Taking Care of Second Cancer Risk

Krista L. Wilkins, PhD, RN; Roberta L. Woodgate, PhD


Cancer Nurs. 2012;35(1):55-62. 

In This Article

Implications for Clinical Practice

From a practice perspective, the study's findings lend support for nurses and other healthcare professionals to be more vigilant in recognizing the concerns and needs of the cancer survivors. Successful follow-up care for cancer survivors requires that support be provided throughout their lifetime.

This study emphasizes the importance of effective risk communication to support the decisions made by cancer survivors with respect to taking care of second cancer risk. There is some information in the literature suggesting that nurses should be focusing more on assessing and understanding how cancer survivors perceive and act on their second cancer risk.[24] In this study, cancer survivors wanted to have a general idea of their second cancer risk. Cancer survivors generally do not want a precise risk statistic because they did not understand second cancer risk merely as an epidemiological calculation. Indeed, recent research indicates that cancer survivors' understanding of second cancer risk incorporates personal meanings, familial experiences, and social conditions in the construction of knowledge about risk and health behaviors.[17] To develop individualized interventions to support cancer survivors in taking care of their second cancer, nurses need to do more than ask cancer survivors to assign a numerical value to their second cancer risk as survivors understand it. Nurses need to ascertain what that second cancer risk means to cancer survivors and how they plan to act upon it because each cancer survivor can hold valid and different risk perceptions and frames of reference for cancer risk factors. Discussing second cancer risk without discussing what cancer survivors can do about that risk is futile. Individuals cannot fully take care of their second cancer risk unless they are aware of their risk and all the choices that are available to them to take care of that risk. Nurses need to be aware that providing cancer survivors with current and updated information of cancer risks may not always result in any changes in cancer prevention practices. Cancer survivors need reassurance that what they are doing to take care of their second cancer risk is correct. They also need to know that their second cancer risk concerns are justified and shared by other cancer survivors.

Adopting proactive, wellness-focused, lifelong follow-up care is warranted to ensure that the health needs of cancer survivors are included in all aspects of care. A logical first step would be to improve cancer survivors' adherence to cancer screening recommendations for the general population. In a healthcare system with increasing wait times for medical testing, fair queuing is needed. Study participants recommended that fair queuing requires that patients receive care in a timely fashion, with priority determined by factors such as the person's cancer history, severity of the presenting symptoms, and risk of adverse event occurring while waiting. The next step would be to develop comprehensive, evidence-based policies for the longitudinal care of survivors so that there will be consistency in survivorship care across Canada. Another step would be to be offer much needed support in the form of information, automated follow-up appointments, and peer support.