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This web based educational tool is developed to guide health care professionals to assess all aspects of quality of life and overall well being in breast cancer survivors and to make appropriate referrals.  A standardized checklist for surveillance is to assess all aspects of well being in cancer survivors

1. Physical well being and symptoms

2.Social well being

3.Spiritual well being

4.Psychological well being

Social well being

Family distress
Roles and relationships
Affection /sexual function
Appearance
Enjoyment, isolation
Finances, work

Spiritual well being

Meaning of illness
Religious
Hope
Uncertainity
Inner strength

Psychological well being

Lost of control
Anxiety
Depression
Enjoyment
Fear of recurrence
Cognition /attention
Distress of diagnosisand
control

 

Physical well being and symptoms

Pain
Weight gain
Fatigue
Nausea and vomiting,hairloss,febrile
      neutropenia
Recurrence assessment local and systemic
      recurrence
Second primary
Lymphedema
Healthy lifestyle
Physical activity /Exercise
Cardiac health
Bone health
Sexual dysfunction
Fertility
Overall physical health any comorbid
      conditions

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