The randomized controlled trial, known as the Technology-Enabled Patient and Physician Activation to Enhance Skin Cancer Screening After HCT study, or TEACH, included 720 hematopoietic cell transplant survivors. The findings, published in JNCCN—Journal of the National Comprehensive Cancer Network, indicate that simple educational materials delivered by mail and reinforced through text messages can increase both self-examination and physician-performed skin checks. The results point to a practical strategy for extending survivorship care beyond major cancer centers.

Hematopoietic cell transplantation, also called bone marrow or stem cell transplantation, replaces damaged or diseased blood-forming cells with healthy cells. The procedure is used to treat leukemia, lymphoma, multiple myeloma and other blood cancers, as well as nonmalignant conditions such as aplastic anemia and sickle cell disease. Although transplantation can be lifesaving, the intensive chemotherapy, radiation, immune suppression and long-term immune-system disruption associated with the procedure can produce delayed complications, including an elevated risk of secondary cancers.

Among these complications, skin cancer is particularly important because it can often be detected during routine examinations or by patients themselves. HCT survivors face nearly twice the risk of squamous cell carcinoma compared with the general population, while basal cell carcinoma, melanoma and Merkel cell carcinoma are also concerns. Skin cancers may begin appearing three to five years after transplantation, when many survivors have already transitioned from transplant specialists to primary care providers. This change in care setting can create gaps in surveillance, particularly when patients and physicians are unaware of the specific risks associated with HCT.

The City of Hope intervention was designed to address both sides of that problem. Every participant received mailed educational materials explaining why HCT survivors are at increased risk, how to conduct a systematic self-examination and what suspicious lesions may look like. The materials included images to help participants recognize warning signs such as a changing mole, a new growth, a sore that does not heal or a lesion with unusual color or irregular borders. All participants also received recurring text messages intended to reinforce the information and encourage continued screening behavior.

Approximately half of the participants were assigned to an additional physician-activation group. In that group, the patients’ primary care doctors received information describing the relationship between HCT and skin cancer, along with guidance on conducting full-body skin examinations. This provider-focused component was intended to make skin surveillance a routine part of primary care rather than a responsibility that ends when a patient leaves the transplant clinic.

The investigators reported that the proportion of survivors completing skin self-examinations and receiving annual clinical skin checks nearly tripled overall during the study. Patient education alone produced a clear improvement in self-examination, suggesting that survivors can become active participants in detecting possible cancers when they receive specific instructions and visual examples. The intervention did not depend on frequent specialist appointments, expensive equipment or intensive counseling, making it potentially adaptable to large survivor populations.

The strongest difference emerged when physicians were included in the intervention. Although self-examination increased among participants across the study, the proportion who also received an in-office skin examination was 40 percent higher when their primary care physicians had received the educational materials. The finding suggests that patient awareness may be sufficient to encourage personal monitoring, while physician education is especially important for ensuring that a professional examination takes place.

“This study shows that practical, scalable solutions can close that gap and may be applicable to other long-term complications in cancer survivors,” said Saro Armenian, D.O., M.P.H., the study’s first author and director of the Center for Survivorship and Outcomes at City of Hope. He said the results are already informing how the institution approaches follow-up care, particularly as survivors move from specialty settings into primary care. The model combines patient activation, clinician education and remote communication to support risk-based survivorship care without requiring a high-intensity intervention.

The researchers say the approach could be expanded to address other late effects of transplantation, including cardiovascular disease, bone loss, chronic immune complications and second malignancies. Its broader significance lies in the way it connects specialized cancer knowledge with routine medical care: survivors receive tools to monitor their own health, while primary care physicians receive the context needed to recognize risks that may not be apparent from a standard medical history. Supported by the National Cancer Institute through grant R01 CA249460, the study reinforces the principle that successful cancer treatment is not the end of care, but the beginning of long-term surveillance designed to protect survivors for decades after transplantation.

Subject of Research: Skin cancer screening among hematopoietic cell transplant survivors

Article Title: Technology-Enabled Patient and Physician Activation to Enhance Skin Cancer Screening After HCT (TEACH Study): A Randomized Controlled Trial

News Publication Date: 6-Aug-2026

Web References: https://jnccn.org/view/journals/jnccn/aop/article-10.6004-jnccn.2026.7030/article-10.6004-jnccn.2026.7030.xml

References: National Cancer Institute grant R01 CA249460; JNCCN—Journal of the National Comprehensive Cancer Network

Keywords: Skin cancer, hematopoietic cell transplantation, bone marrow transplantation, stem cell transplantation, cancer survivorship, skin cancer screening, squamous cell carcinoma, melanoma, primary care, patient education, physician activation, survivorship care

Cancer survivorship care encompasses a multifaceted approach that extends beyond the management of residual physical side effects from treatments such as chemotherapy, radiation, or surgery. It involves continuous surveillance for recurrence, screening for secondary malignancies, management of long-term treatment toxicities, and integration of mental health support. Given the varied nature of these needs, the delivery of surveillance and supportive care is inherently complex and demands coordinated efforts among multiple healthcare providers.

