title: Surveillance and Care of the Gynecologic Cancer Survivor.
abstract: BACKGROUND
  Care of the gynecologic cancer survivor extends beyond cancer treatment to encompass promotion of sexual, cardiovascular, bone, and brain health; management of fertility, contraception, and vasomotor symptoms; and genetic counseling.
  
  
  METHODS
  This is a narrative review of the data and guidelines regarding care and surveillance of the gynecologic cancer survivor. We searched databases including PubMed, Cochrane, and Scopus using the search terms gynecologic cancer, cancer surveillance, and cancer survivor and reached a consensus for articles chosen for inclusion in the review based on availability in the English language and publication since 2001, as well as key older articles, consensus statements, and practice guidelines from professional societies. However, we did not undertake an extensive systematic search of the literature to identify all potentially relevant studies, nor did we utilize statistical methods to summarize data. We offer clinical recommendations for the management of gynecologic cancer survivors based on review of evidence and our collective clinical experience.
  
  
  RESULTS
  Key messages include the limitations of laboratory studies, including CA-125, and imaging in the setting of gynecologic cancer surveillance, hormonal and non-hormonal management of treatment-related vasomotor symptoms and genitourinary syndrome of menopause, as well as recommendations for general health screening, fertility preservation, and contraception.
  
  
  CONCLUSIONS
  A holistic approach to care extending beyond cancer treatment alone benefits gynecologic cancer survivors. In addition to surveillance for cancer recurrence and late treatment side effects, survivors benefit from guidance on hormonal, contraceptive, and fertility management and promotion of cardiovascular, bone, brain, and sexual health.
authors.affiliation: 1 Division of General Internal Medicine, Women's Health Clinic, Mayo Clinic , Rochester, Minnesota.
authors.forename: Stephanie S
authors.initials: SS
authors.lastname: Faubion
authors.affiliation: 2 Department of Family Medicine, Mayo Clinic , Rochester, Minnesota.
authors.forename: Kathy L
authors.initials: KL
authors.lastname: MacLaughlin
authors.affiliation: 3 Department of Obstetrics and Gynecology, Mayo Clinic , Rochester, Minnesota.
authors.forename: Margaret E
authors.initials: ME
authors.lastname: Long
authors.affiliation: 4 Division of General Internal Medicine, Breast Diagnostic Clinic, Women's Health Clinic, Mayo Clinic , Rochester, Minnesota.
authors.forename: Sandhya
authors.initials: S
authors.lastname: Pruthi
authors.affiliation: 3 Department of Obstetrics and Gynecology, Mayo Clinic , Rochester, Minnesota.
authors.forename: Petra M
authors.initials: PM
authors.lastname: Casey
mesh_terms: D003267:Contraception / Q000379:methods; D005260:Female; D059247:Fertility Preservation; D005833:Genital Neoplasms, Female / Q000401:mortality / Q000523:psychology / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D011159:Population Surveillance; D011788:Quality of Life; D015996:Survival Rate; D017741:Survivors / Q000523:psychology*