The first aspect of the survivorship care plan is the treatment summary. Patients vary widely in knowledge about their diagnosis and the treatment they received.2 Surgeons describe their procedures in operative reports, and radiation oncologists almost uniformly write "completion notes" that summarize the site, indication, and dose and fractionation of the radiation that was delivered. Medical oncologists do not consistently summarize a course of their treatment, however. Part of the reason is that systemic therapy is generally an ongoing process rather than a discrete treatment event or course. Doses of drugs are reduced and reescalated, breaks are taken, and the duration of therapy varies depending on the clinical situation, tolerance of treatment, and tumor response. The IOM's recommended care plan suggests that "upon discharge from cancer treatment, including treatment of recurrences, every patient should be given a record of all care received and important disease characteristics." Such a treatment summary would indicate the diagnosis and stage, the name of the regimen and component drugs, and starting dosages. It would indicate the number of cycles, the finishing doses, the toxicities that necessitated any dose delays or reductions, the best response, and the reason treatment was discontinued. Awareness of these elements of the patient's history is necessary to guide surveillance for recurrence and late effects.
Was this article helpful?