Advances in improved diagnostic methods and treatment of hematologic malignancies have led to an increased number of cancer survivors. Although most therapeutic modalities for cancer are beneficial and life-saving, long-term or late adverse sequelae are increasingly prevalent, serious, and persistent in survivors of pediatric and adult cancers.1 A thorough review of a patient’s medical history, treatments, and co-morbid conditions is necessary for the primary care physician to recognize late effects of therapy and pursue appropriate interventions.2 Limited studies effectively associate treatment exposures with future consequences; however, through the grading of late effects, appropriate surveillance and treatment interventions may be implemented.3 Blood cancer survivors should be evaluated for cancer recurrence during follow-up visits with primary care providers (PCPs). Effective monitoring begins with PCP awareness of disease-specific signs and symptoms and includes thorough patient history and examination, along with appropriate use of laboratory tests and diagnostic procedures.
Aziz NM. Acta Oncol. 2007;46:417-432.
Ganz PA. Prim Care Clin Office Pract. 2009;36:721-741.
Aziz NM. "Late Effects of Cancer Treatments." In: Cancer Survivorship. New York: Springer New York; 2007:54-76.
- Describe the role of primary care practitioners in caring for cancer survivors
- Describe the long-term and late effects associated with treatments for blood cancers
- Identify clinical trials evidence for late effects of treatments and survivorship in blood cancers
- Identify signs or symptoms that suggest the need for increased observation, testing and/or referral for possible recurrence or other morbidity in blood cancer survivors
- List the screening tests and optimal schedule for monitoring of blood cancer survivors for routine cancer prevention and detection of long- and late-term effects of treatment
Robert J. Arceci, MD, PhD
King Fahd Professor of Pediatric Oncology
Professor of Pediatrics and Oncology
The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Hospital
Baltimore, MD
Judith E. Karp, MD
Professor of Oncology and Medicine
Director, Leukemia Program
The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Hospital
Baltimore, MD
CREDIT DESIGNATION
Postgraduate Institute for Medicine designates this educational activity for a maximum of 1.75 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
- Dr. Robert J. Arceci has no affiliations with commercial interests to disclose.
- Dr. Judith E. Karp has no affiliations with commercial interests to disclose.
The planners and managers reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:
Robert Michael Educational Institute LLC
- Sherri Kramer, MD, has no affiliations with commercial interests to disclose.
- Laura Altobelli, MS, has no affiliations with commercial interests to disclose.
Postgraduate Institute for Medicine
- Jan Hixon, RN, BSN, MA, has no affiliations with commercial interests to disclose.
- Trace Hutchison, PharmD, has no affiliations with commercial interests to disclose.
- Julia Kimball, RN, BSN, has no affiliations with commercial interests to disclose.
- Samantha Mattiocci, PharmD, has no affiliations with commercial interests to disclose.
- Jan Schultz, RN, MSN, CCMEP, has no affiliations with commercial interests to disclose.
- Patricia Staples, MSN, NP-C, CCRN, has no affiliations with commercial interests to disclose.
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Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient's conditions and possible contraindications on dangers in use, review of any applicable manufacturer's product information, and comparison with recommendations of other authorities.
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