Survivorship

Abstract

Advances in the treatment of childhood cancers and supportive care have resulted in marked improvements in survival rates. As of 2009, there were an estimated 363,000 survivors of childhood cancer in the United States; of these approximately 24 % have survived more than 30 years since their diagnosis, contributing to the growing number of long-term survivors of childhood and adult cancer in the United States (Mariotto et al. 2009). However, the use of chemotherapy, radiation, and/or surgery at an early age can contribute to complications that may not become apparent until years after the completion of therapy (Armenian and Robison 2013). A recent article from the Childhood Cancer Survivor Study (CCSS) cohort reported that two out of three survivors will develop a chronic health condition, and more than one-third will develop a condition that is severe or life-threatening (Oeffinger et al. 2006). To address the needs of this growing population, in 2005, the Institute of Medicine (IOM) published From Cancer Patient to Cancer Survivor: Lost in Transition, a report outlining the gaps in survivorship care. The report introduced the concept of survivorship care plans to summarize information critical to the individual’s long-term care, such as the cancer diagnosis, treatment, and potential consequences; the timing and content of follow-up visits; tips on maintaining a healthy lifestyle and preventing recurrent or new cancers; legal rights affecting employment and insurance; and the availability of psychological and support services (Hewitt et al. 2006). This report provided the basis for professional organizations including the Children’s Oncology Group, National Comprehensive Cancer Network and the American Society of Clinical Oncology to publish evidenced-based guidelines for survivorship care for cancer survivors. It is crucial for health-care professionals who care for cancer survivors at all stages of their survivorship to be familiar with actual and potential late effects survivors may experience throughout their lifetime.