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From Cancer Patient to Cancer Survivor: Lost in Transition
Surveillance needed for potential recurrence of cancer:
Semi-annual PSA until 5 years post-op, then annual PSA; annual digital rectal exam
Surveillance needed for second malignancies:
Physicians responsible for monitoring of toxicity, recurrence, second malignancies:
Dr. Smith will be following Mr. Doe for recurrence and will also assess treatment side effects.
Identified psychosocial issues or concerns:
Short-term depression following surgery, resolved with counseling and support group. Assess psychosocial distress during follow-up visits.
Recommended preventive behaviors, interventions, or genetic testing:
Patient counseled regarding diet/exercise (avoidance of obesity). At follow-up visits assess sexual function and depression. 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: Mark Litwin, committee member, 2005.
Example of an End-of-Treatment Consultation Note: Colorectal Cancer
Date of note: April 18, 2005
Name: John Smith Age: 70
Date of tissue diagnosis of cancer: September 15, 2004
Diagnosis: Colon cancer
Stage of cancer: T3N2M0 (IIIB)
Pathologic findings: Moderately differentiated adenocarcinoma penetrating through the muscularis propria. No lymphovascular or perineural invasion. 5/13 regional lymph nodes positive for cancer.
Initial treatment plan:
Surgery: Left hemicolectomy 9/28/04
Radiation therapy: None
Chemotherapy: FOLFOX (5-FU 400 mg/m2 bolus followed by