The document discusses challenges in survivorship care and improving support for cancer patients after initial treatment. It notes the growing population of cancer survivors and issues around long-term health, quality of life, and unmet needs. Additionally, it examines evidence for interventions like physical activity programs, smoking cessation, and cognitive behavioral therapy in managing late and long-term effects of cancer treatment.

1. Survivorship Professor Sara Faithfull Faculty of Healthy and Medical Sciences

4. Political agenda

6. Patient power: survivorship

10. Follow up after cancer GP or nurse at GP’s surgery

11. The proportion of respondents having a specialist check-up (62) (48) * * *

12. If faced with health concerns relating to cancer what do you do? The specialist nurse they have contact details for, not one they see for check-ups

15. Physical training programme (54 RCTs) Van Weert E (2008) The development of an evidence-base physical self management rehabilitation programme for cancer survivors Patient Education and Counselling 71 169-190 Intervention components Outcome measures Evidence for improvement Aerobic exercise : cycling, walking heart rate of 50-80% maximal 10-30 min 3 x weekly Aerobic exercise capacity Effect size of 0.51 during and 0.65 after cancer txt Resistance training Muscle strength Some benefit not significant Aerobic exercise Fatigue Effect size of 0.11 Physical exercise, stretching Quality of life Effect size of 0.30

17. Summary of benefits for patients  Possible benefit  Probable benefit  Convincing benefit CBT Exercise Smoking Cessation Depression   Fatigue   Adverse Body Composition  Functional QOL  Physical QOL   Progression  

18. Cancer Survivors’ interest in health related programs Denmark-Wahnefried et al. (2000) Cancer 88: 674-684, Greenhalgh T (2009) BMJ , 338-349

20. Parting words