ASCO developed two types of forms to help people diagnosed with cancer keep track of the treatment they received and medical care they may need in the future: a Cancer Treatment Plan and a Survivorship Care Plan.
First, an ASCO Cancer Treatment Plan is a form that provides a convenient way to store information about your cancer, cancer treatment, and follow-up care. It is meant to give basic information about your medical history to any doctors who will care for you during your lifetime.
Using the treatment plan, your current oncologist can enter the chemotherapy dose you received, the specific drugs that were used, the number of treatment cycles that were completed, surgeries done, and any additional treatment that was given, such as radiation therapy or hormonal therapy.
Second, ASCO offers a form called a Survivorship Care Plan. It contains important information about the given treatment, the need for future check-ups and cancer tests, the potential long-term late effects of the treatment you received, and ideas for improving your health.
None of these forms is intended to provide a complete medical record. And, no single treatment or survivorship care plan is appropriate for all patients due to the complexity of cancer care. Talk with your doctor for more information about your individual treatment and follow-up care. The ASCO Cancer Treatment Plan and Survivorship Care Plan should be used with the guidance of your doctor.
Watch a patient education video led by Dr. Julie Gralow explaining ASCO Cancer Treatment Plans. A full-text transcript is available.
Links below are to downloadable Microsoft Word (.docx) files unless otherwise noted.
Permission to Use ASCO Treatment and Survivorship Care Plan Templates
Patients and other consumers may use ASCO’s Treatment and Survivorship Care Plan Templates without seeking permission from ASCO.
Practitioners may incorporate the Templates into their workflow and/or into their electronic medical records system without seeking permission from ASCO. If the templates will be altered in any way, including the addition of institutional branding, ASCO requires that all ASCO identifiers be removed.
For permission to use the Templates in a commercial manner or in any manner not described above, please contact firstname.lastname@example.org.