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Feature Article

How to care for cancer survivors

Lorraine Chantrill, Martin Tattersall

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Abstract

Cancer survivors are at risk of recurrence of their original cancer and of developing another cancer due to their genetic make up, environmental exposure and/or cancer treatment. In many cases, the family physician has an integral role in following up these patients.

Key Points

  • Follow up of cancer survivors is advocated for several reasons, including early detection of recurrences or a new tumour, monitoring treatment-related sequelae, and undertaking family screening if appropriate.
  • The annualised rate of breast cancer recurrence is 1 to 2% per annum for the first five years after treatment for localised breast cancer. A history of breast cancer doubles the risk of a second breast cancer to about 1% per year.
  • Almost one in three patients who had curative surgery for colorectal cancer dies of recurrent disease; early detection of resectable recurrence improves survival probability.
  • Earlier detection of prostate cancer and the chronicity of metastatic disease in many patients contributes to a large number of men with prostate cancer surviving for many years after diagnosis and/or treatment. PSA testing is recommended six monthly for five years then annually, and digital rectal examinations are recommended annually.
  • In addition to the scheduled follow up investigations, cancer survivors should be encouraged to undergo routine preventive health practices, such as vaccination, and lifestyle modification, such as smoking cessation.

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