成人癌症幸存者的初级保健
Primary Care of Adult Cancer Survivors
影响因子:3.50000
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，美国估计将有2600万癌症幸存者。生存护理的基本组成部分是（1）癌症复发的监视，（2）对新的原发性癌症的监视，（3）治疗的身体和心理长期影响，（4）预防或缓解晚期治疗效应，以及（5）肿瘤学团队和主医生之间的护理协调。监视的建议检测复发因诊断时的癌症类型和阶段而异。对新的原发性癌症进行筛查与普通人群相同。尽管许多癌症幸存者没有接受建议的监视或筛查，但家庭医生可以鼓励和促进依从性。家庭医生还应监测和管理癌症诊断和治疗的身体和心理影响，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，通常是癌症治疗的长期作用。临床医生应咨询患者停止烟草和饮酒，参与建议的体育锻炼水平，并遵守最佳营养建议。最后，家庭医生应与癌症护理团队合作协调护理计划，并确保所有推荐的组件都可以达到。应向癌症幸存者提供书面生存护理计划，以帮助他们从主动治疗过渡到治疗后监测。 。
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. .