Cancer Survivors Push for Better Long-Term Care Plans

Nine years after beating advanced breast cancer, Kara Kenan noticed something her doctor missed. An unusual blood test result could have been an early warning sign that her cancer had returned.

Kenan, who works for advocacy group Cancer Nation, contacted her oncologist directly and got a CT scan. It revealed lesions on her liver that her primary care doctor had overlooked.

Her story highlights a growing challenge facing America's 18.6 million cancer survivors. That's more than 5 percent of the population, and the number keeps climbing as treatments improve and more patients survive.

The problem is simple but serious. After patients finish treatment and ring the bell to celebrate, they're often left without a clear plan for managing the long-term effects of cancer and its treatments.

"We support patients really well during treatment and provide lots of resources," says Michelle Mollica, director of survivorship care delivery at Hollings Cancer Center in South Carolina. "And then we sort of graduate them, they ring a bell and we expect them to go on after their cancer treatment is over like their life is back to normal, but it's not."

Cancer treatment can leave lasting impacts throughout the body. Chemotherapy and radiation damage immune, digestive, and nervous systems, leading to problems that can appear decades later.

Cancer survivors face a 42 percent higher risk of developing heart disease compared to people who never had cancer. They also experience higher rates of pain, insomnia, and mental health challenges.

About 20 percent of new cancer diagnoses each year are actually second or third cancers in people who already survived once. Early detection of these recurrences requires doctors who understand each patient's specific treatment history.

The Bright Side

Advocates haven't given up on solving this problem. The idea of survivorship care plans was proposed 20 years ago, and momentum is building.

The challenge now is training. Many oncologists aren't equipped to manage long-term health issues like diabetes and heart disease. Primary care doctors often feel uncomfortable monitoring cancer-related complications.

"When I go to my family doctor, they say, 'Oh, I don't know anything about that. Go back to your oncologist,'" explains Patricia Ganz, who researches cancer survivorship at UCLA.

The solution involves better coordination between specialists and primary care doctors. When cancer is successfully treated, patients need a clear handoff to clinicians trained in both cancer aftercare and general health management.

Only about a third of people five or more years past treatment currently receive survivorship care. Of those who aren't getting follow-up, 58 percent were told by their doctor it wasn't needed anymore.

By 2035, more than 22 million Americans will be cancer survivors. That makes developing effective long-term care plans not just important but essential for millions of people rebuilding their lives after cancer.