American Society of Clinical Oncology Clinical Evidence Review on the Ongoing Care of Adult Cancer Survivors: Cardiac and Pulmonary Late Effects

2007 ◽  
Vol 25 (25) ◽  
pp. 3991-4008 ◽  
Author(s):  
Joseph R. Carver ◽  
Charles L. Shapiro ◽  
Andrea Ng ◽  
Linda Jacobs ◽  
Cindy Schwartz ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Clinical Oncology ◽  
Late Effects ◽  
Pulmonary Toxicity ◽  
External Beam Radiation ◽  
Drug Discontinuation ◽  
Beam Radiation ◽  
Adult Cancer Survivors ◽  
American Society

Purpose To review the evidence on the incidence of long-term cardiac or pulmonary toxicity secondary to chemotherapy, radiotherapy, or trastuzumab in symptomatic and asymptomatic cancer survivors. Methods An American Society of Clinical Oncology Panel reviewed pertinent information from the literature through February 2006. Results Few studies directly addressing the benefits of screening for long-term cardiac or pulmonary toxicity in asymptomatic cancer survivors who received chemotherapy, radiotherapy, or trastuzumab were identified. The reviewed literature included primarily retrospective and cross-sectional studies describing the incidence of cardiac and pulmonary late effects. Anatomic and/or functional abnormalities have been associated with use of all currently available anthracyclines and their derivatives. Trastuzumab-related cardiac dysfunction rarely causes death, and in most cases is reversible with improvement in cardiac function on drug discontinuation and/or treatment with cardiac medications. The estimated aggregate incidence of radiation-induced cardiac disease is 10% to 30% by 5 to 10 years post-treatment, although the incidence may be lower with modern techniques. Radiation pneumonitis is reported in 5% to 15% of lung cancer patients receiving definitive external-beam radiation therapy. A minority of patients may develop progressive pulmonary fibrosis; late complications include cor pulmonale and respiratory failure. Bleomycin-induced pneumonitis is an acute rather than late effect of treatment. Late pulmonary complications in bone marrow or stem cell transplantation patients who develop interstitial pneumonitis include idiopathic pneumonia syndrome and bronchiolitis obliterans. Conclusion An increased incidence of cardiac and/or pulmonary dysfunction is observed in cancer survivors. Research is needed to identify high-risk patients, and to determine the optimal screening strategies and subsequent treatment.

scholarly journals American Society of Clinical Oncology-recommended surveillance and physician specialty among long-term breast cancer survivors

Cancer ◽  
2010 ◽  
pp. NA-NA ◽  
Author(s):  
Kerry Hollowell ◽  
Courtney L. Olmsted ◽  
Anne S. Richardson ◽  
H. Keith Pittman ◽  
Lisa Bellin ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Clinical Oncology ◽  
Breast Cancer Survivors ◽  
Physician Specialty ◽  
American Society

scholarly journals Needs for information about lifestyle and rehabilitation in long-term young adult cancer survivors

2021 ◽  
Author(s):  
Lene Thorsen ◽  
Synne-Kristin H. Bøhn ◽  
Hanne C. Lie ◽  
Sophie D. Fosså ◽  
Cecilie E. Kiserud
Keyword(s):  
Physical Activity ◽  
Young Adult ◽  
Cancer Survivors ◽  
Late Effects ◽  
Information Needs ◽  
Rehabilitation Services ◽  
Young Adult Cancer Survivors ◽  
Adult Cancer Survivors ◽  
Young Adult Cancer

Abstract Background Healthy lifestyle and rehabilitation may mitigate late effects after cancer treatment, but knowledge about lifestyle and rehabilitation information needs among long-term young adult cancer survivors (YACSs) (≥ 5 years from diagnosis) is limited. The present study aimed to examine such information needs among long-term YACSs, and identify characteristics of those with needs. Material and methods The Cancer Registry of Norway identified long-term YACSs diagnosed with breast cancer, colorectal cancer, non-Hodgkin lymphoma, leukemia, or malignant melanoma at the age of 19–39 years, between 1985 and 2009. Survivors were mailed a questionnaire, in which respondents reported their information needs on physical activity, diet, and rehabilitation services 5–30 years post-diagnosis. Descriptive statistics and logistic regression analyses were used to examine the prevalence of information needs and associated factors. Results Of 1488 respondents (a response rate of 42%), 947 were included. Median age at diagnosis was 35 years (range 19–39) and median observation time since diagnosis was 14 years (range 5–30). In total, 41% reported information needs for information about physical activity, 45% about diet, and 47% about rehabilitation services. Information needs were associated with higher treatment intensity, increasing number of late effects, and an unhealthy lifestyle. Conclusion A large proportion of long-term YACSs report information needs regarding lifestyle and/or rehabilitation more than a decade beyond treatment. Assessments of such information needs should become a part of long-term care of these cancer survivors.

scholarly journals Long-Term Follow-Up of Children, Adolescents, and Young Adult Cancer Survivors