In recent exploratory research conducted by the University of Missouri School of Medicine, investigators delved into the experiences of female cancer survivors transitioning from acute oncology care to longer-term survivorship management overseen largely by primary care clinicians (PCCs). This stratified care shift aims to leverage the longitudinal and holistic relationship that primary care providers have with patients, but the study illuminated significant systemic and practical challenges impeding continuity of care. Among the 57 women surveyed and interviewed, only about one-third reported consistent contact with the same primary care clinician post-treatment, highlighting fragmentation risks.

The fragmented nature of survivorship care stems in part from unclear delineations of roles and responsibilities between oncologists and primary care practitioners. When transitioning patients after active treatment, ambiguity regarding who is accountable for surveillance protocols, symptom management, and psychological support can cause gaps in care continuity. Miscommunications between specialties and lapses in patient-provider relationships may exacerbate these discontinuities, potentially compromising early detection of recurrence or management of late effects.

Moreover, the research resonates with findings from previous studies that many primary care providers experience a lack of confidence and preparedness to deliver comprehensive survivorship care. Despite their willingness to engage in additional training, PCCs often cite insufficient educational resources and ambiguous clinical guidelines as barriers. This gap presents an opportunity for integrating targeted educational programs within primary care training frameworks to enhance preparedness for survivorship challenges.

Notably, the research team identifies several promising educational interventions designed to equip primary care clinicians with the necessary knowledge and skills. These include modular online courses, interactive workshops, webinars, and tele-mentoring programs like the Extension for Community Healthcare Outcomes (ECHO) model. The ECHO program, in particular, facilitates remote collaboration and case-based learning between oncology specialists and primary care teams, promoting shared expertise and improved patient outcomes.

The study also underscores the preference among many cancer survivors for shared-care models, where primary care and oncology specialists collaboratively engage in ongoing management. Shared-care approaches capitalize on the strengths of both disciplines: oncologists bring in-depth knowledge of cancer-specific risks and therapies, while PCCs offer longitudinal oversight of overall health, comorbidities, and preventive care. Such models can foster patient-centered continuity and potentially mitigate fragmentation.

Looking forward, the researchers aim to expand investigations into the evolving needs and preferences of cancer survivors during the survivorship phase. Understanding nuanced patient priorities—ranging from symptom management and psychosocial support to communication preferences—will be critical in designing survivorship care pathways that are not only clinically effective but also aligned with patients’ lived experiences and expectations.

This body of work contributes valuable insights into the structural and educational reforms necessary to optimize cancer survivorship care. As the survivor population grows, health systems must innovate integrated care models that adequately support primary care clinicians, promote seamless specialty-primary care coordination, and address the holistic needs of survivors.

The broader implications of these findings highlight a pressing need for policy initiatives and resource allocation to enhance survivorship training and care infrastructure. Investing in scalable educational platforms and fostering multidisciplinary collaboration will be key to meeting the anticipated demand for comprehensive survivorship services.

In sum, while advances in oncology have significantly improved survival, the continuum of care beyond treatment remains riddled with challenges. Empowering primary care providers through targeted education and structured collaborative models offers a promising avenue to bridge existing gaps. This approach is poised to redefine survivorship care and improve outcomes for millions who navigate life after cancer treatment.

The observational study titled “Continuity of Cancer Care: Female Participants’ Report of Healthcare Experiences After Conclusion of Primary Treatment” was published in the July 2025 issue of Current Oncology. Authored by experts including Jane McElroy, PhD, of the University of Missouri’s Department of Family and Community Medicine, and Mirna Becevic, PhD, from the Department of Dermatology, the study highlights essential directions for future cancer survivorship research and clinical practice.

Subject of Research: People

Article Title: Continuity of Cancer Care: Female Participants’ Report of Healthcare Experiences After Conclusion of Primary Treatment

News Publication Date: 11-Jul-2025

Web References:
DOI: 10.3390/curroncol32070399

Keywords:
Family medicine, Oncology, Cancer patients, Cancer screening, Preventive medicine, Cancer treatments

Survivorship care, a comprehensive approach designed to support patients after their primary cancer treatment concludes, remains underutilized and under-recognized, even as the population of cancer survivors continues to rise. The Northwestern study surveyed over 300 individuals treated for head-and-neck cancers over the past decade, revealing that more than 70% reported their mental health needs went unaddressed during treatment. This troubling statistic underscores a systemic blind spot within oncology care, which often prioritizes tumor surveillance and physical recovery while overlooking psychosocial well-being.

Head-and-neck cancer patients frequently endure debilitating side effects, many of which persist long after radiation therapy ends. These include xerostomia (dry mouth), dysphagia (difficulty swallowing), altered taste perception, and ongoing dental problems, all of which compromise quality of life and complicate nutrition and social interaction. Astonishingly, 40% of survey respondents continued to suffer from dry mouth, and nearly 25% reported swallowing difficulties, illustrating the chronic burdens patients carry. Despite these challenges, less than a third of these survivors had sufficient information or access to survivorship care programs designed to address such long-term effects.

