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Survivorship Care

"An individual is considered a cancer survivor from the time of diagnosis, through the balance of his or her life. Family members, friends, and caregivers are also impacted by the survivorship experience and are therefore included in this definition."

 -National Cancer Institute (NCI) Office of Cancer Survivorship (adapted from the National Coalition for Cancer Survivorship)

In 2006 the Institute of Medicine (IOM) influential report From Cancer Patient to Cancer Survivor: Lost in Transition focused attention on unmet needs of the nation's growing population of cancer survivors. Included in the report's call to action was the recommendation "that each cancer patient receive a 'survivorship care plan.' "

Since the report's publication, the population of cancer survivors in the U.S. has grown from 10 million to nearly 17 million.  This number is expected to reach 22.1 million by 2030.1

In late 2019, the American College of Surgeons Commission on Cancer (CoC) released Optimal Resources for Cancer Care: 2020 Standards for  for cancer program accreditation. The newly revised standards went into effect in January 2020; however, many of the new standards are phased in, including Standard 4.8 Survivorship Program.2  This standard requires that the cancer program's cancer committee "oversee the development and implementation of a survivorship program directed at meeting the needs of cancer patients treated with curative intent." With this phased-in standard, the CoC calls for a coordinator of the survivorship program (Standard 2.1), and the development of a survivorship program team composed of multidisciplinary cancer care professionals (e.g., physicians, nurses, advanced practice providers, social workers, nutritionists, physical therapists, and other allied health professionals). This team is responsible for determining the services and programs - available on-site or by referral - required to meet the needs of cancer survivors. The CoC includes survivorship care plans as among the services a survivorship program may choose to include.

Although many cancer programs and practices have initiated integration of survivorship care plans into the continuum of care, multiple facets of the current healthcare delivery system can make the process of developing and delivering these plans an ongoing challenge.    

Despite obstacles, survivorship care remains an important area of ongoing discussion not only because the population of survivors continues to grow, but also new treatment paradigms are emerging, requiring fresh perspectives on the post-treatment needs of patients. In 2018, the National Academy of Medicine (formerly the Institute of Medicine) published proceedings from its workshop on Long-Term Survivorship Care After Cancer Treatment

ACCC is pleased to offer a resource that explores the new frontier of Survivorship Care Plans for Patients Receiving Immunotherapy. The publication describes processes for developing survivorship care plans (SCPs) for patients treated with immunotherapy, effective practices in SCP design, and considerations for SCP delivery for this patient population.

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1. American Cancer Society. Cancer Treatment & Survivorship: Facts & Figures 2019-2021. Atlanta: American Cancer Society; 2019. Last accessed January 8, 2020.

2. American College of Surgeons. Commission on Cancer. Optimal Resources for Cancer Care: 2020 Standards. 
Last accessed January 10, 2020.


Survivorship Resources

Featured Programs

Elevating Survivorship
ACCC has partnered with the National Coalition for Cancer Survivorship (NCCS) on the Elevating Survivorship project. ACCC has launched a web-based survey to learn about gaps in survivorship care delivery, technical support needed to improve survivorship care, and unmet and evolving survivorship care needs of patients who have been treated with immunotherapy.
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Let’s Be Clear: Communicating to Improve the Patient Experience
With this education initiative ACCC seeks to help cancer programs across the country to improve survivorship programming through the application of the health literacy principles.
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ACCC Metastatic Breast Cancer Project
While breast cancer is a high-profile disease, receiving significant private and public research funding and focused awareness and prevention initiatives, patients with metastatic breast cancer face unique challenges. ACCC has identified these 6 effective principles for patient suppor
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ACCCBuzz Blog Posts

From Oncology Issues

  • Expanding Patient Access to Cancer Care Services
    Kelley D. Simpson, MBA; Stacy Melvin, MHA; and Sue Fletcher, RN
    Key results from a national survey show a range of new initiatives.
  •  Empowering Cancer Patients Using Integrative Medicine: A Novel Model for Breast Cancer Risk Modification
    Christina M. Bowen, MD; Robin Hearne, MS, RN; Caroline Dixon; and Charles H. Shelton, MD
    As a CoC-accredited critical access hospital—one of only about a dozen nationwide—The Outter Banks Hospital has developed a quality program with a focus on removing rurally linked barriers to care.
  •  Young Adult Parents Tap into Long Distance Support
    Laura Melton, PhD, ABPP
    We proposed creating an online video support group to enable patients with cancer who would otherwise have difficulty attending such groups to participate virtually.
  •  "Prescribing" Exercise and Nutrition in Cancer Cares
    Jessica Clague DeHart, PhD, MPH, et al.
    As more evidence is showing, all the activities encompassed under the wellness umbrella can be applied to cancer prevention and the cancer care continuum.
  •  Guided Patient Support: Helping Patients Navigate the Clinical, Psychosocial, and Financial Aspects of Cancer Care
    Jessica Sima, MSN, RN, ACM, et al.
    This innovative program provides coordinated whole-person care, ensuring that patients receive the support they need through psychosocial counseling, social support, rehabilitation services, financial counseling, nurse navigation, nutritional intervention, transportation assistance, physical therapy, tertiary care referrals, and medication assistance. The GPS approach helps the cancer care team proactively identify patient needs and prepare patients for treatment.
  •  Supporting Cancer Survivors in Making Healthful Lifestyle Changes
    Wendy Demark-Wahnefried, PhD, RD, et al.
    Evidence-based diet and exercise interventions and programs that can improve cancer survivors’ quality of life and physical and mental health.
  •  Impact of a Community-Based Cancer Survivorship Program on Quality of Life
    Rrachel Funk-Lawler, PhD, et al.
    Despite the demonstrated need to implement evidence-based interventions that address the psychosocial and behavioral concerns of cancer survivors, few studies have evaluated the effectiveness of community-based survivorship programs. To address this need, the Fort Worth Program for Community Survivorship—a community-based cancer survivorship program at the University of Texas Southwestern Medical Center Moncrief Cancer Institute in Fort Worth, Tex.—conducted a study involving more than 200 post treatment cancer survivors to evaluate the effectiveness of the program’s services.
  •  Implementing and Evaluating an Online Educational Resource for Veterans with Cancer
    Cheryl Booth, RN, MSN, NP-C, AOCNP, AND Gwendolyn Hooper, PhD, RN, FNP, APRN-BC
    One VA Center improved patient education by developing an online resource for veterans with cancer. Although several barriers emerged during this quality improvement process, the VA Center was able to meet its patients needs and decrease their anxiety.
  •  Addressing Cancer-Related Cognitive Impairment in Cancer Survivorship
    Lynne S. Padgett, PHD, et al.
    Poor executive function, attention and concentration deficits, and impairment to short term memory are a few of the symptoms of cancer-related cognitive impairment that can impact patients during- and post-treatment. Find out how patients present these symptoms and how assessment and screening can help early interventions.
  •  Partnering with Data Analytics to Promote Survivorship Care Plan Success
    Andrea Rowe, BS, RHIT, et al.
    Creating and maintaining a survivorship care plan is a complex process, but it is essential to creating a survivorship compliance report that informs clinical and management team decision-making.

In 2007-2008 ACCC conducted an educational initiative to raise awareness about the importance of comprehensive survivorship programs. ACCC President (2007-2008) Richard B. Reiling, MD, FACS, selected survivorship as his president's theme, and ACCC developed Comprehensive Survivorship Services: A practical guide for community cancer centers

Publication and distribution of ACCC's Comprehensive Survivorship Services: A Practical Guide for Community Cancer Centers was made possible through a sponsorship funded by AstraZeneca and Abraxis Oncology.