Michael Jefford

The Australian Cancer Plan is a 10‐year national framework to improve cancer outcomes for all Australians. Its third Strategic Objective envisions integrated, coordinated, data‐driven high‐quality health systems that deliver optimal cancer care and outcomes, with survivorship and palliative care as priority areas for action. In this perspective article, we examine the challenges and opportunities to achieving this objective. We identify persistent gaps in survivorship and palliative care and in equity for priority populations. To achieve the stated objective, we present opportunities to expand team‐based models of follow‐up care, strengthening of comprehensive cancer networks and embedding patient‐reported outcome and experience measures nationally.

Purpose of review: Persistent chemotherapy-induced alopecia (pCIA) is defined as incomplete hair growth ≥6 months after chemotherapy completion. This scoping review aimed to identify gaps for future research by mapping pCIA’s incidence, risk factors, quality-of-life (QoL) impacts, presentation, prevention, and management. Recent findings: Thirty-nine articles were included. The most common study type was case reports (12/39, 30.8%). Only 2/39 (5.1%) were randomized controlled trials (RCTs). Most studies (27/39, 69.2%) reported pCIA in patients with breast cancer. Alkylating agents, taxanes, and anthracyclines were most frequently reported to be associated with pCIA. All six studies that evaluated QoL reported that pCIA negatively affected patients’ psychological, functional, and social well-being. Scalp cooling was the only intervention shown to prevent pCIA in four studies. Twenty-one studies reported on interventions for the management of pCIA. Topical minoxidil was reported to improve pCIA in 7 out of 12 studies (58.3%). Low-dose oral minoxidil demonstrated benefit in 7 out of 7 studies (100%). Summary: pCIA’s incidence and risk factors should be prospectively evaluated across cancer types and chemotherapeutic agents. Given pCIA’s significant QoL impacts, RCTs should be conducted to investigate existing and emerging interventions for its prevention and management, and to consider including these interventions in the standard of care.

Objective: Poor sleep is a common issue among adolescents and young adults (AYA) with cancer. The present study describes the feasibility and impact of the Can‐Sleep stepped‐care intervention for AYA with cancer. Methods: A total of 51 AYA with cancer were screened. AYA who reported sleep disturbance (defined as insomnia severity index score [ISI] > 7) received self‐managed cognitive behavioural therapy for insomnia (SMCBT‐I) in the first instance (Step 1) followed by individual cognitive behavioural therapy for insomnia (ICBT‐I) if symptoms continued (Step 2). AYA screened as high risk for intrinsic sleep abnormalities (e.g., obstructive sleep apnoea) were referred to a specialised service. Results: Of the 51 AYA, 38 participants reported sleep disturbance. In total, 37 AYA commenced SMCBT‐I, four attending the specialised sleep service prior. Thirty‐one (84%) completed Step 1. Of these, 45% improved and required no further treatment, and 55% (17) were eligible for ICBT‐I (ISI > 7). Following intervention, the SMCBT‐I group showed a significant decline in insomnia symptoms ( p < 0.001, d = 0.84). Among the 17 AYA continuing to report sleep disturbance, 11 (65%) were referred to ICBT‐I, with 8 (73%) accepting and completing Step 2. Those who received the ICBT‐I showed a significant reduction in insomnia symptoms ( p = 0.007, d = 1.33). Conclusions: This study provides preliminary efficacy and acceptability of a stepped‐care intervention for sleep disturbances in AYA with cancer. A stepped‐care intervention may offer an effective and resource‐efficient method for managing sleep disturbance in AYA with cancer.

Introduction: Menopausal symptoms are common after cancer treatment, with wide-ranging impacts on cancer survivors’ daily living. While evidence shows that cancer survivors have menopause-related needs, these have not been synthesised. This systematic review aims to identify cancer survivors’ unmet needs in managing menopausal symptoms. Method: The study was registered with the Prospective Register for Systematic Reviews (CRD42024464668). We searched four databases (MEDLINE, Embase, PsycINFO, CINAHL) for original qualitative or quantitative research published in English between 2013 and 2025, and focusing on cancer survivors’ unmet menopause-related needs. Manual searches of reference lists were also conducted. Quantitative studies were reported descriptively, while qualitative data was analysed using inductive thematic analysis. Results: The search returned 8256 abstracts, of which, 20 studies (13 qualitative and 7 quantitative) met the inclusion criteria. Three key themes were identified regarding unmet needs: treatment, support, and information. Treatment needs involved survivors untreated, those finding treatment ineffective, and desire for more options. Between 26 and 80% were untreated or self-managing their symptoms, 15–76% found their treatments ineffective, and 23–68% desired additional treatment. Support needs included inadequate support from healthcare professional. Some felt abandoned, their symptoms dismissed, and therefore needed extra support in managing their symptoms. Gaps in access to information about cancer treatment-induced menopause and its management were identified. Most sought information from diverse sources; however, their needs were not fully met. Conclusion: The review revealed unmet needs in treatment, support, and information for cancer survivors managing menopausal symptoms. These findings could guide providers to improve practice and inform supportive care policies.

