Craig C. Earle, MD, MSc
Harvard Medical School
Center for Outcomes and Policy Research
Dana-Farber Cancer Center
The recent Institute of Medicine (IOM) report From Cancer Patient to Cancer Survivor: Lost in Transition recommended that “survivorship care plans” be created for patients as they complete primary therapy for cancer in order to ensure clarity for all involved about patients’ diagnoses, treatment received, and plan for surveillance. The survivorship care plan should explicitly identify the providers responsible for each aspect of ongoing care and give information on resources available for psychosocial and other practical issues that may arise as a result of the prior cancer diagnosis. Creation of such a document would likely require a dedicated “off-treatment” or “transition” consultation in most cases. The IOM stated that such survivorship care plans “have strong face validity and can reasonably be assumed to improve care unless and until evidence accumulates to the contrary.” This may be true, but it was an unusual step to make such a strong recommendation in the absence of much evidence. The logistics and resources required to implement survivorship care planning are nontrivial. If evidence eventually does not support their use, a lot of time, money and effort will have been wasted. Therefore, it is incumbent on the health services research community to quickly yet rigorously evaluate each element of the survivorship care plan and the effects, both good and bad, of its implementation.
The theory implicit in this focus on optimizing the transition from cancer patient to survivor is that if treatment summaries and survivorship