Survivorship Care Plans

Institute of Medicine (IOM) – Cancer Survivorship Care Planning

In 2005, the IOM adopted minimum care plan elements and standards for cancer survivorship care planning. They also recommended that all cancer patients completing primary treatment be provided with a comprehensive written treatment summary and follow-up care plan. The 2016 Commission on Cancer Program Standards now require that all accredited cancer centers deliver treatment summaries and care plans to an increasing percentage of patients who have been treated in their facilities.

Cancer Survivorship Care Plans: A Toolkit for Health Care ProfessionalsTriage Cancer SCP Toolkit Cover

This toolkit was created to educate healthcare professionals about integrating survivorship care plans into practice and systems of care, and to promote them for cancer survivors. The CDOC Survivorship Care Plan Advisory Group is a collaboration of cancer community stakeholders from across California who have worked to develop this toolkit in partnership with Triage Cancer.

Survivorship Care Plan Project – Best Practice Document:  Survivorship Care Plan ToolsMichigan Survivorship Cancer Care Consortium

This document, developed by the Michigan Cancer Consortium, presents the survivorship care plan tools currently available for use, links to the various templates, and explains the pros and cons of each.

Online Resources for Creating Survivorship Care Plans

Below, please find templates available to healthcare providers to complete on behalf of their patients. These templates are also detailed in the Survivorship Toolkit by the California Dialogue on Cancer and Triage Cancer. The trend for many cancer care organizations is to create personalized treatment summaries & survivorship care plans through their EMR system.

LIVESTRONG Care Plan powered by Penn Medicine’s OncoLink These care plans can be created and shared by any healthcare professional that has a treatment summary in hand. There is also a section for cancer patients and survivors to develop their own care plan by filling in the information about their treatment. The plan can be saved on electronic devices, printed, and later reviewed with the oncology team and other healthcare providers.  oncolinklife-logo@2x
Journey Forward The Cancer Care Plan Builder is a free online tool that oncology professionals can use to create treatment plans, treatment summaries, and survivorship care plans for patients. It also has the ability to import data from some cancer registries.  Journey Forward
ASCO’s Cancer Treatment Summaries & Survivorship Care Plans The American Society of Clinical Oncology (ASCO) developed a template to provide a way for survivors to record and store information about their cancer, cancer treatment, follow-up care, and gives basic information about a survivor’s care to future healthcare providers.  ASCO Answers Cancer Survivorship.pdf
Registry Plus™ Web Plus Survivorship Module

 

The CDC is working with the Colorado Cancer Registry to integrate a secure, web-based application into Web Plus, “which allows providers to use previously collected cancer surveillance data from the state’s central cancer registry to pre-populate and semi-automate survivorship care plans.” This application is scheduled to be available to central cancer registries interested in using it in the future.  Roadmap To Your Future care-plan
Society of Gynecological Oncology (SGO) Survivorship Toolkit This toolkit includes templates for individualized care plans available to survivors of cervical, endometrial, ovarian and vulvar cancers. General follow-up recommendations and post-treatment self-care plans for all cancer survivors are also available.  SGO Survivorship Toolkit

How Patients & Survivors Can Advocate for Their Own Survivorship Care Plan

Some patients and survivors may be unable to obtain a formalized survivorship care plan from their oncology provider. This link provides templates enabling them to begin creating a Survivorship Care Plan for themselves. These templates allow patients to fill in the details known about their cancer journey, and then schedule a meeting with their oncology team to complete the document. The goal is to then share this document with other members of their healthcare team.

Treatment Care Plans – A More Comprehensive Approach

Within some oncology practices, it is becoming more common to begin the survivorship care planning process at diagnosis, when the oncology team creates an organized treatment plan document. This is a summary of the cancer care that is scheduled for your patient. The treatment care plan is designed to be shared with the patient’s healthcare team to create a better understanding of the therapy prescribed and the providers who are involved in the treatment. This document then transitions into a complete post-treatment survivorship care plan.

MSKCC – Caring for Survivors

Memorial Sloan Kettering Cancer Center has an extensive list of topics focused on healthcare providers who are caring for cancer survivors. These topics are designed to share information about clinical practice guidelines and strategies for approaching the long-term care of cancer survivors.

Journey Forward’s Survivorship Library for Healthcare Providers

Journey Forward has a collection of topics, including information on late and long-term effects and other survivorship care links to credible resources for patients, families, and healthcare providers.

CDC – Resources for Health Professionals and Researchers

The Centers for Disease Control and Prevention has created this extensive list of links to help health professionals care for cancer patients and survivors.

Understanding the Needs of Cancer Survivors – From Cancer Patient to Cancer Survivor – Lost in Transition

 

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