Handbook of Cancer Survivorship

pp 19-42

Quality of Care

  • Craig C. Earle

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In its recent report,1 the Institute of Medicine (IOM) urged as its first recommendation that cancer survivorship be recognized as “a distinct phase of cancer care.” The rationale for this is that until recently cancer survivorship has been relatively neglected in clinical practice, advocacy, and research. By virtue of their sheer numbers and the expected rate of growth of this population, however, the quality of the medical care cancer survivors receive is an increasingly important public health issue. Part of the problem is that there has not been a unifying identity for these patients and the challenges they face. The IOM report strove to address this by defining and highlighting a constellation of long-term and late effects that result from having had cancer treatment: issues around surveillance for and prevention of recurrence and second cancers, long-term and late effects of treatment, psychological sequelae, and social problems such as employment and insurance concerns.