成人癌症幸存者的初级护理
Primary Care of Adult Cancer Survivors
DOI 原文链接
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影响因子:3.5
分区:医学3区 / 医学：内科3区 初级卫生保健3区
发表日期:2024 Jul
作者:
Stephen Carek, John F Emerson, Jatin Patel
摘要
到2040年，预计美国将有2600万癌症幸存者。幸存者护理的核心内容包括：(1) 癌症复发的监测，(2) 新原发性癌症的监测，(3) 长期治疗的身体和心理影响管理，(4) 预防或缓解晚期治疗效果，以及(5)肿瘤科团队与初级保健医师之间的护理协调。检测复发的筛查方案因癌症类型和诊断阶段而异。新原发癌的筛查与普通人群相同。尽管许多癌症幸存者未按建议进行监测或筛查，家庭医生可以鼓励并促进其遵从。家庭医生还应监控和管理癌症诊断及治疗带来的身体和心理影响，例如抑郁、淋巴水肿、疼痛和性功能障碍。心血管疾病是癌症幸存者的主要死亡原因之一，常为癌症治疗的长期影响。临床医生应指导患者戒烟戒酒，参与推荐的体育锻炼水平，并遵循最佳营养建议。最后，家庭医生应与肿瘤护理团队合作，协调护理计划，确保所有建议的组成部分得到落实。应向癌症幸存者提供书面幸存者护理计划，帮助他们从积极治疗过渡到后续监测。
Abstract
By 2040, there will be an estimated 26 million cancer survivors in the United States. The essential components of survivorship care are (1) surveillance for cancer recurrence, (2) surveillance for new primary cancers, (3) management of physical and psychological long-term effects of treatment, (4) prevention or mitigation of late treatment effects, and (5) coordination of care between the oncology team and primary care clinicians. Recommendations for surveillance to detect recurrence vary with cancer type and stage at diagnosis. Screening for new primary cancers is the same as for the general population. Although many cancer survivors do not undergo recommended surveillance or screening, family physicians can encourage and facilitate adherence. Family physicians should also monitor and manage the physical and psychological effects of cancer diagnosis and treatment, such as depression, lymphedema, pain, and sexual dysfunction. Cardiovascular disease is a leading cause of death for cancer survivors, often as a long-term effect of cancer treatments. Clinicians should counsel patients on cessation of tobacco and alcohol use, participation in recommended levels of physical activity, and adherence to optimal nutrition recommendations. Finally, family physicians should work with the cancer care team to coordinate the care plan and assure that all recommended components are achieved. Written survivorship care plans should be provided to cancer survivors to help them transition from active treatment to posttreatment monitoring. .