J Korean Med Assoc.  2015 Mar;58(3):216-226. 10.5124/jkma.2015.58.3.216.

Management of cancer survivors in Korea

• Shin DW
• Sunwoo S
• Lee J

• KMID: 2194942
• DOI: http://doi.org/10.5124/jkma.2015.58.3.216

Abstract

With the early detection of cancer and advances in cancer treatment, the number of cancer survivors is increasing dramatically and is currently over 1 million. Many cancer survivors face lifetime risks associated with their cancer therapy, with a significant proportion at risk for serious morbidity and premature mortality. The long-term physical and psychosocial effects of cancer treatment on cancer survivors and their families are increasingly being recognized as emerging problems from both clinical and public health perspectives. This article summarizes the core principles of management of cancer survivors: follow-up of primary cancer; screening and prevention of a second primary cancer; management of late effects of cancer treatment and comorbid conditions; promotion of healthy behaviors such as smoking cessation, exercise and physical activity, nutrition, and weight management; management of psychosocial problems; and support for family caregivers. Finally, we discuss the way forward for improving survivorship care: shared care between oncologists and primary care physicians; a comprehensive cancer support program; and further research to generate relevant evidence regarding these management principles.

Keyword

Neoplasms; Survivors; Second primary neoplasm; Korea

MeSH Terms

Caregivers
Early Detection of Cancer
Follow-Up Studies
Humans
Korea
Mass Screening
Mortality, Premature
Motor Activity
Neoplasms, Second Primary
Physicians, Primary Care
Public Health
Smoking Cessation
Survival Rate
Survivors*

Figure

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  Figure 1 Prevalence of major cancer sites by time since diagnosis on January 1, 2012 in Korea (From Jung KW, et al. Cancer Res Treat 2014;46:109-123, with permission from Korean Cancer Association) [1].

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  Figure 2 Cancer Care trajectory and the target of survivorship care (From Hewitt M, et al. From cancer patients to cancer survivor: lost in transition. Washington, DC: National Academic Press; 2006, with permission from National Academy Press) [3].

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  Figure 3 Proposed model for shared care of cancer survivors. (A) Current practice and (B) community-based shared practice. CA, cancer; DX, diagnosis; Off RX, completion of cancer therapy; PCP, primary care physician; Onc, oncologist (From Oeffinger KC, et al. J Clin Oncol 2006;24:5117-5124, with permission from American Society of Clinical Oncology) [35].

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  Figure 4 Lifetime risk-based cancer survivorship healthcare delivery system. NCC, national cancer center; RCC, regional cancer center; F/U, follow-up; ISCC, integrated supportive care center; PCP, primary care physician (From Shin DW, et al. J Korean Med Sci 2013;28:651-657, with permission from Korean Academy of Medical Science) [10].

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