In part thanks to advancements in both cancer treatment and supportive care, the number of cancer survivors is expected to reach 22 million by 2030. Adolescent and young adult (AYA) patients aged 15–39 constitute only 5% of new cancer diagnoses but have an 85% relative five-year survival rate. They represent a significant portion of all current and future cancer survivors and have unique needs, including reaching developmental milestones, coping with disruptions in personal and professional relationships, and encountering potential difficulties in family planning.  

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.

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 The oncology infusion nurse notices that Jamie appears withdrawn and nervous, so he takes time to ask her how she is feeling about completing treatment.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.”

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.

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. 

More than a decade ago, the National Academy of Medicine first proposed that “all patients should be given a comprehensive summary and a clear explanation of the details of their cancer therapy as well as recommendations for necessary follow-up.” This seemingly simple task has proved difficult to deliver in many cancer care settings.

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.

With more than 15.5 million Americans living beyond cancer, it’s no surprise that more attention is being paid to survivorship than ever before. Once treatment ends, patients can be thrown back into a world after cancer with little or no attention paid to their concerns about recurrence, late effects from treatment, how to follow up with their future care, and a great many more unknowns.

Since the Institute of Medicine called attention to it in its seminal 2005 report, From Cancer Patient to Cancer Survivor: Lost in Transition, cancer survivorship has been a hot-button topic.

As discussed in the March 2012 ONS Connect Up Front article, “Life After Cancer,” the American College of Surgeons’ Commission on Cancer standards will require all of its accredited facilities to have survivorship care plans in place by 2015.