“Looking at future cancer survivors, give them a roadmap”: addressing fertility and family-building topics in post-treatment cancer survivorship care

Author(s):  
Catherine Benedict ◽  
Jen-Ling Nieh ◽  
Alexandria L. Hahn ◽  
Alyssa McCready ◽  
Michael Diefenbach ◽  
...  
2021 ◽  
pp. 154041532110015
Author(s):  
Oscar Yesid Franco-Rocha ◽  
Gloria Mabel Carillo-Gonzalez ◽  
Alexandra Garcia ◽  
Ashley Henneghan

Introduction: The number of cancer survivors is increasing in Colombia, and health policy changes are necessary to meet their unmet needs and improve their health outcomes. Similar trends have been identified in developed countries, and positive changes have been made. Methods: We conducted a narrative review to provide an overview of Colombia’s social structure, health care system, and health care delivery in relation to cancer, with recommendations for improving cancer survivorship in Colombia based on the model of survivorship care in the United States. Results: We proposed general recommendations for improving cancer survivors’ care including (1) recognizing cancer survivorship as a distinct phase of cancer, (2) strengthening methods and metrics for tracking cancer survivorship, (3) assessing and monitoring cancer symptoms and quality of life of cancer survivors, (4) publishing evidence-based guidelines considering the social, economic, and cultural characteristics of Colombian population and cancer survivors’ specific needs. Conclusion: These recommendations could be used to inform and prioritize health policy development in Colombia related to cancer survivorship outcomes.


2018 ◽  
Vol 25 (4) ◽  
Author(s):  
S. Singh-Carlson ◽  
F. Wong ◽  
G. Oshan

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.


2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 58-58
Author(s):  
Claire Michelle Sutherby (Bennett)

58 Background: More than 15.5 million cancer survivors live in the United States. This number is expected to be over 20 million by 2026. Cancer survivors have increased risk of morbidity; therefore, preventive and on-going medical treatment requires close monitoring and coordination. The Institute of Medicine’s (IOM) 2005 report, Cancer Patient to Cancer Survivor: Lost in Transition, recommended health providers raise awareness of cancer survivors’ needs and establish cancer survivorship as a distinct phase of care. The IOM also recommended patients who complete primary treatment are provided a comprehensive summary and plan that is effectively explained. A survivorship care plan maps out and improves care related to accessibility of past diagnosis and treatment history, surveillance guidelines, and potential long term side effects. In 2012, the Commission on Cancer (CoC) added Standard 3.3 Survivorship Care Planto the program standards. This met the IOM’s objective of addressing potential patients that get “lost” as they transition from care they received during treatment through phases of their life or disease. Methods: The Cancer Committee within a CoC certified organization developed multiple strategies to address the IOM and CoC standards. Strategies included a process to disseminate a comprehensive care summary for cancer patients who are completing primary treatment, adoption of the American Society of Clinical Oncology’s Treatment Summary and Survivorship Care Plan template, and adding a survivorship nurse navigator to the interprofessional treatment team. The survivorship nurse navigator monitors and reviews survivorship care plans with patients, advises when to seek treatment for symptoms, discusses surveillance guidelines, navigates patients through therapies, and educates on prevention and screening. Results: Evaluation for quality of life and compliance with individualized surveillance guidelines is ongoing. Conclusions: The oncology nurse navigator role is uniquely positioned to lead care coordination and improve outcomes through the continuum of care. Providing patients with a summary of their treatment and a plan moving forward may decrease stress related to the transition from active treatment to survivorship.


Author(s):  
Eden R. Brauer ◽  
Elisa F. Long ◽  
Laura Petersen ◽  
Patricia A. Ganz

Abstract Purpose Breast cancer-specific survivorship care guidelines for the more than 3.8 million survivors in the U.S. are available, but implementation in clinical practice remains challenging. We examined current practice patterns and factors associated with guideline-concordant survivorship care among oncologists. Methods A national sample of medical oncologists, recruited using two databases, participated in a survey focused on practice patterns for breast cancer survivorship care. A “survivorship care composite score” was calculated for each respondent based on provision of services recommended in the survivorship guidelines. Descriptive statistics and multivariable linear regression analyses examined associations between physician and practice characteristics and composite scores. Results The survey was completed by 217 medical oncologists, with an overall response rate of 17.9% and eligibility rate of 56.9% for those who responded. Oncologists reported high engagement in evaluation of disease recurrence (78%). Performed less frequently were the provision of survivorship care plans (46%), assessment of psychosocial long-term and late effects (34%), and screening for subsequent cancers (34%). Lack of survivorship care training (p = 0.038) and not routinely informing patients about potential late effects (p = 0.003) were significantly associated with poorer survivorship care composite scores. Conclusions Despite the availability of disease-specific survivorship care guidelines, adherence to their recommendations in clinical practice is suboptimal. Survey results identified key gaps in survivorship care for breast cancer survivors, particularly related to subsequent primary cancers and psychosocial long-term and late effects. Implications for Cancer Survivors Improving the delivery of comprehensive survivorship care for the growing population of breast cancer survivors is a high priority. Disease-specific clinical guidelines for cancer survivorship provide valuable recommendations, but innovative strategies are needed to integrate them into the care of long-term breast cancer survivors.


