Primary care physician’s confidence and coordination regarding the survivorship care for older breast cancer survivors

Purpose: This is the first pilot study to examine survivors’ experiences and primary care physicians and nurse practitioners’ knowledge and behaviour practices with respect to late effects (e.g., fatigue, chemobrain, lymphodema, cardiac problems, reproductive, infertility and sexual health issues, bone problems, and pain). Methods: Two separate focus groups consisting of 5 breast cancer survivors and 5 primary care physicians and nurse practitioners recruited from a local hospital in Central Illinois answered predetermined questions about cancer survivorship care. We intentionally limited the sample in order to conduct a detailed discussion (90 minutes) to gain every participant’s perspective. Results: Breast cancer survivors expressed a void in discussion and lack of knowledge among their primary care physicians regarding late effects as well as psychological consequences, referrals to support groups, and availability of resources (e.g., finances), thereby negatively affecting survivors’ quality of life. A primary care clinician (PCC) focus group revealed a service gap for mental health services for all patients, knowledge deficit about late effects, and lack of awareness of patient resources. Both cancer survivors and PCCs were extremely supportive about a shared care survivorship model between oncology and primary care. All focus group participants were unequivocally receptive about enhancing survivorship care throughout a cancer survivor’s lifetime. Conclusion: Complementing cancer survivorship care with primary care clinicians in the areas of late effects, in addition to psychological consequences, screening, and lifestyle habits will enhance a cancer survivor’s health-related quality of life.

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Primary care physicians’ perspectives of the survivorship care for older breast cancer survivors: a pilot study

Supportive Care in Cancer ◽

10.1007/s00520-019-04855-5 ◽

2019 ◽

Vol 28 (2) ◽

pp. 645-652 ◽

Cited By ~ 3

Author(s):

Jessica L. Krok-Schoen ◽

Jennifer DeSalvo ◽

Dori Klemanski ◽

Christian Stephens ◽

Anne M. Noonan ◽

...

Keyword(s):

Breast Cancer ◽

Primary Care ◽

Pilot Study ◽

Cancer Survivors ◽

Primary Care Physicians ◽

Breast Cancer Survivors ◽

Survivorship Care

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PRIMARY CARE PHYSICIANS’ PERSPECTIVES OF THE SURVIVORSHIP CARE FOR OLDER BREAST CANCER SURVIVORS: A PILOT STUDY

10.26226/morressier.5cdbe0aa618793e647b12a22 ◽

2019 ◽

Author(s):

Jessica Krok-Schoen ◽

Jessica Schoen

Keyword(s):

Breast Cancer ◽

Primary Care ◽

Pilot Study ◽

Cancer Survivors ◽

Primary Care Physicians ◽

Breast Cancer Survivors ◽

Survivorship Care

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Perspectives of Survivorship Care Plans Among Older Breast Cancer Survivors: A Pilot Study

Cancer Control ◽

10.1177/1073274820917208 ◽

2020 ◽

Vol 27 (1) ◽

pp. 107327482091720

Author(s):

Jessica L. Krok-Schoen ◽

Michelle J. Naughton ◽

Anne M. Noonan ◽

Janell Pisegna ◽

Jennifer DeSalvo ◽

...

Keyword(s):

Breast Cancer ◽

Health Care ◽

Pilot Study ◽

Focus Groups ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Survivorship Care Plan ◽

Survivorship Care ◽

Care Providers ◽

Term Care

The Commission on Cancer’s standard 3.3 represents a paradigm shift in the care of cancer survivors, recommending that survivors receive a treatment summary and survivorship care plan (SCPs). A focus on older breast cancer survivors is needed, as they are the majority of the breast cancer population and their experiences and perspectives of SCPs is limited in the literature. This pilot study utilized a mixed methods approach (focus groups and self-report questionnaire data) to gather information on older (≥65 years) breast cancer survivors’ perspectives of their SCPs, cancer survivorship, and communication with their health-care providers. The questionnaire was completed individually by the participants prior to the focus group and contained items on basic demographics and their health status following cancer treatment. The focus groups indicated that only a minority of women actually developed a SCP. Those who developed a SCP in collaboration with their providers valued the personal care and attention received. However, some participants reported poor communication with their providers and within their health-care team, resulting in frustration and confusion. Participants’ suggestions for ideal SCPs included better education and personalization, particularly in appropriate nutrition and exercise, and managing side effects and comorbidities. Lastly, the women believed that additional long-term care resources, such as health coaches, were important in improving their survivorship. These findings provide insight into enhancing the content, communication, and application of SCPs to improve the survivorship experience of older breast cancer survivors.

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Developing a treatment summary and survivorship care plan responsive to African‐American breast cancer survivors

Psycho-Oncology ◽

10.1002/pon.3939 ◽

2015 ◽

Vol 25 (6) ◽

pp. 729-731 ◽

Cited By ~ 4

Author(s):

Kimlin Tam Ashing ◽

Lily Lai ◽

Shirley Brown ◽

Kommah McDowell ◽

DeBorrah Carter ◽

...

