Recommended preventive behaviors, interventions, or genetic testing:

This patient already has a very health lifestyle and habits, but she is encouraged to avoid weight gain and to remain physically active. Genetic testing has been advised as noted earlier. Patient given NCI booklet, Life After Cancer Treatment, and the NCCS “Cancer Survival Toolbox: An Audio Resource Program” that address medical and psychosocial issues, including those related to health insurance and employment.

NOTE: All individual and hospital names are fictitious.

SOURCE: Patricia Ganz, committee member, 2005.

Date of note: April 20, 2005

Name: John Doe Age: 65

Date of tissue diagnosis of cancer: October 21, 2001

Diagnosis: Prostate cancer

Stage of cancer: Clinical T1c

Pathologic findings: pT2cN0M0, Gleason 4+4, 2.3 cm

Initial treatment plan:

• Surgery: Yes

• Radiation therapy: None

• Chemotherapy: None

Treatment received (specify dates, location, and providers):

Radical prostatectomy with nerve sparing on December 1, 2001, Eastside Medical Center, Dr. Roger Smith

Unusual or unexpected toxicities during treatment:

None

Expected short- and long-term effects of treatment:

Mild urinary leakage for 3 weeks, now dry

Sexual dysfunction for 3 months, now potent with occasional sildenafil

Late toxicity monitoring needed:

None