ASCO Rolls Out First Three Guidelines on Survivorship Care

The American Society of Clinical Oncology (ASCO) announced today three new evidence-based clinical practice guidelines on neuropathy, fatigue, and depression and anxiety in cancer survivors, the first three in a planned series of ASCO guidelines on survivorship care.

The first, Prevention and Management of Chemotherapy-induced Peripheral Neuropathy in Survivors of Adult Cancers, outlines evidence-based recommendations in the prevention and treatment of chemotherapy-based peripheral neuropathy (CIPN), a side effect of certain chemotherapy regimens, which is estimated to occur in 30% to 40% of patients treated with chemotherapy.

"There is no clear panacea for neuropathy," Gary Lyman, MD, MPH, co-chair of the ASCO Survivorship Guidelines Advisory Group, said in a press release. "Some of the drugs used for prevention or treatment of neuropathy may cause side effects or interfere with other drugs. We want to be clear that if there is no evidence of benefit from those drugs, it's probably best not to take them."

The second guideline, Screening, Assessment and Management of Fatigue in Adult Survivors of Cancer, provides recommendations on screening, assessment, and treatment approaches for adult cancer survivors experiencing fatigue. The new guidelines also recommend that all survivors should be evaluated for symptoms of fatigue following completion of primary treatment.

About one-third of patients suffer from persistent fatigue that can last years after their treatment is completed. "Fatigue is an extremely common symptom in people with cancer," Smita Bhatia, MD, MPH, co-chair of the ASCO Survivorship Guidelines Advisory Group, said in a press release. "We hope that this guideline will help ensure that screening for fatigue and appropriate management are incorporated in the care of every cancer survivor."

The third guideline, Screening, Assessment, and Care of Anxiety and Depressive Symptoms in Adults with Cancer, was developed to help cancer patients and survivors with the stress of their disease. The guideline recommends that all cancer patients be evaluated for symptoms of depression and anxiety. The guidelines state that healthcare providers should periodically evaluate all survivors for symptoms of depression and anxiety and supportive care services should be offered to all survivors.

"Distress is very common among people with cancer, but the types and causes of distress vary. Depression can go undetected unless it is specifically sought for and evaluated," said Bhatia.

The guidelines were published today in the Journal of Clinical Oncology.