Cancer survivorship in the era of precision health

Abstract

Survival after treatment for most types of childhood cancer has improved dramatically. However, life after curative treatment is not without late effects, some of which are life-threatening. Pediatric oncology nurses, advanced practice nurses, and nurse scientists have been in the forefront of program development for systematic follow-up for long-term childhood cancer survivors (CCS), studying determinants of—and interventions to ameliorate—late effects, and implementing a risk-based approach to follow-up care. Survivorship is a dynamic process, and nurses have adapted to this changing landscape. With the evolution of precision health (including genetics and genomics), the landscape will evolve, and nursing needs to be at the forefront of integrating this new information (big data) to provide comprehensive survivorship care. Nurse scientists now have opportunities to leverage the advances that have been made in precision health to both lead and contribute to informatics’ solutions for data collection and data analyses with the unique nursing perspective derived from our decades of survivorship experience, and nurses in clinical practice and education are well positioned to translate research into clinical care to improve survivors’ lifetime health. The goal of nursing science is the translation of evidence to improve population health. The prospects for nurse scientists to move the pendulum for all CCS’ care toward a precision health-based framework from which to provide care are vast. Challenges remain in how best to reach many survivors who are not engaged in long-term follow-up care, as it is this type of precision health care that the survivors need most.