The number of cancer survivors is growing around the world. With improvements in early diagnosis and treatment, and an ageing population we need to tackle the healthcare needs of long-term cancer survivors. This has traditionally been the remit of secondary care; cancer management is complex and requires specialist expertise – it follows that ongoing management should make use of this same expertise.

However there has been a growing realisation that primary care needs to take on a greater share of this healthcare activity. This has challenged all of us in primary and secondary care to think creatively about how our roles should adapt. This presentation will examine some of the contemporary issues facing GP-led cancer survivorship models.

GPs can contribute to cancer survivorship in areas such as psychosocial support, monitoring for recurrence, rehabilitation, management of symptoms (such as fatigue) and helping people back to work. Ideally, GPs should work with multidisciplinary teams, there should be excellent communication channels between community and hospital based care and there should be well defined routes back into specialist care when this is needed. The reality in health services around the world is quite a mixed picture and there are many challenges; there are training needs for GPs, there is variability in the quality of primary care cancer patients receive and many examples of lack of overall integration - leaving patients uncertain about who is in control.

However integrated models of survivorship care, highlighting clear and tangible roles for GPs are emerging. Some GPs remain resistant to taking on cancer patients and many patients feel uneasy about the expertise of their GP in managing their conditions. Nevertheless with an ageing population of cancer patients with multiple co-morbidities primary care must tackle the survivorship challenge.