The Role of Survivorship Care Following Active Cancer Treatment

The role of an oncology nurse is a complex one. Ensuring that a patient understands their diagnosis, administering treatments, and monitoring their conditions are all vital parts of providing care during treatment. When cancer patients make the transition from patient to survivor, oncology nurses must be ready to take on the role of helping them navigate this next stage.

This is especially important as the population of cancer survivors in the United States is expected to increase to 22 million by 2030, according to the American Cancer Society.¹ This is largely due to the fact that this population continues to expand and age as advances in treatment and early detection continue to increase cancer survival. 

As more and more patients transition from active treatment or monitoring to survivorship, where they experience a great deal of new challenges, oncology nurses are instrumental in identifying the issues and making the appropriate referrals. Additionally, oncology nurses are tasked with educating patients about what to expect during this process and how they can manage side effects and other quality-of-life issues.

Although cancer survivorship and posttreatment care have been studied for many years, new models and innovations for coordinated care after treatment are still needed. A recent study that compared the effectiveness of specialist-led posttreatment care with shared-care models — ie, posttreatment follow-up cancer care delivered by a team of nurses and primary care doctors — suggests shared-care models are acceptable and may have economic benefits over specialist-led care.² Additionally, this study showed that no models of follow-up cancer care have a negative impact on cancer survivor outcomes.

At our center, a collaborative approach is used throughout the cancer care continuum. Physician assistants or nurse practitioners with special knowledge, training, and skills in certain cancer types collaborate closely with doctors and nurses in survivorship clinics. These clinics focus on the special healthcare needs of cancer survivors and include family members, friends, and caregivers as part of the survivorship experience.

With the shared-care model, a team of healthcare providers can keep a watchful eye out for long-term psychosocial effects while providing guidance and education about health and wellness. It also allows a patient’s team to check for recurrent and/or second cancers and gives survivors a plan to help manage their care.

Cancer survivorship plans offer detailed reports of the treatment a patient has received, as well as a detailed outline of recommended follow-up care. These plans can include suggested testing and potential side effects a patient may still experience that need follow-up. They also may list suggestions for health and wellness, as well as necessary cancer screenings and possible long-term and late effects of a patient’s treatment.

While more research is needed on best practices for managing cancer survivorship, a comprehensive approach can reassure cancer survivors that they will continue to be offered care and resources under the guidance of their oncologists and other providers even as they move to the unfamiliar stage of survivorship.

Anna Liza Rodriguez is chief nursing officer and vice president of Nursing and Patient Services at Fox Chase Cancer Center.

References

1. Miller KD, Nogueira L, Mariotto AB, Rowland JH, et al. Cancer treatment and survivorship statistics, 2019. CA Cancer J Clin. 2019;69(5):363-385. doi:10.3322/caac.21565

2. Chan RJ, Crawford-Williams F, Crichton M, et al. Effectiveness and implementation of models of cancer survivorship care: an overview of systematic reviews. J Cancer Surviv. 2023;17(1):197-221. doi:10.1007/s11764-021-01128-1