Breast cancer survivors may experience issues with the areas listed below. If you have any concerns in these or other areas, please speak with your doctors or nurses to find out how you can get help with them. or depression Functioning ☐Anxiety ☐Insurance ☐Sexual and mental health or concentration loss Smoking ☐Emotional ☐Memory ☐Stopping changes ☐Fatigue ☐Parenting ☐Weight functioning ☐Fertility ☐Physical ☐Other advice or assistance ☐Financial ☐School/work A number of lifestyle/behaviors can affect your ongoing health, including the risk for the cancer coming back or developing another cancer. Discuss these recommendations with your doctor or nurse: use activity ☐Alcohol ☐Physical ☐Other screen use ☐Diet ☐Sun of my medications use/cessation ☐Management ☐Tobacco of my other illnesses management (loss/gain) ☐Management ☐Weight Resources you may be interested in: Other: comments: Prepared by: Delivered on:
Breast cancer survivors may experience issues with the areas listed below. If you have any concerns in these or other areas, please speak with your doctors or nurses to find out how you can get help with them. ☐Anxiety or depression ☐Insurance ☐Sexual Functioning ☐Emotional and mental health ☐Memory or concentration loss ☐Stopping Smoking ☐Fatigue ☐Parenting ☐Weight changes ☐Fertility ☐Physical functioning ☐Other ☐Financial advice or assistance ☐School/work A number of lifestyle/behaviors can affect your ongoing health, including the risk for the cancer coming back or developing another cancer. Discuss these recommendations with your doctor or nurse: ☐Alcohol use ☐Physical activity ☐Other ☐Diet ☐Sun screen use ☐Management of my medications ☐Tobacco use/cessation ☐Management of my other illnesses ☐Weight management (loss/gain) Resources you may be interested in: Other: comments: Prepared by: Delivered on:
breast-cancer-treatment-summary-and-survivorship-care-plan.docx