This gap in care is not merely about managing physical symptoms—it extends deeply into mental health. Approximately 15% of surveyed survivors screened positive for clinical depression, a condition often masked or dismissed in oncology settings. The resilience required to navigate the aftermath of cancer treatment is formidable, and psychological distress can exacerbate physical symptoms, impede recovery, and diminish overall well-being. The failure to integrate mental health services as a standard component of cancer follow-up care reveals a critical insufficiency in patient-centered oncology.

Traditional oncology follow-ups tend to focus narrowly on detecting cancer recurrence, but longer-living survivors necessitate a broader framework that encompasses chronic disease management, preventive health, and psychosocial support. The researchers at Northwestern advocate for adopting the Cancer Survivorship Framework—a multidisciplinary model addressing five essential domains: physical effects, psychosocial health, cancer screening, chronic disease management, and health promotion. This holistic approach aims to deliver personalized care that adapts to survivors’ evolving needs over time, and it has the potential to be applied widely across cancer types beyond head-and-neck malignancies.

Interestingly, the study also discovered that nearly half of surveyed patients preferred a survivorship care model involving one extended clinic visit every six to twelve months, as opposed to multiple shorter appointments. This preference highlights a need for coordinated, efficient care pathways that can comprehensively evaluate patients’ multifaceted needs in a single setting. Women and those recently completing treatment expressed stronger preferences for this model, suggesting that timing and demographic factors influence care delivery preferences which healthcare systems should carefully consider.

Addressing these complex needs requires assembling dedicated, multidisciplinary teams composed not only of oncologists but also dietitians, mental health counselors, social workers, and other specialists. This integrated model would empower patients with tailored interventions targeting both the physical and emotional challenges of cancer survivorship. Alexis Larson, the study’s lead author and a certified nurse practitioner at Northwestern Medicine, emphasizes that comprehensive survivorship care cannot be relegated to brief encounters but must be thoughtfully constructed to provide sustained and coordinated support.

The urgency of this need is underscored by demographic trends: in 2022, there were an estimated 18.1 million cancer survivors in the United States alone, accounting for roughly 5.4% of the population. Projections indicate this number will swell to 26 million by 2040 due to advances in therapeutic approaches and an aging society. This burgeoning survivor cohort demands scalable, systematic approaches to survivorship that ensure patients are not left isolated after treatment completion.

Taking these findings into practice, Northwestern Medicine is pioneering a dedicated survivorship clinic embedded within its Department of Radiation Oncology. Building on insights from the study, the clinic will incorporate all five domains of the Cancer Survivorship Framework and specifically focus on integrating mental health resources, including pilot testing cognitive behavioral therapy (CBT) interventions. This targeted approach aims to mitigate psychological distress and help patients manage chronic pain, anxiety, and depression that frequently accompany post-radiation recovery.

Moreover, this initiative will complement existing survivorship programs available through the Robert H. Lurie Comprehensive Cancer Center but distinguishes itself by delivering care within the very environment where patients received their initial treatment. Such proximity facilitates continuity, enhances communication between care teams and patients, and fosters more seamless coordination of services. It represents a strategic step toward patient-centered care innovations that resonate with survivors’ articulated needs.

Published in the journal Supportive Care in Cancer on April 30, 2025, the study titled “Survivorship Therapy Needs after Radiotherapy for Head and Neck Cancer: Surveying Opportunities for Growth (STRONG)” spotlights the profound importance of rethinking survivorship paradigms. Funded partly by the National Institutes of Health’s National Center for Advancing Translational Sciences, this research offers a compelling call to action for clinicians, healthcare systems, and policymakers to prioritize comprehensive survivorship services that holistically address both the seen and unseen consequences of cancer treatment.

As oncology continuously evolves, it is imperative that survivorship care keeps pace, embracing the complex intersection of physical symptoms, mental health, and long-term wellness. By integrating multidisciplinary care models and embedding validated psychological interventions within survivorship programs, institutions like Northwestern Medicine are charting a path forward. This approach transcends head-and-neck cancer and offers an adaptable template for all cancer survivors, ensuring that the triumphs of extended survival are matched by improved quality of life.

History has shown that curing cancer is only half the battle—the true victory lies in supporting survivors to thrive beyond their diagnosis. Studies like STRONG underscore that survivorship care is not a luxury but a necessity, demanding renewed focus and resources as the cancer survivor population expands. It is time for oncology practices across the globe to heed these findings and foster a healthcare ecosystem equipped to heal the whole person, body and mind.

Subject of Research: Survivorship care needs and mental health support in head-and-neck cancer survivors post-radiotherapy.

Article Title: Survivorship Therapy needs after Radiotherapy for head and Neck cancer: surveying opportunities for Growth (STRONG)

News Publication Date: 30-Apr-2025

Web References:

• Journal article DOI: 10.1007/s00520-025-09429-2
• Cancer Survivorship Framework: https://pmc.ncbi.nlm.nih.gov/articles/PMC6855988/

References: Northwestern Medicine study conducted on 317 head and neck cancer survivors between 2013 and 2023; published in Supportive Care in Cancer, April 2025.

Keywords: Cancer, Radiation therapy, Cancer patients, Head and neck cancer, Cancer screening, Cancer policy