Feature Article

How to care for cancer survivors

Lorraine Chantrill, Martin Tattersall



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.