Survivorship and cancer
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Cancer Survivorship: Challenges and Opportunities
Symptom Burden and Quality of Life in Cancer Survivorship
Cancer survivorship is marked by a significant symptom burden that can persist long after treatment ends. Common symptoms include fatigue, depression, sleep disruption, pain, and cognitive limitations, which can severely impact the quality of life (QOL) of survivors. These symptoms are not only prevalent during treatment but can continue to affect survivors for years, leading to increased disability and healthcare utilization. Factors such as younger age, lower socioeconomic status, and increased comorbidities are associated with poorer QOL and higher symptom distress.
Long-Term and Late Sequelae of Cancer Treatment
Advances in cancer detection and treatment have increased the number of survivors, but these treatments often come with long-term and late adverse effects. These sequelae are more serious and persistent than previously expected, particularly among those diagnosed in adulthood. The lack of standardized follow-up care for adult cancer survivors exacerbates these issues, highlighting the need for regular monitoring to manage adverse outcomes, detect recurrences, and screen for second cancers. Effective follow-up care can also help manage comorbidities and implement preventive strategies such as lifestyle changes.
Survivorship Care Plans (SCPs)
Survivorship care plans (SCPs) are recommended to help manage the long-term care of cancer survivors. However, evidence on their effectiveness is mixed. While SCPs are feasible and can improve healthcare professionals' knowledge of survivorship care, they do not significantly impact patient-reported outcomes such as physical functioning, anxiety, or depression . The variability in SCP implementation and study designs may contribute to these mixed results, suggesting a need for further research to optimize SCPs and ensure their recommendations are acted upon.
Health Care Utilization in Cancer Survivorship
Cancer survivors have increased healthcare needs that persist throughout their lives. Most survivors visit primary care providers regularly, and those who also see oncologists or other specialists receive better cancer screenings and care for non-cancer-related conditions. High care density and low care fragmentation between specialties are associated with lower healthcare costs and reduced redundant care. As the survivorship period lengthens, understanding long-term healthcare utilization patterns is crucial for designing effective follow-up care plans.
Primary vs. Secondary Care in Survivorship
The role of primary care in cancer survivorship is gaining attention. Studies show that primary care can provide survivorship care with similar clinical and patient-reported outcomes as secondary care, often at lower costs. However, differences in guideline adherence and follow-up tests between primary and secondary care highlight the need for more research to establish the best practices for survivorship care.
Cancer Survivorship in the Gulf Countries
Research on cancer survivorship in the Gulf countries is limited, with significant gaps in both the countries reporting on the topic and the domains of survivorship studied. Most research focuses on clinical structure, surveillance, and management of physical and psychosocial effects, while areas like chronic condition management and patient and caregiver experiences are underreported. This underscores the need for more comprehensive research in these regions to address the full spectrum of survivorship needs.
Conclusion
Cancer survivorship presents numerous challenges, including persistent symptom burden, long-term and late treatment effects, and complex healthcare needs. While SCPs and primary care involvement offer potential benefits, their implementation and effectiveness require further research. Addressing these challenges through comprehensive, evidence-based survivorship care plans and regular follow-up can significantly improve the quality of life for cancer survivors.
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