Battling breast cancer is tough, but survivors need care, too. Now, two major groups in cancer care have issued guidelines on the type of follow-up these patients require.
The protocols, released jointly by the American Cancer Society and the American Society of Clinical Oncology, are “much needed for the 3.1 million breast cancer survivors who are alive in the United States today,” said one expert, Dr. Eleonora Teplinsky, a medical oncologist with North Shore-LIJ Cancer Institute in Lake Success, N.Y.
“Survivorship is defined as living with, through and beyond cancer, and each of these phases comes with unique concerns and challenges,” she said.
According to the new guidelines, regular monitoring of patients for the return of any cancer is one key recommendation.
This monitoring should include evaluation — such as a detailed cancer history and physical examination — and patients should also be screened for any new primary breast cancer.
However, in patients with no symptoms, the current evidence does not support routine laboratory tests or medical imaging (scans), except for mammography when indicated, the guidelines say.
Primary care doctors should advise breast cancer survivors about the need to maintain a healthy lifestyle and adhere to endocrine therapy — hormonal treatments such as tamoxifen, used to keep cancer at bay.
Patients should also be monitored for post-treatment symptoms that could harm their quality of life, the guidelines say.
The new protocols also provide information on a number of other issues that might face breast cancer survivors, such as thinking and memory problems, body image, fatigue and problems with coordinating care.
“Breast cancer survivors face potentially significant impacts of cancer and its treatment, and deserve high-quality, comprehensive, coordinated clinical follow-up care,” the guideline authors wrote.
“Primary care clinicians must consider each patient’s individual risk profile and preferences of care to address physical and psychosocial impacts,” they added.
Another expert agreed that, while the need for standardized guidelines is clear, there’s no one-size-fits-all approach to caring for survivors.
The new advisory “helps create a more uniform plan of action for breast cancer patients,” said Dr. Stephanie Bernik, chief of surgical oncology at Lenox Hill Hospital in New York City. “One must remember, however, that there may be times to deviate from the norm and methods of surveillance need to be discussed with a patient’s doctor, as well.”
The Breast Cancer Survivors Foundation offers resources for breast cancer survivors.
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