Is It Better to Transfer Long-Term Cancer Survivors to General Practitioners or Develop Clinics for Long-Term Survivors Within the Cancer Centers?

Abstract

TO THE EDITOR: The interesting work by Virgo et al highlights the importance and at the same time the problematic of long-term follow-up for cancer survivors. The limited experience and low interest of the general practitioner on the management of cancer patients in long-term care are major barriers to the transferability of long-term patients with cancer to their general physician, although is clear that the increasing number of cancer survivors are a limitation for the care from medical oncologist. As admitted by Virgo et al, one limitation of the study is that this was based mainly on breast and colon cancer survivors while the difference in patients with lymphoma could have been more evident. In our view, the problem not yet studied of the transfer of the patients from medical oncologist/hematologist to general practitioner is the willingness of patients with cancer to do that. In fact, the patients with cancer are usually reluctant to abandon the primary medical oncologist and to be transferred to their general practitioners. It should be important to have the point of view of organizations for patients with cancer on this matter. In our view, it would be much better, although more costly, to develop a cancer survivors clinic within the department of oncology of the major cancer hospitals with medical oncologist and psychologist working together, and transfer these patients to these new structures to give the best supportive care either medical and psychological to patients with cancer, also in association with other specialists, in particular cardiologists. In fact, it should not be forgotten that cardiovascular adverse effects are becoming increasingly important in long-term care of cancer survivors, in particular patients with breast cancer and lymphoma that may have received anthracyclines and/or radiotherapy. In our cancer center, the cancer clinic for long-term survivors is active with combined work of medical oncologist/hematologist and psychologist.