Cancer Survivorship: Monitoring the Long-Term and Late Effects of Treatment

The majority of this text is focused on protocols for surveillance of cancer recurrence and new primary cancers. Optimal care of the cancer survivor involves dealing with many other issues, however. In its 2005 report From cancer patient to cancer survivor: Lost in transition [1], the Institute of Medicine (IOM) noted in its first recommendation that survivorship should be considered a distinct entity with cross-cutting issues. Indeed, while the details of surveillance might be specific to the site and stage of cancer a patient had, all survivors are concerned about the possibility of recurrence. Moreover, the effects of a history of cancer on insurance, employment, and relationships are remarkably similar almost regardless of the specific cancer diagnosis. This chapter outlines the general approach we took to survivorship care at the Lance Armstrong Foundation Adult Survivorship Clinic at Dana-Farber Cancer Institute in Boston, MA.