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National Comprehensive Cancer Network

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NCCN Presents New Guidelines for Survivorship

The new NCCN Guidelines® for Survivorship were presented at the NCCN 18th Annual Conference: Advancing the Standard of Cancer Care™ on March 14, 2013.

FORT WASHINGTON, PA — The National Comprehensive Cancer Network® (NCCN®) has issued its first ever NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Survivorship. The new NCCN Guidelines were presented at the NCCN 18th Annual Conference: Advancing the Standard of Cancer Care™ by NCCN Guidelines® Panel Chair, Crystal S. Denlinger, MD, Attending Physician and Assistant Professor of Medical Oncology, Fox Chase Cancer Center; as well as NCCN Guidelines Panel Member, Jennifer A. Ligibel, MD, Attending Physician, Adult Oncology, Dana-Farber/Brigham and Women’s Cancer Center, and Assistant Professor, Department of Medicine, Harvard Medical School.

According to the National Cancer Institute (NCI), there are more than 12 million American cancer survivors. Recognizing and managing the health care needs of these survivors has become a significant responsibility of oncologists and primary care providers.

“An individual is considered a cancer survivor from the time of diagnosis, through the balance of his or her life,” said Dr. Ligibel. “The NCCN Guidelines for Survivorship focus on the vast and persistent impact both the diagnosis and treatment of cancer have on the adult survivor particularly after they have completed their initial cancer treatment.”

The NCCN Guidelines for Survivorship cover eight distinct areas: anxiety and depression, cognitive function, exercise, fatigue, immunizations and infections, pain, sexual function, and sleep disorders. Key to proper survivorship care, noted Dr. Denlinger, is accurate assessment of survivor’s needs and concerns on a routine basis. The NCCN Guidelines include a sample assessment tool with two to three questions on each of the eight key criteria covered in the guidelines.

For accurate assessment of cognitive function, the NCCN Guidelines for Survivorship recommend obtaining a complete, focused history and consideration of contributing factors, such as medication side effects, hormonal interaction, and distress. These evaluations can lead to important interventions for survivor and/or family education, including, but not limited to, supportive self-management, enhanced organizational strategies, and regular exercise—up to 20 minutes per session of light exercise, one to three days per week.

“Sexual health is an important part of an individual’s overall physical and emotional well-being,” said Dr. Denlinger. The NCCN Guidelines for Survivorship provide physicians with symptom checklists and inventories to assess sexual function in both male and female cancer survivors, and recommend that physicians initiate proactive discussions about sexual function at regular intervals, including topics such as sexual desire, pain, and ability to maintain erection.

Dr. Ligibel spoke about the NCCN Guidelines for Survivorship recommendations for exercise, stating, “Exercise plays a distinct role in post-cancer health. Physical activity should be discussed at every physician visit and survivors should be encouraged to avoid inactivity. Survivors’ exercise recommendations should be tailored to individual ability and preference.”

The NCCN Guidelines for Survivorship recommend that physicians determine survivors’ ability to exercise by attaining a focused history, and assessing factors that impede physical activity, including, but not limited to, physical limitations, social support, environmental factors, pain, fatigue, emotional distress, and comorbidities. The general recommendations for exercise include an overall weekly volume of 75-150 minutes of exercise, depending on intensity, as well as two to three weekly sessions of strength training that include major muscle groups.

The NCCN Guidelines are developed and updated through an evidence-based process in which the expert panels integrate comprehensive clinical and scientific data with the judgment of the multidisciplinary panel members and other experts drawn from NCCN Member Institutions. Access to the complete library of NCCN Guidelines is available free-of-charge to clinicians at NCCN.org.

The full conference agenda is available at NCCN.org. Press inquiries and requests for interview should be addressed to Katie Kiley Brown at brown@nccn.org.

About the National Comprehensive Cancer Network

The National Comprehensive Cancer Network® (NCCN®) is a not-for-profit alliance of 28 leading cancer centers devoted to patient care, research, and education. NCCN is dedicated to improving and facilitating quality, effective, efficient, and accessible cancer care so patients can live better lives. Through the leadership and expertise of clinical professionals at NCCN Member Institutions, NCCN develops resources that present valuable information to the numerous stakeholders in the health care delivery system. By defining and advancing high-quality cancer care, NCCN promotes the importance of continuous quality improvement and recognizes the significance of creating clinical practice guidelines appropriate for use by patients, clinicians, and other health care decision-makers around the world.

The NCCN Member Institutions are:

  • Abramson Cancer Center at the University of Pennsylvania
  • Fred & Pamela Buffett Cancer Center
  • Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute
  • City of Hope National Medical Center
  • Dana-Farber/Brigham and Women's Cancer Center | Massachusetts General Hospital Cancer Center
  • Duke Cancer Institute
  • Fox Chase Cancer Center
  • Huntsman Cancer Institute at the University of Utah
  • Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance
  • The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
  • Robert H. Lurie Comprehensive Cancer Center of Northwestern University
  • Mayo Clinic Cancer Center
  • Memorial Sloan Kettering Cancer Center
  • Moffitt Cancer Center
  • The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute
  • O'Neal Comprehensive Cancer Center at UAB
  • Roswell Park Comprehensive Cancer Center
  • Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine
  • St. Jude Children's Research Hospital/The University of Tennessee Health Science Center
  • Stanford Cancer Institute
  • UC San Diego Moores Cancer Center
  • UCSF Helen Diller Family Comprehensive Cancer Center
  • University of Colorado Cancer Center
  • University of Michigan Rogel Cancer Center
  • The University of Texas MD Anderson Cancer Center
  • University of Wisconsin Carbone Cancer Center
  • Vanderbilt-Ingram Cancer Center
  • Yale Cancer Center/Smilow Cancer Hospital