Addressing the needs of colorectal cancer survivors: current strategies and future directions

Abstract

Colorectal cancer (CRC) is one of the three topmost common cancers in men and the second most common cancer in women worldwide. With current advances in the medical and surgical treatment of CRC, care has slowly transformed to curative treatment. With these advances, CRC survivors are increasing in numbers and these patients have a unique range of medical, physical and psychological needs that require regular follow-up. In 2006, the Institute of Medicine recommended that cancer survivors who are completing primary treatment receive a survivorship care plan. There are many different programs of different complexity that are implemented for CRC survivors. This review outlines the needs of CRC survivors, the current surveillance techniques used in the continuing care of patients with CRC after curative treatment and the evidence behind these strategies.

Keywords:

• cancer survivorship
• colorectal cancer
• exercise
• follow-up care
• oncology
• quality of life

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Key issues

• Survivorship care plans (SCPs) are meant to facilitate holistic care. Implementing a structured program for detection and surveillance will assist physicians and surgeons in detecting relapsed disease, other noncancer disease progression and assisting the treatment and management of chronic and late complications of the initial primary treatment.

• Compliance with post-treatment surveillance for patients with colorectal cancer is key for early detection of metastasis.

• Survivorship care provides an opportunity to encourage a healthy lifestyle. Exercise and activity have been associated with a reduced risk of cancer recurrence and mortality.

• SCPs involve a collaborative multidisciplinary effort between multiple healthcare providers to empower patient involvement in health decision-making, translating to greater satisfaction with treatment choices; improved coping mechanisms during the diagnosis, treatment and post-treatment phase; reductions in anxiety and mood disturbances; and improved communication with family members.

• The concept of personalized medicine with chronic use of selected drugs (e.g., aspirin) informed by the molecular pathology of the tumor could also have a role in survivorship care.