Download [DATE] «RRESRC» «NRESRC», «TRESRC» «ARESRC

[DATE]
«RRESRC» «NRESRC», «TRESRC»
«ARESRC»
«CRESRC», «SRESRC» «ZRESRC»
RE: Survivorship Care Plan for «F00009_Name_First» «F00008_Name_Last»
Dear Dr. «NRESRC»:
The Community Memorial Hospital Cancer Program is required to provide all patients, diagnosed and/or
treated with cancer at CMH, with a cancer survivorship care plan upon completion of treatment for their
cancer. This is required by the American College of Surgeons Commission on Cancer to continue our
accredited cancer program. This standard will be implemented for all patients diagnosed on or after
January 1, 2015, but we are currently providing this for colon cancer patients to test our procedure.
The survivorship care plan is a very important part of the patient’s cancer care. It summarizes the
surgical treatment, chemotherapy and radiation therapy that was given as well as outlines the site, stage
and histology of the patient’s cancer. Most importantly, it outlines the recommended follow-up care
and tests recommended by the American Society of Clinical Oncologists to ensure that any possible
recurrence is caught early.
The CMH Cancer Registry will provide a draft treatment summary to all the physicians known to be
involved in the patient’s care. We would like each physician to review the details of the document and
add any information that may be missing. If information is added, please fax the updated form to the
CMH Cancer Registry at (805) 652-5479. We can then add the updated information to our database.
Please put this document in the patient’s medical record for discussion at the patient’s next follow-up
appointment. This form is intended to be given to the patient to make them aware of their scheduled
follow-up visits and tests and ensure that they are compliant with follow-up recommendations. In
addition, there is valuable information provided to educate the patient on signs and symptoms of
recurrence.
We hope that you find this process helpful. We would like to hear your feedback on how to improve the
procedure. We do want you to be aware that we do not always get complete treatment information.
We do hope that you will be able to fill in the missing pieces for a complete, up-to-date survivorship care
plan.
Cordially,
Lynn Kong, M.D.
Medical Director, CMH Cancer Program