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Cancer Survivorship 

Cancer Survivorship
Chapter:
Cancer Survivorship
Author(s):

Anne Reb

, and Denice Economou

DOI:
10.1093/med/9780190862374.003.0043
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date: 24 August 2019

Cancer survivors are living longer as a result of treatment advances, and, for those with advanced cancer, there is more uncertainty regarding prognosis and future needs. Survivors will need support to manage long-term side effects including physical and emotional concerns such as fear of recurrence and uncertainty. The palliative care approach to cancer survivors includes assessment of physical, psychological, social, family, and spiritual concerns. Psychosocial, emotional, and spiritual concerns may contribute to physical symptoms, a fact that supports the importance of a holistic and comprehensive approach to symptom management. Referrals to palliative or supportive care should be based on patient and caregiver needs rather than on prognosis. Survivors with advanced cancer or high symptom burden should be referred to interdisciplinary palliative care teams. Survivors in transition from active treatment and those in remission may benefit from early referrals to rehabilitation services to help improve function and manage common symptoms. A comprehensive geriatric assessment can help to identify health concerns and the need for supportive care interventions. This chapter will discuss considerations for incorporating palliative care during the cancer survivorship trajectory; common symptoms and assessment strategies; communication challenges; and a brief overview of nonpharmacologic approaches to symptom management.

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