Prognosis for Cancer

Follow-up after primary treatment

Cancer does not disappear completely in some people. They may receive treatment on a regular basis with chemotherapy, radiotherapy, or other treatments to maintain the cancer under control and receive a specific follow-up adjusted to the progression of the disease.

If the treatment has eliminated the tumour or overcome the cancer, patients may still have concerns about the possibility of acquiring another cancer. Such events are known as “new chronic conditions”, in other words, situations that until recently were only contemplated from the perspective of an acute disease (diagnosis and treatment) but which are now considered in the long-term. This applies to other conditions besides cancer. This concept of “new chronic conditions” can also apply to seronegative HIV patients or patients with Down syndrome who reach old age.

In the case of cancer, the main aim of follow-up after the primary treatment is:

• To detect local or distant recurrences.
• To detect and treat treatment complications. An adverse effect is considered to be an unintentional lesion or damage that is caused by any of the treatments and not by the actual disease.
• Prevention and early treatment of psychological changes secondary to the cancer or its treatment. Psychosocial changes require prevention, detection and early treatment with systems that provide psychosocial support and promote occupational reintegration.

Long-term survivors after cancer remission

Long-term survivors are individuals who survive for a prolonged period after cancer remission. Fortunately, the cancer survivor population is constantly growing. Cancer survivors are recognised as being in a phase of cancer care. Quality care for survivors includes monitoring for recurrence and second tumours, intervention in the control of symptoms and psychosocial needs, and care coordination.

The survival stage after primary treatment can imply a period of education and an opportunity for the patient to recover their health and healthy lifestyle habits with respect to non-cancer health problems. This is a very important point, and in Spain they are already developing post-cancer treatment intervention projects to address issues such as nutrition, physical exercise and weight control.

Care programmes for survivors include:

• Rehabilitation.
• Early detection of recurrence.
• Early intervention in complications associated with cancer and its treatment.
• Health promotion. Reduction of the risk of developing comorbidities or second tumours.
• Assessment and intervention in the socioeconomic consequences of cancer and its treatment.
• Standardisation of access to work.
• Coordination with primary healthcare. Sharing of information, referral circuits and protocols.