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NCCN Guidelines Insights: Survivorship, Version 2.2019

Featured Updates to the NCCN Guidelines

Tara Sanft, Crystal S. Denlinger, Saro Armenian, K. Scott Baker, Gregory Broderick, Wendy Demark-Wahnefried, Debra L. Friedman, Mindy Goldman, Melissa Hudson, Nazanin Khakpour, Divya Koura, Robin M. Lally, Terry S. Langbaum, Allison L. McDonough, Michelle Melisko, Kathi Mooney, Halle C.F. Moore, Javid J. Moslehi, Tracey O’Connor, Linda Overholser, Electra D. Paskett, Lindsay Peterson, William Pirl, M. Alma Rodriguez, Kathryn J. Ruddy, Sophia Smith, Karen L. Syrjala, Amye Tevaarwerk, Susan G. Urba, Phyllis Zee, Nicole R. McMillian and Deborah A. Freedman-Cass

years with a terminal diagnosis and uncertainty about the future; how to handle comorbid conditions and disease prevention, screening, and treatment in the setting of limited life expectancy; managing discussions regarding new drugs and early

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Guadalupe R. Palos, Katherine Gilmore, Patricia Chapman, Weiqi Bi, Paula Lewis-Patterson and Alma Maria Rodriguez

Background: NCCN Guidelines recommend annual mammography for surveillance in asymptomatic women diagnosed with breast cancer. There is limited evidence to support which type of mammogram—screening or diagnostic—should be ordered for asymptomatic

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Ann M. Berger, Kathi Mooney, Amy Alvarez-Perez, William S. Breitbart, Kristen M. Carpenter, David Cella, Charles Cleeland, Efrat Dotan, Mario A. Eisenberger, Carmen P. Escalante, Paul B. Jacobsen, Catherine Jankowski, Thomas LeBlanc, Jennifer A. Ligibel, Elizabeth Trice Loggers, Belinda Mandrell, Barbara A. Murphy, Oxana Palesh, William F. Pirl, Steven C. Plaxe, Michelle B. Riba, Hope S. Rugo, Carolina Salvador, Lynne I. Wagner, Nina D. Wagner-Johnston, Finly J. Zachariah, Mary Anne Bergman and Courtney Smith

clinically indicated. Screening should identify fatigue. Patients and families should be informed that managing fatigue is an integral part of total health care. All patients should receive symptom management. Furthermore, if patients cannot tolerate their

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Crystal S. Denlinger, Tara Sanft, K. Scott Baker, Shrujal Baxi, Gregory Broderick, Wendy Demark-Wahnefried, Debra L. Friedman, Mindy Goldman, Melissa Hudson, Nazanin Khakpour, Allison King, Divya Koura, Elizabeth Kvale, Robin M. Lally, Terry S. Langbaum, Michelle Melisko, Jose G. Montoya, Kathi Mooney, Javid J. Moslehi, Tracey O'Connor, Linda Overholser, Electra D. Paskett, Jeffrey Peppercorn, M. Alma Rodriguez, Kathryn J. Ruddy, Paula Silverman, Sophia Smith, Karen L. Syrjala, Amye Tevaarwerk, Susan G. Urba, Mark T. Wakabayashi, Phyllis Zee, Deborah A. Freedman-Cass and Nicole R. McMillian

Survivors for whom screening does not indicate an issue with sexual function should be rescreened at subsequent visits. For survivors with sexual function concerns who do not wish to discuss them at the current visit, referral can be made to a sexual health

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Shilpa Grover and Sapna Syngal

particularly valuable given that genetic testing has limitations in sensitivity and that uninformative results may lead to false reassurance and poor adherence to recommended cancer screening. 42 Studies have shown that these 3 prediction models have

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Peter F. Coccia, Jessica Altman, Smita Bhatia, Scott C. Borinstein, Joseph Flynn, Suzanne George, Robert Goldsby, Robert Hayashi, Mary S. Huang, Rebecca H. Johnson, Lynda Kwon Beaupin, Michael P. Link, Kevin C. Oeffinger, Kathleen M. Orr, Alberto S. Pappo, Damon Reed, Holly L. Spraker, Deborah A. Thomas, Margaret von Mehren, Daniel S. Wechsler, Kimberly F. Whelan, Bradley J. Zebrack, Hema Sundar and Dorothy A. Shead

, TP53 (Li-Fraumeni syndrome), or PTEN (Cowden syndrome), or those who have received mantle field irradiation for HL are at an increased risk of developing breast cancer during young adulthood. 1 , 11 Screening for breast cancer may be warranted in

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J. Matt McCrary, David Goldstein, Terry Trinh, Hannah C. Timmins, Tiffany Li, Jasmine Menant, Michael Friedlander, Craig R. Lewis, Mark Hertzberg, Siobhan O’Neill, Tracy King, Annmarie Bosco, Michelle Harrison and Susanna B. Park

measures provides the most comprehensive approach. 11 For clinical use, a recent Delphi survey showed that any CIPN assessment with ≥6 items is unlikely to be feasible. 10 The development of targeted assessments to facilitate clinical screening of

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Azeez Farooki

modulate the risk of osteonecrosis of the jaw and atypical femur fracture (AFF). Screening for Osteoporosis to Reduce the Risk of Fracture Characterized by low bone mass and structural deterioration of the microarchitecture of bone tissue

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Archna Sarwal and Andrew J. Roth

– 147 . ( Most recent version available at www.nccn.org ). 9 Roth AJ Kornblith AB Batel-Copel L . Rapid screening for psychologic distress in men with prostate cancer: A pilot study . Cancer 1998 ; 82 : 1904 – 1908 . 10

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Philip E. Lammers, Christine M. Lovly and Leora Horn

showed the likely presence of a germline EGFR T790M mutation, which has been previously reported. 21 - 23 With the expansion of mutational screening to a wider audience and the high sensitivity of the testing, a larger number of patients will be found