AOCNP Survivorship and Long-Term Follow-Up

Question 1

According to the ONCC AOCNP framework, survivorship care planning begins at which point in the cancer continuum?

Accepted Answer

At the time of diagnosis and continues throughout treatment and beyond

Answer

The Institute of Medicine (2006, 'From Cancer Patient to Cancer Survivor') established that survivorship care begins at diagnosis. The survivorship care plan (SCP) should be developed throughout treatment and provided at treatment completion to guide ongoing surveillance and late effect management.

Question 2

Chemotherapy-induced peripheral neuropathy (CIPN) most commonly occurs with which drug class?

Accepted Answer

Platinum compounds (oxaliplatin, cisplatin) and taxanes (paclitaxel)

Answer

CIPN predominantly affects the peripheral sensory (and less commonly motor) nerves and most commonly results from platinums (particularly oxaliplatin causing acute cold dysesthesia and chronic sensory loss) and taxanes (paclitaxel causing dose-dependent sensory neuropathy). Vinca alkaloids primarily cause motor neuropathy.

Question 3

Aromatase inhibitor (AI)-induced arthralgias affect a significant percentage of breast cancer survivors. Which intervention has the strongest evidence for relieving AI-associated musculoskeletal symptoms?

Accepted Answer

Aerobic and resistance exercise programs

Answer

Exercise interventions, both aerobic and resistance training, have the strongest evidence base for reducing AI-associated arthralgia severity and improving functional status in breast cancer survivors. Physical therapy and acupuncture also have supporting evidence. Vitamin D optimization is also recommended.

Question 4

Post-treatment surveillance guidelines for breast cancer survivors typically include clinical examination every 3–6 months for the first 3 years, then annually, combined with:

Accepted Answer

Annual mammography of remaining breast tissue

Answer

ASCO and NCCN surveillance guidelines for breast cancer survivors recommend annual mammography as the primary imaging tool, along with clinical history and physical examination. Routine tumor markers (CA 15-3, CA 27-29) and CT/bone scans are NOT recommended for asymptomatic survivors due to lack of survival benefit and harms of overdiagnosis.

Question 5

Cancer-related cognitive impairment (CRCI or 'chemo brain') is characterized by which cluster of symptoms?

Accepted Answer

Subtle deficits in memory, attention, processing speed, and executive function

Answer

CRCI (chemotherapy-related cognitive changes/chemo brain) presents as subjective and objective deficits primarily in attention, working memory, processing speed, and executive function. It is distinct from dementia and may be subtle but significantly impacts quality of life and occupational function. Assessment tools include FACT-Cog.

AOCNP - Advanced Oncology Certified Nurse Practitioner Practice Test

AOCNP - Advanced Oncology Certified Nurse Practitioner Practice Test

AOCNP Survivorship and Long-Term Follow-Up