2021 ◽  
Vol 44 (4) ◽  
pp. 184-189
Author(s):  
Inken Hilgendorf ◽  
Corinna Bergelt ◽  
Carsten Bokemeyer ◽  
Peter Kaatsch ◽  
Ulf Seifart ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Late Effects ◽  
Early Stage ◽  
Normal Population ◽  
Therapeutic Interventions ◽  
Term Survival ◽  
Young Adult Cancer Survivors ◽  
Adult Cancer Survivors

<b><i>Background and Summary:</i></b> Thanks to increasing cure rates to currently &#x3e;80%, children, adolescents, and young adults (CAYA) survive their cancer much more frequently today than decades ago. Due to their long life expectancy, CAYA cancer survivors are at a particular risk of long-term sequelae from the cancer itself or the therapy applied; this requires specific follow-up, and preventative or even therapeutic interventions. Thus, compared to the normal population, morbidity and mortality may be significantly increased. In 2 of 3 survivors, the cancer and the respective treatment can lead to late effects, even after 30 years, which require specific therapy; in about one-third of these cases, these effects are classed as severe. Applying structured follow-up could identify these late effects at an early stage and initiate immediate treatment. In 2018, a working group dealing with long-term survival after cancer detected &#x3c;40 years of age was founded within the framework of the National Cancer Plan of the German Federal Ministry of Health.

Considerations for Adult Cancer Survivors

Hematology ◽  
2005 ◽  
Vol 2005 (1) ◽  
pp. 516-522 ◽  
Author(s):  
André Tichelli ◽  
Gérard Socié
Keyword(s):  
Cancer Survivors ◽  
Late Effects ◽  
Underlying Disease ◽  
Initial Therapy ◽  
Primary Malignancy ◽  
Patient Decision ◽  
Adult Cancer Survivors ◽  
Long Time ◽  
Effect Of Treatment

Abstract With improvements in outcome, increased numbers of adult cancer patients survive free of their primary malignancy. Today, about 60% of adult patients diagnosed with cancer will survive 5 years after diagnosis. Therefore, immediate survival is no longer the sole concern. The aim of the cancer treatment now is to cure a patient’s underlying disease and, at the same time, to minimize the incidence of post-treatment complications and ensure the best possible long term quality of life. The long time span between initial therapy and late effects, the multiple factors influencing cancer-related health risk and the unknown effect of treatment on normal aging are common characteristics of late effects. While the treatment strategy for a cancer patient depends widely on the type and extension of the disease, considerations for a long-term survivor depend much more on the type of treatment applied, age of the patient, and the patient’s general health status as well as his or her familial and social integration. We discuss, based on the most recent knowledge, some typical examples of late effects in cancer survivors and the practical recommendations that could assist practitioner and patient decision about appropriate healthcare for specific clinical circumstances.

scholarly journals Physical Comorbidities and Depression in Recent and Long-Term Adult Cancer Survivors: NHANES 2007–2018

Cancers ◽  
2021 ◽  
Vol 13 (13) ◽  
pp. 3368
Author(s):  
Dafina Petrova ◽  
Andrés Catena ◽  
Miguel Rodríguez-Barranco ◽  
Daniel Redondo-Sánchez ◽  
Eloísa Bayo-Lozano ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Cancer Patients ◽  
Cancer Diagnosis ◽  
Depression Symptoms ◽  
Depression Risk ◽  
Adult Cancer Survivors ◽  
Before And After ◽  
Nationally Representative ◽  
Risk Of Cancer

Many adult cancer patients present one or more physical comorbidities. Besides interfering with treatment and prognosis, physical comorbidities could also increase the already heightened psychological risk of cancer patients. To test this possibility, we investigated the relationship between physical comorbidities with depression symptoms in a sample of 2073 adult cancer survivors drawn from the nationally representative National Health and Nutrition Examination Survey (NHANES) (2007–2018) in the U.S. Based on information regarding 16 chronic conditions, the number of comorbidities diagnosed before and after the cancer diagnosis was calculated. The number of comorbidities present at the moment of cancer diagnosis was significantly related to depression risk in recent but not in long-term survivors. Recent survivors who suffered multimorbidity had 3.48 (95% CI 1.26–9.55) times the odds of reporting significant depressive symptoms up to 5 years after the cancer diagnosis. The effect of comorbidities was strongest among survivors of breast cancer. The comorbidities with strongest influence on depression risk were stroke, kidney disease, hypertension, obesity, asthma, and arthritis. Information about comorbidities is usually readily available and could be useful in streamlining depression screening or targeting prevention efforts in cancer patients and survivors. A multidimensional model of the interaction between cancer and other physical comorbidities on mental health is proposed.

scholarly journals Self-reported late effects and long-term follow-up care among 1889 long-term Norwegian Childhood, Adolescent, and Young Adult Cancer Survivors (the NOR-CAYACS study)

