The term “cancer survivor” can mean different things to different people. For some, the term refers to anyone who has been diagnosed with cancer. Others consider a cancer survivor to be someone who has completed active treatment and is free of any signs of disease.
For the purpose of Memorial Sloan Kettering’s survivorship program, the transition from cancer patient to cancer survivor occurs after you have completed active treatment, as determined by your treating physician. However, all patients can consider themselves cancer survivors.
During the survivorship phase of your care, you will be carefully monitored by a healthcare provider for a period of time determined by your treating physician.
Key components of your follow-up care may include:
- Surveillance for disease recurrence
- Identification and management of late or long-term effects of cancer treatment
- Health-promotion strategies, such as recommendations for physical activity, diet, and smoking cessation
- Recommendations for cancer screening
- Provision of a treatment summary and care plan
- Communication with your primary care provider
If you are a patient at Memorial Sloan Kettering, your treating physician can refer you to one of our disease-specific survivorship clinics if the program is appropriate for you.
While most cancer survivors lead healthy, active lives, cancer treatment can have a long-standing impact. Long-term effects are those that begin during or shortly after treatment and last for many months or years. Late effects are those that can occur years after treatment is completed.
Not all cancer survivors experience these effects, but if you are having difficulty, please consult your healthcare provider. There are strategies to help you identify and manage the physical and emotional effects of treatment.
Your doctor or nurse practitioner will recommend specific tests to check for any signs of a cancer recurrence or a new cancer development, depending on your individual diagnosis, treatment outcomes, and follow-up plan. Your healthcare provider may also order tests to check for late effects of treatment that could affect your health. Some tests may be performed at every visit, and others may be performed less frequently.
Your follow-up care may include a physical exam and laboratory tests to look for abnormalities in samples of your blood, urine, or other body fluids. Many different imaging technologies are also used to identify a cancer recurrence or second cancer.
A survivorship care plan is a record of a patient's cancer treatment and recommendations for follow-up care.
Survivorship care plans have received increasing attention since the Institute of Medicine’s publication of the report From Cancer Patient to Cancer Survivor: Lost in Transition. The report strongly recommends that at the completion of cancer treatment, clinicians provide patients and primary care providers with a summary of the treatment delivered and a detailed plan for ongoing care, including follow-up schedules for visits and testing, and recommendations for the early detection and management of treatment-related effects and other health problems. The plan should define the responsibilities of each of your healthcare providers. Even if you have a written plan, it is important to talk with your doctors about your future care.
Oncology nurses and physicians from the Memorial Sloan Kettering survivorship program have developed a cancer treatment summary and follow-up plan template. In addition, the National Cancer Institute offers a detailed fact sheet with more information about survivorship care plans.
Other cancer organizations have developed similar templates. The LIVESTRONGTM Care Plan is based on the answers you provide in a brief questionnaire. The American Society of Clinical Oncology (ASCO) offers disease-specific cancer treatment summaries and follow-up plans. Journey Forward is a tool for developing survivorship care plans based on ASCO guidelines.
It is normal to feel anxious before your follow-up tests and appointments. There are several ways to ease pre-appointment anxiety. Write down questions you have about any issues you are or have been experiencing — this could be about long-standing symptoms, emotional aspects of survivorship, or practical issues such as questions about health insurance. You may want to ask a friend or family member to sit with you while you wait for your scans.
In the days before your appointments, schedule activities that can help distract you from worrying, such as going for walks, talking with friends and family, or doing yoga. These practices can help alleviate some of the anxiety you may be experiencing, and you may find that your anxiety lessens or disappears over time.
If your anxiety becomes overwhelming, persists for many weeks, or makes it difficult for you to keep your appointments, please consider consulting a mental health professional.
The following actions can improve your health:
Quitting smoking is one of the best ways to improve your general health. Quitting will help you breathe easier and feel better overall. It will also reduce your risk of developing certain cancers, and will help prevent cardiovascular disease. Learn more about Memorial Sloan Kettering’s smoking cessation programs.
Protect Yourself from the Sun
You can reduce your risk of getting skin cancer by protecting yourself from the sun's ultraviolet rays. Protect your skin from direct sunlight by wearing protective clothing, applying sunscreen, staying in the shade, and avoiding sunlamps and tanning booths. The Skin Cancer Foundation offers a guide for sun protection.
Eat a Nutritious Diet
Eating a nutrient-rich diet with plenty of fruits and vegetables can help you feel better and may lower your chances of developing other health problems. Eating Your Way to Better Health and Eating Well During and After Your Cancer Treatment offer general dietary guidance.
Achieve and Maintain a Healthy Weight
After cancer treatment, speak with your healthcare provider about whether you need to gain or lose weight. If you need to gain weight, you will have to eat more calories than you use. If you need to lose weight, you will have to reduce your caloric intake and increase your energy expenditure through physical activity. Ask for a referral to one of our nutritionists if you want help in managing your weight.
Exercise after cancer treatment, regardless of how active you were prior to your diagnosis, can improve cardiovascular fitness and muscle strength. Regular exercise may also reduce fatigue in some cancer survivors. Learn more about exercise by viewing the video The Importance of Exercise in Cancer Survivorship.
Your risk of recurrence depends on the type of cancer you had, the stage of cancer at diagnosis, the treatment you received, how much time has elapsed since your treatment, genetic factors, and environmental factors that are still being studied. Your doctor can discuss your personal risk of recurrence with you.
The signs and symptoms of recurrence vary, based on the type of cancer and how it has grown. In some cases, people will not feel or see any signs. Therefore, it is important to attend follow-up visits with your doctor or nurse to monitor your health.
Tell your healthcare provider about any new symptoms you have so that they can be evaluated. However, at the same time, remember that every symptom you have will not be related to cancer.
Some cancer survivors have a higher risk of developing a second primary cancer as a result of their prior cancer treatment, environmental exposures, or genetic factors. Having appropriate cancer screening tests performed at the recommended intervals is an important step in the early detection of these cancers. Discuss what screening tests you should have with your doctor or nurse.
The National Cancer Institute provides additional information about cancer causes and risk factors.
Health insurance questions are important and often complex. To discuss health insurance questions pertaining to treatment at Memorial Sloan Kettering, you can call our insurance information hotline at 646-497-9176. You can also learn more in our insurance information section and in our financial resources for survivors section.
Your cancer history may entitle you to protection under the Americans with Disabilities Act. Your employer cannot discriminate against you as long as you are able to perform the essential functions of your job. If your cancer or the effects of treatment interfere with your ability to perform your job, your employer may need to provide reasonable accommodations to allow you to continue working. Find information on health insurance and workplace issues in work, education, and financial resources.
To learn more about cancer survivorship, please visit our Survivorship Center. You can connect to other web sites through Recommended Links: Living Beyond Cancer.