Structure of a physician assistant (PA)-managed survivorship practice within a multidisciplinary breast clinic

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 6087-6087
Author(s):  
B. A. Moore ◽  
D. W. Northfelt
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Well Being ◽  
Standards Of Care ◽  
Team Approach ◽  
Breast Clinic ◽  
Early Detection Of Disease ◽  
Medical Needs

6087 Background: In the last two decades, success in breast cancer screening and treatment has resulted in evolution of a growing patient population with unique medical needs. The American Cancer Society currently estimates a 98% relative five-year survival rate for patients with localized breast cancer, 88% for all stages combined. Caring for survivors represents both opportunity and challenge for the medical community. The integrated team approach in a multidisciplinary breast center is the ideal model to incorporate PAs in providing comprehensive long-term surveillance and support in this setting. Methods: The core mission of a PA-managed survivorship practice is outlined as follows: Maximize health and quality of life in breast cancer survivors, recognizing physical, psychological and spiritual factors; Provide early detection of disease recurrence and/or new breast cancer occurrence in women with a breast cancer history; Aggressively manage and overcome problems resulting from breast cancer treatment; Aid women in understanding and overcoming risks, including genetic risks, for developing breast cancer. Evidenced-based algorithms defining standards of care create the foundation for clinical decision making and establish precedent for continuity of care. The scope of care is enhanced by opportunities to incorporate research and genetic counseling. Results: Of 205 patients seen between 9/1 and 12/31/2005, 48% were younger than 70, 55% were Stage I, 82% were less than 5 years post-treatment, 63% were on hormone therapy. Conclusions: With continued trends in breast cancer survival, specialized long-term surveillance and support is essential to providing quality, comprehensive care that addresses the unique medical needs of these patients. A PA-managed breast cancer survivorship practice within a multidisciplinary breast clinic not only provides forum for such endeavors, but also fosters opportunity for life-long partnership focusing on quality of life, health and well-being. [Table: see text] No significant financial relationships to disclose.

scholarly journals Longitudinal Evolution of Cognitive Function in Colorectal and Breast Cancer Survivors Treated with (Neo)Adjuvant Chemotherapy.

2021 ◽  
Author(s):  
Ana Callejo ◽  
Patricia Iranzo ◽  
Laura Otal ◽  
Paloma Gotor ◽  
Lola Berbiela ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Cognitive Function ◽  
Visual Memory ◽  
Breast Cancer Survivors ◽  
Well Being ◽  
Term Survival ◽  
Neo Adjuvant Chemotherapy

Abstract Introduction & objectives: Advances in early diagnosis and treatment are improving the long-term survival of patients with cancer. Cancer-related cognitive impairment (CRCI) is often reported as a long-term chemotherapy sequel. Improving the knowledge of CRCI may help to prevent, manage and identify risk factors. Our main goal is to assess the cognitive function evolution and determine the potential influence of chemotherapy in neurological decline. Material and methods We designed a prospective and longitudinal study of a colorectal and breast cancer patient cohort (n=62) and we assessed cognitive function evolution using a battery of 11 neuropsychological tests at three time points: baseline, post chemotherapy and 6 months after finishing chemotherapy. Sociodemographic features, quality of life, anxiety and depression status were recorded as well as their interplay with cognitive evolution. Results At baseline, 14.5% of the patients had cognitive dysfunction. Older age, low level of education, colorectal cancer and comorbidities were associated to initial cognitive damage. A total of 61.9% of patients presented a decline of scores in 4 or more tests from baseline to post chemotherapy assessment. This percentage decreased to 24.4% in the late follow up evaluation, showing an intra-patient recovery after chemotherapy. Verbal and visual memory is the domain most affected. Conclusion Our data suggest that cognitive function of cancer patients treated with chemotherapy may subtly but transiently decline during treatment, with most patients recovering their cognitive function over time. Further research is needed in this field as CRCI continues to impact on quality of life and mental well-being.

