How to begin a survivorship program in your community oncology practice

In 2012, the United States had an estimated 12 million cancer survivors. In November 2005 the Institute of Medicine (IOM) issued a call to action on cancer survivorship for health care professionals to recognize challenges, treat conditions, and support our patients more comprehensively after their diagnosis with cancer. This support begins with educating patients about their disease and treatment, their follow-up plan, and potential complications. It involves an assessment for potential complications of disease and treatment, and intervention when warranted. Survivorship programs have emerged throughout the country, but the composition of the programs and operational process by which they are implemented are widely varied. There is some divergence about what defines a cancer survivor, though most current programs treat individuals who have undergone early stage disease treatment through palliation. The site of service where survivorship programs are delivered varies from hospital to center to clinic. The structure of the delivery mechanism can be as a consultation, assuming individuals will have usually 1 survivorship visit, or as longitudinal, setting the precedent that patients will follow up at some regular interval for continued survivorship care. The most striking variation in survivorship programs is the depth and breadth of services that they provide to their patients.