The Multinational Association for Supportive Care in Cancer and the American Society of Clinical Oncology (MASCC-ASCO) have recently published new guidelines entitled “Survivorship Care for Individuals Affected by Advanced or Metastatic Cancer,” on April 29, 2024. These guidelines provide comprehensive and evidence-based recommendations intended to improve the quality of life and optimize the outcomes for individuals affected by these conditions.

Individuals with advanced or metastatic cancer, as well as their caregivers, often have distinct care goals and encounter unique challenges in comparison to those with early-stage disease or those in the final stages of their disease course. The purpose behind these practice recommendations is to ensure the consistent delivery of high-quality survivorship care for individuals impacted by advanced or metastatic cancer.

In this discussion, we will explore the key takeaways from the guidelines and provide insights into potential future updates. Please note that this list does not encompass all major points. For a complete list of recommendations, refer to the full text guideline above or the pocket guide provided here. Now, let’s get to it!

Key Takeaways

The Guidelines provide seven standards, (1) Person-Centered Care; (2) Coordinated and Integrated Care; (3) Evidence-Based and Comprehensive Care; (4) Evaluated and Communicated Care; (5) Accessible and Equitable Care; (6) Sustainable and Resourced Care; and (7) Research and Data-Driven Care.  We will review a two of them below:

Person-Centered Care

  • The recommendations emphasize the importance of customizing survivorship care plans to meet the unique needs, preferences, and goals of each patient and their family. Personalized care plans take into account factors such as treatment history, symptoms, psychosocial support needs, and comorbidities.
  • These practice recommendations also punctuate the  fluidity of preferences for individuals who may be experiencing disease progression, changes in treatment regimen, and declines in overall health status and self-management capabilities. Therefore, survivorship care should include person-reported & patient-centered outcome and experience measures that are regularly utilized to promote active engagement of cancer survivors and caregivers in shared decision-making and self-management strategies.

Accessible and Equitable Care

  • Developing health equity metrics for ongoing evaluation is crucial to ensure that care options are innovative, inclusive, and targeted at eliminating disparities. This includes providing consistent, quality, and evidence based patient care regardless of personal, cultural, or religious factors. For instance,  it is important to recognize that individuals with advanced or metastatic cancer may have heightened spiritual needs, and addressing these needs is vital to prevent spiritual pain and distress.
  • Additionally, the design and selection of care modalities should prioritize accessibility and safety. Utilizing telehealth, virtual clinics, and hybrid modes have been shown to be effective in improving cancer survivor outcomes and potentially reducing costs, particularly for those in rural and remote areas. These approaches can enhance the quality of care and ensure that survivors and caregivers have access to the necessary support.

Considerations for Future Guidelines

  • Managing the financial strain of cancer treatment and navigating insurance and employment issues can be daunting tasks for many cancer survivors. Providing resources and recommendations for financial counseling, employment assistance, and access to supportive services can greatly benefit survivors and their families.
  • While survivorship care focuses on life after cancer treatment, it is crucial to also address and facilitate discussions surrounding advanced care planning and end-of-life care needs for individuals with advanced or metastatic cancer. Offering guidance on integrating palliative care, creating advance directives, and having conversations about goals of care can enhance the overall quality and comprehensiveness of the recommendations.
  • Numerous individuals diagnosed with advanced or metastatic cancer often turn to complementary medicine or therapy in order to alleviate symptoms and enhance their quality of life. By incorporating guidance on the utilization of these therapies in conjunction with traditional treatments, a more comprehensive approach to survivorship care may be able to be achieved.

Thank you for joining us for our Guidelines Spotlight on “Survivorship Care for People Affected by Advanced or Metastatic Cancer.” Please feel free to share your thoughts on this article or topics you’d like seen in future spotlights. 

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