Most cancer diagnoses in the United States occur later in life, in patients older than 60 years, although most of the common pediatric diagnoses occur in those younger than 10 years. Pediatric and adult patients receive similar cancer therapies. The goal is to kill rapidly dividing cancer cells. Unfortunately, most of a child’s cells also undergo rapid division, and treatment can damage healthy tissue. Therefore, treatment that cures pediatric cancer can also cause long-term survivorship issues.

Myeloproliferative neoplasms are a group of blood cancers that start with a small mutation in the stem cells of the bone marrow. Although MPNs are quite rare, essential thrombocythemia, polycythemia vera, and myelofibrosis are the most common types. Each represents a mutation of a different source of stem cell.

A child’s cancer diagnosis can tear apart a family’s sense of security. After successfully navigating the cancer experience and all that comes with it, no one wants to face that again, and patients and families may fear an increased risk for secondary cancers. Oncology nurses can support pediatric cancer survivors and their families with resources for monitoring and reassurance about the possibility of facing secondary cancer.

Primary care for patients who are cancer survivors is multifaceted. Although my goal as a primary care physician (PCP) remains the same as with all my patients—to continue helping them lead long, healthy lives—care for this population requires some additional steps. 

Colorectal cancer (CRC) is the third most common cancer affecting men and women in the United States. When CRC is found at an early stage before it has spread, the five-year relative survival rate is about 90%, yet it remains a leading cause of cancer-related death among both genders. 

Cancer is second only to heart disease as the leading cause of death in the United States. But heart conditions overlap with cancer in more ways than mortality. Chemotherapy, immunotherapy, radiation, and the myriad medication combinations used in cancer can lead to various complications, including cardiotoxic side effects. Because of the prevalence of heart disease, many patients with cancer also present with pre-existing cardiac comorbidities.

Oncology nurses are critical to meeting three components of the newly revised Commission on Cancer (CoC) standards released in fall 2019: certification, survivorship, and barriers to care.

Jamie is completing her last cycle of carboplatin and paclitaxel for stage I ovarian cancer. The oncology infusion nurse notices that Jamie appears withdrawn and nervous, so he takes time to ask her how she is feeling about completing treatment. Jamie responds, “I feel as frightened about finishing treatment as I did when I was diagnosed with cancer.” She also shares that she doesn’t want to ring the cancer center’s bell to ceremoniously signify the end of her treatment because she doesn’t want to “jinx it.”

Since the National Academies of Medicine (formerly the Institute of Medicine) issued Cancer Patient to Cancer Survivor: Lost in Transition in 2005, the oncology field has made small strides to implement successful survivorship resources to support patients after their treatment. Because of the vast differences in patient populations, disease types, study locations, and institutional resources, best practices to support patients transitioning from treatment to survivorship care are often unclear. This poses an issue for providers, and patients hear mixed messaging or little information for follow-up care. With many patients receiving treatment in outpatient settings, ambulatory oncology nurses must understand how to provide support for patients during their transition.

Women who survived pediatric cancer but developed breast cancer as an adult are more than twice as likely to die prematurely, mostly from comorbid conditions, according to results of a study published in the Journal of Clinical Oncology.

Patients with hematologic cancers have a 19% increased risk for blood clots or bleeding events even 10 years after diagnosis, according to the results of a study published in the Journal of Thrombosis and Haemostasis.

Since 2016, then-candidate Trump promised he was going to bring healthcare costs under control. In a White House announcement on June 24, 2019, the president took steps to add transparency to the process by requiring insurance companies, hospitals, and physicians to identify fees and costs in public and simple ways for patients to see in advance and to understand.

As more patients receive treatment with chimeric antigen receptor (CAR) T-cell therapy, oncology nurses will need to be aware of the long-term effects of treatment that may persist into survivorship. However, because the treatment is so new, studies measuring those patient-reported concerns are still forthcoming. The majority of today’s recommendations for survivorship management are based on experts’ clinical experience.

Rising prescription medication costs has been a major focus area for both the Trump administration and the 116th Congress. In January 2019, both the House and Senate committees of jurisdiction held public hearings on soaring drug costs. Despite constant media attention and mounting pressure from government officials, no pharmaceutical company executives chose to testify. Congress threatened to subpoena the industry if it happened again.

Healthcare providers need to address three priority areas to improve outcomes for cancer survivors and support caregivers for patients with cancer, according to findings from an evidence review published in CA: A Cancer Journal for Clinicians.

A survivorship clinic allows APRNs to practice autonomously and highlights their strengths and skills, including assessing long-term toxicities, providing expert symptom management, coordinating with other disciplines, and making referrals as appropriate. Long-term toxicities from cancer treatment are disease- and treatment-specific and will be unique to each patient.

Cancer prevention is a full-time job, and the Centers for Disease Control and Prevention (CDC) works around the clock to raise awareness and promote necessary early detection and screening methods. Cancer survivors are a unique subset of patients and require information that’s been individualized to the survivorship experience.

In 2016, the American Cancer Society (ACS) reported that the number of currently living cancer survivors is estimated at 15.5 million Americans. For 2018, ACS is projecting another 1.7 million new cases of cancer diagnoses. On one hand, the growing number of survivors indicates that early diagnosis, new technologies, targeted interventions, treatment options, and access to care are making a huge difference for patients. 