Keyword(s):

Breast Cancer ◽

African American ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Care Plan ◽

Survivorship Care Plan ◽

Survivorship Care ◽

Treatment Summary

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Quality of life and mental health in breast cancer survivors compared with non-cancer controls: a study of patient-reported outcomes in the United Kingdom

Journal of Cancer Survivorship ◽

10.1007/s11764-020-00950-3 ◽

2020 ◽

Author(s):

Helena Carreira ◽

Rachael Williams ◽

Harley Dempsey ◽

Susannah Stanway ◽

Liam Smeeth ◽

...

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Primary Care ◽

Cancer Survivors ◽

Patient Reported Outcomes ◽

Breast Cancer Survivors ◽

Patient Reported ◽

History Of ◽

History Of Cancer

Abstract Purpose There is limited high-quality evidence on quality of life, anxiety, and depressive symptoms in breast cancer survivors and women with no history of cancer. We aimed to address this by comparing patient-reported outcomes between breast cancer survivors and women with no history of breast cancer. Methods Breast cancer survivors and women with no prior cancer were selected from the UK Clinical Practice Research Datalink GOLD primary care database, which includes population-based primary care electronic health record data. Breast cancer survivors and controls were frequency matched by age and primary care practice. Outcomes were assessed with validated instruments via postal questionnaire. Linear and logistic regression models were fitted to estimate adjusted associations between breast cancer survivorship and outcomes. Results A total of 356 breast cancer survivors (8.1 years post diagnosis) and 252 women with no prior cancer participated in the study. Compared with non-cancer controls, breast cancer survivors had poorer QoL in the domains of cognitive problems (adjusted β (aβ) = 1.4, p = 0.01), sexual function (aβ = 1.7, p = 0.02) and fatigue (aβ = 1.3, p = 0.01), but no difference in negative feelings, positive feelings, pain, or social avoidance. Breast cancer survivors had higher odds of borderline-probable anxiety (score ≥ 8) (adjusted OR = 1.47, 95%CI:1.15–1.87), but no differences in depression. Advanced stage at diagnosis and chemotherapy treatment were associated with poorer QoL. Conclusions Compared with women with no history of cancer, breast cancer survivors report more problems with cognition, sexual function, fatigue, and anxiety, particularly where their cancer was advanced and/or treated with chemotherapy. Implications for Cancer Survivors Breast cancer survivors with more advanced disease and/or treated with chemotherapy should be closely monitored and, when possible, offered evidence-based intervention for fatigue, cognitive dysfunction, and sexual problems.

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Evaluation of the delivery of survivorship care plans for South Asian female breast cancer survivors residing in Canada

Current Oncology ◽

10.3747/co.25.3734 ◽

2018 ◽

Vol 25 (4) ◽

Cited By ~ 2

Author(s):

S. Singh-Carlson ◽

F. Wong ◽

G. Oshan

Keyword(s):

Breast Cancer ◽

Cancer Survivors ◽

South Asian ◽

Breast Cancer Survivors ◽

Family Members ◽

Female Breast Cancer ◽

Post Treatment ◽

Survivorship Care ◽

Female Breast

Background This paper focuses on phase iii of a study evaluating the development and implementation of a survivorship care plan (scp) that could ultimately improve post-treatment quality of life for South Asian (sa) breast cancer survivors (bcss). Evaluating the utility of the scp was important to understand how sociocultural influences might affect uptake of the scp by sa bcss, especially as they transition from treatment to community care.Methods Post-treatment discharge planning using an individualized scp at discharge for sa female breast cancer patients with stage i or ii disease was offered as a pilot service to oncologists at BC Cancer’s Fraser Valley and Abbotsford centres. A longitudinal study using a mixed-methods approach was used to evaluate the utility of that service at 1 year after discharge.Results Participants (n = 16) completed a survey about their scp delivery experience, and a 1-year post implementation survey about the scp content and its utility. Most participants reported the discharge appointments to be extremely or very helpful with respect to post-treatment care questions. All have visited their family physicians for follow-up as recommended. The three major sources of support were family, faith, and family physician. Qualitative responses from the health care professionals who developed or implemented the scps identified two challenges in scp delivery: engaging patients or family members in relationship, and translating key information through interpreters.Conclusions It is important to evaluate the utility of scps for sa female survivors, who might differ from the general bcs population because of a different understanding of the disease; language barriers; strong influence of family members; societal stigmas; and personal, social, cultural, and religious beliefs and values. A formal nurse-led discharge appointment with discussions about follow-up care and an individualized scp outlining the short- and long-term effects of treatment are recommended. Particular attention has to be paid to the practical and psychosocial needs of sa bcss and their supporting family members.

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