General practitioners face a dilemma. In a recent survey (Ann Intern Med. 2014;160:11-17), most reported being unfamiliar with the guidelines and uncomfortable treating adult survivors of childhood cancer; however, they can expect to see more such patients each year as treatments for childhood cancer become increasingly successful.
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“I envision the development of a subspecialty — either of doctors or nurse practitioners — who deal with cancer patients outside the care of an oncologist and who are trained in survivorship, know a lot about treatment, and know about supportive, palliative, and nutritional care in survivors,” she said.
In the meantime, however, family practitioners are in the driver’s seat.