Incorporating survivorship care plans into a hospital’s electronic medical records (EMRs) can be a tremendous aid for oncology nurses supporting their patients entering survivorship. Using the National Comprehensive Cancer Network treatment guidelines as a template for care, the oncology team can prepare a patient’s medical record with the necessary individualized information. 

The medical terms for living with and beyond a cancer diagnosis identify patients as entering the survivorship phase of their cancer journey. However, as science continues to develop new treatments responsible for extending patients’ lives, new levels of survivorship are being determined.

More than 13,000 children are diagnosed with cancer every year in the United States. Because treatment options continue to improve, more than 80% of those children will survive at least five years after their diagnosis.

It’s been a long time coming, but the Childhood Cancer Survivorship, Treatment, Access and Research (STAR) Act was finally signed into law on June 6 by President Trump. The act focuses on advancing pediatric cancer research and treatments along with improving screening programs and supporting patients into survivorship. As with many issues in the U.S. capital, the issue had two sides: many healthcare professionals see it as a win to support childhood cancer survivors, but it raised concerns for others about potential coverage issues.

By 2026, How Big Is the U.S. Cancer Survivor Population Estimated To Be?

A. 18.1 million 

B. 20.3 million 

C. 33.6 million 

D. 50.8 million 

On May 22, the U.S. House of Representatives passed S.B. 292, the Childhood Cancer Survivorship, Treatment, Access, and Research (STAR) Act. The legislation will improve efforts to identify and track childhood cancer incidence, improve quality of life for childhood cancer survivors, ensure pediatric expertise at the National Institutes of Health by requiring the National Cancer Advisory Board to have at least one pediatric oncology expert on its board, and identify opportunities to increase childhood cancer research to better treat the 10,270 children diagnosed with cancer in the United States every year.   

As improved screening, diagnosis, and treatments lead to cancer’s classification as a chronic disease, people with cancer are surviving longer than ever before. However, with lengthened survival comes long-term physical and emotional symptoms and other sequelae that require ongoing surveillance and management. Advanced practice registered nurses (APRNs) are essential to delivering quality survivorship care.

Radiation therapy is a precise cancer treatment that targets tumor cells specifically and spares healthy surrounding tissues. Contrary to pharmacologic treatment methodologies, side effects are predominantly site-specific.

Research has shown that women aged 65 and older who have breast cancer experience higher rates of heart failure compared to their age-matched counterparts, ranging from 29% of women with breast cancer who received no chemotherapy to 38% of women who received treatment with anthracyclines. However, little is known about the association between heart failure and long-term survival in older women with breast cancer, and it is unclear how the relative contribution of heart failure to mortality risk varies by breast cancer stage.

Even 10 years after diagnosis and without recurrence, cancer survivors have a higher opioid prescription rate than healthy controls, according to the results of a study published in Cancer.

The American Cancer Society (ACS) has guidelines on nutrition and physical activity for cancer survivors that focus on healthy body weight, physical activity, and a diet high in vegetables, fruits, and whole grains. To assess how adherence to those guidelines impacts disease-free survival (DFS), relapse-free survival (RFS), or overall survival (OS), researchers conducted a prospective study of 992 patients with stage III colon cancer who enrolled in an adjuvant chemotherapy clinical trial between 1991 and 2001. The researchers presented the study at the ASCO Annual Meeting.

Hot flashes, also known as hot flushes, are marked by periods of sudden, intense feelings of warmth that begin at the chest and radiate to the neck and face, along with flushing, sweating, and heart palpitations, lasting several seconds to minutes. Compared to healthy postmenopausal women, breast cancer patients and survivors are prone to experiencing more severe and longer-lasting hot flashes. A bothersome symptom, hot flashes can occur anytime during a 24-hour period, but those occurring at night are most troubling because they interfere with sleep. Sleep deprivation negatively impacts daytime functioning as well as pain, fatigue, depression, and anxiety levels, diminishing quality of life significantly.

The latest edition of the Annual Report to the Nation on the Status of Cancer, 1975-2014, confirms that death rates are decreasing for 11 of the 16 most common types of cancer in men and 13 of the 18 most common types in women.

A study published in Cancer Epidemiology, Biomarkers, and Prevention looking at the ultraviolet radiation exposure and sun protection behaviors among melanoma survivors found that many survivors have room for improvement.

Journey Forward, a free online survivorship tool, allows oncology professionals to create personalized treatment plans, treatment summaries, and care plans that can be printed out and shared with patients and their primary care providers.

In a joint venture between the National Cancer Institute (NCI) and the American Cancer Society (ACS), a new web tool aims to provide better understanding for cancer survivors’ treatment options and what happens to them when treatment is over. The initiative, Springboard Beyond Cancer, is meant to empower survivors by providing them when education and resources about living beyond their cancer diagnosis. Springboard Beyond Cancer aims to address the following survivorship issues for patients.

For more than 14 million Americans, a cancer diagnosis is something they live with everyday. While some may just be embarking on their cancer journey, many others have completed their trek and are living beyond their cancer diagnosis. For those patients, they experienced the joy and relief that came with finally finishing their treatments. However, there often can be uncertainty when patients consider their lives after cancer. Sometimes, many are left wondering, “What happens next?”