Aim: To describe the development, consultation, and endorsement process for a joint position statement from the Cancer Nurses Society of Australia (CNSA) and the Clinical Oncology Society of Australia (COSA) regarding the contribution of nurses to cancer survivorship care in Australia. Methods: A development team of nursing and oncology experts ( n = 11) was convened in September 2025. The draft position statement was informed by key literature, including the COSA Model of Survivorship Care, Australian Cancer Plan, a modified Delphi study defining nurse capabilities in survivorship care, and an overview of systematic reviews on nurse‐led care models. A consultation survey was then distributed via Qualtrics to CNSA and COSA members and partner organisations from October to November 2025. Respondents provided qualitative feedback across four domains: service delivery, research, education and policy. The expert panel incorporated the feedback and finalised the position statement, which was endorsed by COSA Council and CNSA Board in March 2026. Results: Submissions from 37 individuals and 10 organisations provided feedback on the draft position statement. Respondents were clinical nurse consultants/specialists ( n = 24), nurse practitioners ( n = 3), researchers ( n = 2), educators ( n = 1), managers ( n = 3), non‐nurse healthcare professionals ( n = 4), and administrators of relevant not‐for‐profit organisations ( n = 10) across Australia. Feedback was highly supportive, with respondents endorsing the statement's comprehensiveness. Key feedback included calls for greater specificity around implementation in under‐resourced settings, recognition of survivorship as a nursing speciality, the need for a national survivorship minimum dataset, and emphasis on telehealth‐enabled models. The final CNSA‐COSA position statement articulates 40 recommendations to strengthen nursing contribution across service delivery ( n = 9), research ( n = 11), education ( n = 9), and policy ( n = 11). Conclusion: This joint CNSA‐COSA position statement provides a framework to guide the integration of nursing into cancer survivorship care across Australia. Its implementation will require coordinated investment in workforce, education, research, and policy reform. Trial Registration : Not applicable as this is not a clinical trial.

Background: Telehealth for follow‐up of survivors of colorectal cancer (CRC) represents an opportunity to reduce health resource use and provide flexibility for patients and healthcare providers (HCPs). Understanding the perspectives of HCPs who have delivered telehealth‐based CRC survivorship care is critical in determining whether this is an acceptable and appropriate model. Aims: To examine the experiences of oncologists and general practitioners (GPs) who provided telehealth for CRC survivors within the Shared Care for Colorectal Cancer (SCORE) trial, focusing on implementation outcomes and perceived facilitators and barriers to implementation. Methods: This qualitative descriptive study involved semi‐structured interviews. Interviews were audio‐recorded and transcribed, and data analyzed using inductive thematic analysis. Results: Twenty‐three HCPs (13 GPs, 10 oncologists) participated. Seven themes were identified: (1) forced adoption and rapid implementation of telehealth during COVID; (2) patient benefits of convenience and safety; (3) patient factors that determine appropriateness for telehealth; (4) clinical factors that preclude telehealth; (5) HCP preferences and views on quality of care; (6) technical and administrative barriers; and (7) training, technology, administrative support and reimbursement to support future telehealth use. Telehealth was considered acceptable for routine CRC follow‐up care, however required judicious use. Challenges were identified regarding technology, logistical and administrative processes, and the potential for disparities in telehealth access. Conclusions: This study supports the use of telehealth for the provision of CRC survivorship care, provided that certain patient‐related and clinical characteristics are met. Future research may address decision making for telehealth use and understanding and mitigating disparities in access. Trial Registration: The Shared Care for Colorectal Cancer (SCORE) Trial is registered with the Australian New Zealand Clinical Trials Registry, ACTRN12617000004369p. Registered on 3 January 2017; protocol version 4 approved 24 February 2017

The growing population of cancer survivors underscores the need for models of care that effectively address their long-term needs. Over recent decades, various models have been proposed, but guidance regarding their development, testing, implementation, and evaluation remains limited. To address this gap, we conducted an overview of randomized controlled trials that assessed survivorship care models (1) to identify common features and methodological gaps and (2) to assess how these models contribute to improving survivorship care by mapping their predefined endpoints to the quality domains of the Quality of Cancer Survivorship Care Framework and the goals of the Quintuple Aim. Lastly, we provide recommendations for future studies, specifically focusing on clarifying terminology, adopting trial methods that move beyond standard comparative designs, expanding research to more diverse populations and settings, and incorporating endpoints that capture high-quality care and broader health system performance.