Endocrine Abstracts

Approximately 1 in 650 children will develop a childhood malignancy by the age of 15 years. Improvements in diagnosis, treatment and supportive care over the last 30 years mean that approximately 80% of children diagnosed with cancer can now expect to survive more than five years. Approximately 1 in 250 young adults in the UK is a survivor (more than five years from end of therapy and disease-free) of childhood cancer. In the adult field it is estimated that 2 million people in the UK are living with or beyond cancer (Macmillan 2004), and that annually this will increase by 3.5%.

Late effects are the physical and psychosocial problems that result from the cancer and its treatment. There are a number of well established Late Effects Services across the UK, including our service in Sheffield. The role of the Late Effects Service is to provide ongoing surveillance and management of late effects in survivors whilst providing appropriate information and support to both survivors and their families / carers.

The cancer reform strategy (DoH 2007) outlined the need for increased focus on survivors. NHS Improvement in collaboration with Macmillan and the Department of Health subsequently established the National Cancer Survivorship Initiative (NCSI) in 2008 to implement this area of the Cancer Reform Strategy. The Children’s and Young Peoples Improving Outcomes Guidance (CYP IOG, NICE 2005) has looked at all areas of the care of children and young adults with cancer, including late effects. These initiatives have all led to an increased awareness of survivorship issues and focus on improving services.

The NCSI has established work streams in 7 areas of survivorship; i) Assessment, care planning and immediate post treatment approaches to care. ii) Managing active, progressive and recurrent disease, iii) Late effects of treatment, iv) Survivors of childhood cancers, v) Work and finance, vi) Self management and vii) Research. 17 test communities have been identified by the NCSI for the adult survivorship pathways and 10 for children and young people.

Undoubtedly there will be implications for nursing as these survivorship initiatives offer a new way of working. There are not only clinical or medical needs to be met, but psychosocial as well, highlighting the importance of effective communication skills. Nurses will be faced with new challenges and opportunities to demonstrate their clinical and interpersonal skills.

The burden of survivorship has enforced recognition of this new cohort of patients and government initiatives are in place to enhance the quality of care available to them.