Survivorship and Coordination of Care

The number of cancer survivors in Australia is increasing rapidly due to the advent of new treatments and earlier detection through screening programs. In 1998-2004, the 5-year survival rate increased to 58%, from 41% in 1982-1986.

Studies have shown that GP-based follow-up after cancer treatment is a safe and reasonable alternative to hospital clinic care. Some suggested benefits of GP involvement in survivorship care include the accessibility of GPs as opposed to specialists, the long-term nature of the relationship that GPs maintain with their patients and the greater focus on health promotion, surveillance and psychosocial care in general practice.

Models of post-treatment follow-up call for enhanced education of GPs surrounding cancer survivorship (in terms of secondary malignancies, late effects of treatment, etc.). Shared care programs represent one potential vehicle for this knowledge transfer.

Planning Fact Sheet

The Institute of Medicine has put out a brief fact sheet to give an overview of the importance of coordinated care following treatment for cancer, the elements of a Survivorship Care Plan and questions which survivors should ask following their treatment.


Journey Forward

Journey Forward is a new program designed for health professionals and their patients who have recently completed active treatment for cancer.  The program encourages the use of Survivorship Care Plans, to be completed by the oncology team, which outline clear steps for care after active treatment.



Cancer Survivorship E-Learning Series for Primary Care Providers (PCPs) provides health professionals with video lectures by experts, quizzes, case studies and access to tools and resources. The aim is to equip PCPs to provide much needed post-treatment care to cancer survivors.

View series


Cancer in General Practice: a practical guide for Primary Health Care Nurses.

This series of three Cancer Council Victoria videos provides practical advice to general practice nurses on how to support cancer patients transitioning to the ‘cancer survivor’ stage.

  1. Coordination of Care
  2. Supportive Care
  3. Palliative Care
Watch now