Survivorship and Long-Term Follow-Up Flashcards

Cardiotoxicity monitoring in cancer survivors who received anthracyclines includes which primary surveillance modality?

Answer: Echocardiogram or MUGA scan to assess left ventricular ejection fraction (LVEF)

Anthracyclines (doxorubicin, epirubicin) cause dose-dependent cardiomyopathy through oxidative damage to cardiomyocytes. Survivors require baseline and periodic echocardiogram (or MUGA) assessment of LVEF, especially those who received cumulative doxorubicin doses >300 mg/m² or combined with chest radiation or trastuzumab.

A colorectal cancer survivor who completed curative resection should receive which surveillance study at 1 year post-surgery?

Answer: Colonoscopy at 1 year post-resection (if not done preoperatively), then per findings

ASCO/NCCN guidelines for colorectal cancer surveillance recommend colonoscopy at 1 year after surgery (or within 3–6 months if preoperative colonoscopy was incomplete). If normal, repeat at 3 years, then every 5 years, along with CEA monitoring every 3–6 months for 5 years and CT chest/abdomen/pelvis annually for 3–5 years.

Post-treatment sexual dysfunction in female cancer survivors most commonly manifests as which symptoms?

Answer: Dyspareunia, vaginal dryness, and decreased libido

Genitourinary syndrome of menopause (GSM) related to cancer treatment (ovarian failure, aromatase inhibitors, pelvic radiation) causes vaginal atrophy, dryness, dyspareunia, and decreased libido. Non-hormonal treatments (lubricants, moisturizers, vaginal dilators, ospemifene) and low-dose vaginal estrogen (where appropriate) are first-line management.

Which psychosocial phenomenon describes the positive psychological growth and transformation that some cancer survivors experience after their diagnosis and treatment?

Answer: Post-traumatic growth (PTG)

Post-traumatic growth (PTG) refers to positive psychological change (greater appreciation for life, deeper relationships, increased personal strength, spiritual development, new possibilities) that can emerge through the struggle with highly challenging life circumstances such as cancer diagnosis and treatment.

Long-term pulmonary toxicity in cancer survivors is most strongly associated with which treatment exposure?

Answer: Bleomycin, carmustine (BCNU), and/or thoracic radiation

Bleomycin (used in Hodgkin lymphoma regimens like ABVD) and carmustine (BCNU) are the chemotherapy agents most strongly associated with chronic pulmonary fibrosis. Combined with thoracic radiation, the risk is substantially amplified. Survivors require periodic pulmonary function testing and should avoid high-concentration oxygen when possible.

The survivorship care plan should include which minimum components per ASCO/IOM recommendations?

Answer: Treatment summary, surveillance schedule, late effect information, and referrals for ongoing care needs

Per ASCO and IOM standards, the survivorship care plan must include: (1) treatment summary (diagnosis, staging, treatments received with dates/doses), (2) surveillance/monitoring schedule for recurrence, (3) potential late and long-term effects with management guidance, and (4) referrals and resources (primary care, mental health, rehabilitation, community support).