Toward a risk-based assessment of the adult cancer survivor: late effects of chemotherapy.

Survivorship care of the cancer patient has become a growing concern among oncologists and primary care physicians in communities across the country. It is now recognized as a distinct phase in the continuum of cancer care. There are an estimated 12 million Americans with a history of cancer looking to their oncologists and primary care physicians for assistance in navigating the difficult waters of survivorship. Although a concerted effort is underway, there are few evidence-based guidelines or recommendations for managing long-term and late effects of adult cancer survivors. The Children 's Oncology Group has developed consensus guidelines to improve and standardize care of the survivors of childhood to young adult cancers. Their successful efforts could serve as a model for a similar undertaking to address the post-treatment care of adult survivors. In the absence of evidence-based or consensus guidelines, knowledge of late effects can inform and direct assessment of survivors presenting with late sequelae of chemotherapy agents.