Survivorship Care Plan

Today many cancer experts agree that cancer Survivorship Care Plans are an essential part of quality care.10 They can facilitate an important discussion about the survivor’s long-term health and wellness. Without them, too many cancer survivors don’t have a clear sense of next steps, or are “lost in transition” after they finish treatment.11 The Survivorship Care Plan describes the cancer care the patient received and any ongoing issues that may need to be addressed. In other words, the Survivorship Care Plan includes both the Treatment Plan and Treatment Summary, as well as information on follow-up care and ongoing concerns.

A Survivorship Care Plan is a coordinated plan for the cancer survivor and their healthcare team, created by the oncology provider and survivor in partnership. The plan should define responsibilities of cancer-related and non-cancer-related healthcare providers so that the patient and heathcare team are aligned. It should include a summary of treatment and a detailed plan for ongoing care, including follow-up schedules for visits and testing, as well as recommendations for early detection and management of treatment-related effects and other health problems.

An oncology nurse or nurse navigator typically creates the Survivorship Care Plan. But, an oncologist, nurse practitioner, physician's assistant, nurse or lay navigator, or even registry technician may also do so. Survivorship Care Plans are shared with the cancer survivor, the oncology provider, the primary care provider and other specialists.

Patients and providers can begin the conversation about survivorship care at any time during the cancer journey.

◀ Treatment Plan ◀ Treatment Summary