2020 ◽  
Author(s):  
A. V. Mellblom ◽  
C. E. Kiserud ◽  
C. S. Rueegg ◽  
E. Ruud ◽  
J. H. Loge ◽  
...  
Keyword(s):  
Young Adult ◽  
Late Effects ◽  
Adolescent And Young Adult ◽  
Young Adult Cancer Survivors ◽  
Adult Cancer Survivors ◽  
Follow Up Care ◽  
Long Term Follow Up ◽  
Young Adult Cancer

Abstract Purpose The majority of childhood, adolescent, and young adult cancer survivors (CAYACS) are at risk of late effects but may not receive long-term follow-up care for these. Here, we investigated (1) self-reported late effects, (2) long-term follow-up care, and (3) factors associated with receiving follow-up care in a population-based sample of Norwegian long-term CAYACS. Methods Survivors were identified by the Cancer Registry of Norway. All > 5-year survivors diagnosed between 1985 and 2009 with childhood cancer (CCS, 0–18 years old, excluding CNS), breast cancer (BC, stages I–III), colorectal cancer (CRC), leukemias (LEUK), non-Hodgkin lymphoma (NHL), or malignant melanoma (MM) at age 19–39 years were mailed a questionnaire (NOR-CAYACS study). Descriptive statistics and logistic regression models were used to analyze occurrence of late effects, long-term follow-up care for these, and associated factors. Results Of 2104 responding survivors, 1889 were eligible for analyses. Of these, 68% were females, with a mean age of 43 years at survey, on average 17 years since diagnosis, and diagnosed with CCS (31%), BC (26%), CRC (8%), NHL (12%), LEUK (7%), and MM (16%). Overall, 61.5% reported the experience of at least one late effect, the most common being concentration/memory problems (28.1%) and fatigue (25.2%). Sixty-nine percent reported not having received long-term follow-up care focusing on late effects. Lower age at survey (p = 0.001), higher education (p = 0.012), and increasing number of late effects (p = < 0.001) were associated with increased likelihood of follow-up care in the multivariate model. Conclusions The majority of survivors reported at least one late effect, but not receiving specific follow-up care for these. This indicates a need for structured models of long-term follow-up to ensure adequate access to care.

Quality of life in long-term childhood cancer survivors and the relation of late effects and subjective well-being

2004 ◽  
Vol 13 (1) ◽  
pp. 49-56 ◽  
Author(s):  
Sigrid Pemberger ◽  
Reinhold Jagsch ◽  
Eva Frey ◽  
Rosemarie Felder-Puig ◽  
Helmut Gadner ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cancer Survivors ◽  
Childhood Cancer ◽  
Late Effects ◽  
Well Being ◽  
Childhood Cancer Survivors ◽  
Subjective Well Being

Prostate Cancer Survivorship Care Guideline: American Society of Clinical Oncology Clinical Practice Guideline Endorsement

2015 ◽  
Vol 33 (9) ◽  
pp. 1078-1085 ◽  
Author(s):  
Matthew J. Resnick ◽  
Christina Lacchetti ◽  
Jonathan Bergman ◽  
Ralph J. Hauke ◽  
Karen E. Hoffman ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Clinical Oncology ◽  
Cancer Survivorship ◽  
Information Needs ◽  
Specific Antigen ◽  
Cancer Surveillance ◽  
Survivorship Care ◽  
Care Guidelines ◽  
American Society

Purpose The guideline aims to optimize health and quality of life for the post-treatment prostate cancer survivor by comprehensively addressing components of follow-up care, including health promotion, prostate cancer surveillance, screening for new cancers, long-term and late functional effects of the disease and its treatment, psychosocial issues, and coordination of care between the survivor's primary care physician and prostate cancer specialist. Methods The American Cancer Society (ACS) Prostate Cancer Survivorship Care Guidelines were reviewed for developmental rigor by methodologists. The American Society of Clinical Oncology (ASCO) Endorsement Panel reviewed the content and recommendations, offering modifications and/or qualifying statements when deemed necessary. Results The ASCO Endorsement Panel determined that the recommendations from the 2014 ACS Prostate Cancer Survivorship Care Guidelines are clear, thorough, and relevant, despite the limited availability of high-quality evidence to support many of the recommendations. ASCO endorses the ACS Prostate Cancer Survivorship Care Guidelines, with a number of qualifying statements and modifications. Recommendations Assess information needs related to prostate cancer, prostate cancer treatment, adverse effects, and other health concerns and provide or refer survivors to appropriate resources. Measure prostate-specific antigen (PSA) level every 6 to 12 months for the first 5 years and then annually, considering more frequent evaluation in men at high risk for recurrence and in candidates for salvage therapy. Refer survivors with elevated or increasing PSA levels back to their primary treating physician for evaluation and management. Adhere to ACS guidelines for the early detection of cancer. Assess and manage physical and psychosocial effects of prostate cancer and its treatment. Annually assess for the presence of long-term or late effects of prostate cancer and its treatment.

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