrambler therapy for the treatment of chemotherapy-induced peripheral neuropathy. Support Care Cancer 2015;23:943–951.

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    Smith T, Cheville AL, Loprinzi CL, et al.. Scrambler therapy for the treatment of chronic post-mastectomy pain (cPMP). Cureus 2017;9:e1378.

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    Ricci M, Fabbri L, Pirotti S, et al.. Scrambler therapy: what’s new after 15 years? The results from 219 patients treated for chronic pain. Medicine (Baltimore) 2019;98:e13895.

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    Smith TJ, Razzak AR, Blackford AL, et al.. A pilot randomized sham-controlled trial of MC5-A scrambler therapy in the treatment of chronic chemotherapy-induced peripheral neuropathy (CIPN). J Palliat Care 2019:825859719827589.

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    Loprinzi CL, Le-Rademacher J, Majithia N, et al.. Scrambler therapy for established chemotherapy-induced neuropathy: a randomized phase II trial [abstract]. J Clin Oncol 2018;36(Suppl):Abstract 10016.

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  • 74.

    Henry NL, Unger JM, Schott AF, et al.. Randomized, multicenter, placebo-controlled clinical trial of duloxetine versus placebo for aromatase inhibitor-associated arthralgias in early-stage breast cancer: SWOG S1202. J Clin Oncol 2018;36:326–332.

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  • 75.

    Hershman DL, Unger JM, Greenlee H, et al.. Effect of acupuncture vs sham acupuncture or waitlist control on joint pain related to aromatase inhibitors among women with early-stage breast cancer: a randomized clinical trial. JAMA 2018;320:167–176.

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  • 76.

    Irwin ML, Cartmel B, Gross CP, et al.. Randomized exercise trial of aromatase inhibitor-induced arthralgia in breast cancer survivors. J Clin Oncol 2015;33:1104–1111.

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Copyright:
Copyright © 2019 by the National Comprehensive Cancer Network 2019
Page Numbers:
11
Article Category:
Other
Print Publication Date:
01 Jul 2019
Online Publication Date:
Jul 2019
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