Introduction: Long-term survivors of gynecological cancers may be cured but still have ongoing health concerns and long-term side effects following cancer treatment. The aim of this brainstorming meeting was to develop recommendations for long-term follow-up for survivors from gynecologic cancer.
Methods: International experts, representing each member group within the Gynecologic Cancer InterGroup (GCIG), met to define long-term survival, propose guidelines for long term follow-up and propose ways to implement long term survivorship follow-up in clinical trials involving gynecological cancers.
Results: Long-term survival with/from gynecological cancers was defined as survival of at least five years from diagnosis, irrespective of disease recurrences. Review of the literature showed that more than 50% of cancer survivors with gynecological cancer still experienced health concerns/long-term side effects. Main side effects included neurologic symptoms, sleep disturbance, fatigue, sexual dysfunction, bowel and urinary problems and lymphedema. In this article, long-term side effects are discussed in detail and treatment options are proposed. Screening for second primary cancers and lifestyle counselling (nutrition, physical activity, mental health) may improve quality of life and overall health status, as well as prevent cardiovascular events. Clinical trials should address cancer survivorship and report patient reported outcome measures (PROMs) for cancer survivors.
Conclusion: Long-term survivors after gynecological cancer have unique longer term challenges that need to be addressed systematically by care givers. Follow-up after completing treatment for primary gynecological cancer should be offered lifelong. Survivorship care plans may help to summarize cancer history, long-term side effects and to give information on health promotion and prevention.
Bibliographical noteFunding Information:
This manuscript and recommendations were reviewed by the ANZGOG consumer research panel, Andrea Krull (Ovarian Cancer Germany), the French patient advocacy group Imagyn and GINECO patient advocates. There was no funding received for this manuscript. AD received support to attend the meeting by the Canberra Hospital Private Practice Fund, was part of an ovarian cancer advisory board for Astra Zeneca and is the RAC chair of ANZGOG. YCL has received honoraria for educational events from the Limbic and for participation on Advisory Board from GSK.PAC has received honoraria for educational events from Seqirus and Astra Zeneca. AF received payment for an educational event by Clovis, was part of an advisory board for MSD and GSK and was an (unpaid) council member of ESGO from 2016-2019. AJ received consulting fees from Genentech. YK is now an employee of MSD K.K. JSM received travel support from the GOG Foundation and consulting fees from Merck, Astra Zeneca, Varian Medical Systems, Primmune and is cervix-co-chair of NRG Oncology. MPMG received honoraria for lectures and travel support from Clovis Oncology, Astra Zeneca, MSD, GSK, Roche. She was part of an advisory board for Clovis Oncology, Astra Zeneca, MSD, GSK, Roche and Pharmamar. Receipt of medical writing from Astra Zeneca and GSK. SS has received honoraria for educational events from AZ and GSK and for participation on Advisory Board from AZ. HW, EVD, NG, SN and FJ declare that there is no conflict of interest.
Copyright © 2022 Elsevier Ltd. All rights reserved.
- Care plans
- Gynecological cancer
- Cancer Survivors
- Quality of Life
- Genital Neoplasms, Female/therapy
- Neoplasm Recurrence, Local/diagnosis
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging