title: Implementing improved post-treatment care for cancer survivors in England, with reflections from Australia, Canada and the USA.
abstract: Increasing cancer incidence together with improved survival rates are contributing to the growing number of cancer survivors. Survivors may encounter a range of potential effects as a result of the cancer itself or cancer treatments. Traditionally, the major focus of follow-up care has been on detection of cancer recurrence; however, the efficacy of such strategies is questionable. Traditional follow-up frequently fails to identify or adequately address many survivors' concerns. Aftercare needs to be planned to enable better outcomes for survivors, while using scarce health-care resources efficiently. This review focuses on provision of survivorship care, rather than on research. England's National Cancer Survivorship Initiative has developed principles for improved care of those living with and beyond cancer. These include risk-stratified pathways of care, the use of treatment summaries and care plans, information and education to enable choice and the confidence to self manage, rapid re-access to specialist care, remote monitoring and well-coordinated care. Many of these principles are relevant internationally, though preferred models of care will depend on local circumstances.
authors.affiliation: Australian Cancer Survivorship Centre-A Richard Pratt legacy, Peter MacCallum Cancer Centre, Locked Bag 1, 'A'Beckett Street, Melbourne, Victoria 8006, Australia. Michael.Jefford@petermac.org
authors.forename: M
authors.initials: M
authors.lastname: Jefford
authors.forename: J
authors.initials: J
authors.lastname: Rowland
authors.forename: E
authors.initials: E
authors.lastname: Grunfeld
authors.forename: M
authors.initials: M
authors.lastname: Richards
authors.forename: J
authors.initials: J
authors.lastname: Maher
authors.forename: A
authors.initials: A
authors.lastname: Glaser
mesh_terms: D000359:Aftercare; D001315:Australia; D002170:Canada; D003695:Delivery of Health Care; D004739:England; D006801:Humans; D009369:Neoplasms / Q000628:therapy*; D012306:Risk; D017741:Survivors; D014481:United States