Evidence-Based Oncology

The Quest for Better Survivorship: Guidelines Promote More Accountable Cancer Care | Page 3

Published Online: December 13, 2013
Peter Page
The NCCN survivorship guidelines are a good start, she said, toward a frank discussion about what outcomes survivors can expect in exchange for the misery and cost of cancer treatment. She cites research that found patients who received palliative care frequently had better outcomes with standard treatment than patients who did not.11

“People need an open conversation about the likely course of the disease,not just their diagnosis,’’ she said. “My prognosis, the likely course of my disease, is that about 11% of people live 5 years. What do I want my next couple of years to look like and feel like? A curative approach that doesn’t cure will take away time from my family, cause me pain, and put me in the hospital where I am exposed to other infection.

“I take medications with the least side effects to hold the cancer at bay and, 3 years out, I feel great, I’ve saved about $500,000 and I have a great life,” Berman said. “But if I hadn’t understood the likely course of this disease, I might have thrown everything at it.’’

Take-Away Points


1. Siegel R, DeSantis C, Virgo K, et al. Cancer treatment and survivorship statistics, 2012. CA Cancer J Clin. 2012;62(4):220-241.

2. Institute of Medicine. From cancer patient to cancer survivor: lost in transition. http://www.iom.edu/Reports/2005/From-Cancer-Patient-to-Cancer-Survivor-Lost-in-Transition.aspx Published November 3, 2005. Accessed November 18, 2013.

3. American Cancer Society. Cancer Treatment and Survivorship Facts and Figures, 2012-13. Atlanta: ACS; 2012. http://www.cancer.org/acs/groups/content/@epidemiologysurveilance/documents/document/acspc-033876.pdf. Accessed November 2, 2013.

4. Ligibel JA, Denlinger CS. New NCCN guidelines for survivorship care. J Natl Compr Canc Netw. 2013;11(5 Suppl):640-644.

5. National Comprehensive Cancer Network. DFCI/NCCN Cancer Survivorship Information. http://www.nccn.org/professionals/survivorship/default.asp. Accessed December 2, 2013.

6. American College of Surgeons. Commission on Cancer, Cancer Program Standards 2012:Ensuring patient-centered care, continuum of care services. http://www.facs.org/cancer/coc/programstandards2012.pdf. Accessed November 24, 2013.

7. Aitken-Swan, J, Easson, EC. Reactions of cancer patients on being told their diagnosis. Br Med J. 1959;1(5124). Accessed November 20, 2013.

8. Levit L, Balogh E, Ganz, PA. Delivering high quality cancer care: charting a new course for a system in crisis, a report of the Institute of Medicine. Washington, DC: National Academies Press. http://www.nap.edu/catalog.php?record_id=18359. Published 2013. Accessed December 2, 2013.

9. Esserman LJ, Thompson IM, Reid B. Overdiagnosis and overtreatment in cancer: an opportunity for Improvement. JAMA. 2013;310(8):797-798.

10. Ganz, PA. Survivorship: adult cancer survivors. Prim Care. 2009;36(4):721-741. 11. Temel JS, Greer JA, Muzikansky A, et al. Palliative care for patients with metastatic non–small-cell lung cancer. N Engl J Med.soo 2010;363:733-742.