2009 ◽  
Vol 3 (2) ◽  
pp. 99-108 ◽  
Author(s):  
Carl Baravelli ◽  
Meinir Krishnasamy ◽  
Carmel Pezaro ◽  
Penelope Schofield ◽  
Kerryann Lotfi-Jam ◽  
...  

2011 ◽  
Vol 29 (18_suppl) ◽  
pp. CRA9006-CRA9006 ◽  
Author(s):  
K. S. Virgo ◽  
C. C. Lerro ◽  
C. N. Klabunde ◽  
C. Earle ◽  
P. A. Ganz

CRA9006 Background: Increased coordination among clinicians in cancer survivorship care is needed yet the literature suggests barriers remain due to a fragmented healthcare system. This is the first nationwide study of barriers PCPs and MOs perceive regarding breast and colorectal cancer survivorship care. Methods: The Survey of Physician Attitudes Regarding the Care of Cancer Survivors (SPARCCS) was mailed to a nationally representative stratified sample (N=5,275) of eligible American Medical Association member PCPs and MOs (N=3,596) providing care to cancer survivors, to permit comparisons of views regarding follow-up testing, roles, knowledge self-confidence, and perceived barriers. We analyzed physician-based barriers using weighted multinomial logistic regression models adjusted for physician demographics, reimbursement, training, and practice characteristics. Results: 2,202 physicians (1,072 PCPs and 1,130 MOs) responded (57.6% response rate; 65.1% cooperation rate). In weighted univariate analyses, PCPs were significantly more likely to report often/always ordering tests or treatments as malpractice protection, being concerned about missed care, and lacking adequate training to manage patient problems. MOs were more likely to report (often/always and sometimes) concerns about duplicated care and about which physician provides general preventive health care. In multivariate regression models, physician specialty remained significant for 3 of 5 physician-based barriers. MOs were less likely to report inadequate training (OR: 0.33, 95% CI: 0.22-0.49), less likely to often/always order extra tests due to malpractice concerns (OR: 0.53, 95% CI: 0.34-0.84), and more likely to report being often/always (OR: 1.97, 95% CI: 1.13-3.43) and sometimes (OR: 2.16, 95% CI: 1.60-2.93) uncertain who is providing general preventive care, compared to PCPs. Conclusions: MOs perceived different physician-based barriers as problematic in cancer follow-up care compared to PCPs. Alleviation of inadequate training, malpractice-driven test ordering, and preventive care delivery barriers may require education and provision of survivorship care plans.


2014 ◽  
Vol 32 (26_suppl) ◽  
pp. 116-116
Author(s):  
Jennifer R. Klemp ◽  
Lori Ranallo ◽  
Catherine J Knight ◽  
Mary Williams ◽  
Carol J. Fabian

116 Background: With more than 2.9 million BrCa survivors in the US, it is imperative to determine how best to deliver post-treatment survivorship care. National accreditation standards are pushing survivorship care plans, while evidence supporting specific methods of delivery and outcomes are lacking. The University of Kansas Breast Cancer Survivorship Center opened in 2007 as a continuity of care, post-treatment survivorship clinic. We report prospective findings from a group of BrCa survivors from 2007-2013. Methods: Four hundred twenty-four BrCa survivors consented to an IRB approved, longitudinal survivorship registry. Baseline variables on demographics, disease history, summary of cancer treatment, late effects, medications and health status were collected. Follow-up data collection included disease status or new primary cancer, patient’s health status and late/long-term effects. Comparisons from baseline to subsequent visits provided information on changes in key variables over time. Results: Participants were ~57 years old, primarily Caucasian, attended at least some college, made >$40K per year, and 49% were premenopausal at diagnosis. Forty-five women reported having another malignancy and 10 were diagnosed with either a recurrence or a second primary breast cancer while followed in the survivorship center. Significant self-reported symptoms included menopausal symptoms: hot flashes (n=164), vaginal dryness (n=211) and a lack of sexual activity (195). 95% were seen for >1 post-baseline visit. Menopausal symptom interventions, lifestyle recommendations (weight loss and increasing physical activity), referrals to specialists (77% referred for colonoscopy completed colon ca screening; 92% referred attending cardio-oncology screening visit; 100% referred completed a bone mineral density analysis), and lymphedema education and management increased significantly. Conclusions: Multidisciplinary care facilitated through a continuity of care survivorship clinic improves compliance with recommended follow-up and cancer screening, however additional research on the cost and impact of delivering survivorship care is needed to evaluate sustainability and long-term patient outcomes.


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