Over the past decade, tremendous progress has been made in the early detection and effective treatment of many cancers, resulting in a growing population of cancer survivors in the United States that exceeds 13.7 million as of 2012.1 With the 5-year survival rate for individuals diagnosed with adult-onset cancers now almost 65%, this gratifying number will certainly increase. As a result, survivorship is becoming a central component of oncology care as we increasingly take on the responsibility of optimizing health outcomes for cancer survivors. What began a decade ago as the interest of a few is becoming a focus of the majority.
The foundational prototype for cancer survivorship in this country is based on pediatric cancer care, because pediatric oncologists have been providing formal follow-up services to their patients for decades. This is due to a number of important factors: the high success rates in treating childhood cancers; the consistent practice of incorporating multidisciplinary services into care of the child beginning at diagnosis; and understanding of the long-term consequences of treatment exposures on developing organs and tissues. Their adult oncology colleagues are recent newcomers to this approach to follow-up care and are only now taking a critical look at how we can move from visits that focus on surveillance for recurrence to a strategy of comprehensive but tailored survivorship care.
Clark EJ, Stoval EL, Leigh S. Imperatives for quality cancercare: access, advocacy, action and accountability. National Coalition for Cancer Survivorship. Silver Spring, MD; 1996.
President’s Cancer Panel. Living Beyond Cancer: Finding a new balance—President’s Cancer Panel Report. Washington, DC: US Dept of Health and Human Services; 2004.
Centers for Disease Control and Prevention. A National Action Plan for Cancer Survivorship: Advancing Public Health Strategies. Washington, DC: US Dept of Health and Human Services; 2004.
Hewitt M, Greenfield S, Stovall E, eds. From Cancer Patient to Cancer Survivor: Lost in Transition. Washington, DC: Institute of Medicine and National Research Council; 2005.
Buswell LA, Ponte PR, Shulman LB. Provider practice models in ambulatory oncology practice: analysis of productivity, revenue, and provider and patient satisfaction. J Oncol Pract 2009;5:188–192.
Del Giudice ME, Grunfeld E, Harvey BJ. Primary care physicians’ views of routine follow-up care of cancer survivors. J Clin Oncol 2009;27:3338–3345.