scholarly journals Physical activity and body weight of breast cancer survivors – VICAN national survey

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
D Rey ◽  
R Touzani ◽  
A Monet ◽  
M K Bendiane ◽  
A D Bouhnik ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Healthy Lifestyle ◽  
Well Being ◽  
Healthy Habits ◽  
Mental Well Being

Abstract Background Cancer recurrence and poor quality of life are major challenges of the growing population of breast cancer (BC) survivors. International guidelines encourage survivors to engage in regular physical activity (PA) and to maintain a healthy body weight (BW), as both have a proven benefit on survival. Our aims were (1) to describe PA and BW 5 years after a BC diagnosis and (2) to define the predictors of long-term engagement in healthy lifestyle, in a representative sample of French survivors. Methods The French National VICAN surveys were implemented in 2012 and 2015 among cancer survivors. This analysis focused on 723 women with BC, without progression at 5 years, and who participated in both surveys. The questionnaires dealt with several topics including socioeconomic status, treatments and side effects, psychometric scales and lifestyle habits. Results Five years after diagnosis, 26% of women reported regular PA, 61% occasional PA and 14% no PA. Moreover, 27% reported a weight gain ≥5kg, and 10% a weight loss ≥5kg. Half of the women had decreased or stopped PA since diagnosis. In logistic regression, long-term regular PA was associated with better mental quality of life (aOR=1.04; 1.01-1.07), no depression (aOR=3.42; 1.21-9.65), higher Post Traumatic Growth Inventory score (aOR=1.02; 1.01-1.04), normal arm mobility (aOR=3.7; 1.6-8.4) and healthy and stable BW since diagnosis (aOR=4.47; 1.61-12.37). Weight gain ≥5kg was associated with younger age (aOR=0.96; 0.93-0.99), higher BW at diagnosis (aOR=1.02; 1.01-1.04), and lymphedema 5 years after diagnosis (aOR=1.69; 1.02-2.83). Conclusions For BC survivors, mental well-being is essential for successful long-term investment in healthy habits. More psychological and dietary support, and a better management of sequelae are needed in this population. Key messages For breast cancer survivors, mental well-being is essential for successful long-term investment in healthy habits. More psychological and dietary support, and better sequelae management are needed to help breast cancer survivors to persist in healthy lifestyle.

Quality of life among breast cancer survivors treated with breast-conserving therapy in Hawaii.

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 154-154
Author(s):  
Francisco A. Conde ◽  
Andrea R. Wilburn
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Side Effects ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Well Being ◽  
Breast Conserving Therapy ◽  
Long Term Survivors

154 Background: Aim of this study was to compare quality of life (QOL), treatment-related side effects, and needs of recent and long-term breast cancer survivors following breast-conserving therapy. Methods: Surveys were sent to 750 women with Tis, T1 – T4 breast tumors without lymph node involvement who received lumpectomy followed by radiotherapy at a large, tertiary care facility in Hawai‘i from January 2001 to December 2010. To assure adequate representation across years, 75 women were randomly selected from each year. Surveys included demographic items, City of Hope Quality of Life – Breast Cancer Instrument, and Breast Cancer Prevention Trial Symptom Scales. Completed surveys were received from 265 (35.3%) women, and findings were analyzed for long-term survivors (diagnosed from 2001-2003, n=76), mid-range survivors (diagnosed from 2004-2007, n=95), and recent survivors (diagnosed from 2008-2010, n=94). Results: Overall, respondents reported high QOL. Similarly to recent breast cancer survivors, long-term survivors reported slight to moderate side effects, including hot flashes, vaginal problems, musculoskeletal pain, and cognitive dysfunction. After controlling for age, ethnicity, and cancer stage, there was no significant differences in QOL physical, psychological, and social well-being subscale scores across time periods. Long-term survivors were more likely than shorter-term survivors to want information regarding nutrition (p<.01), physical activity (p=.018), and ways to restore strength, mobility, and cognition (p<.01). Conclusions: Breast cancer survivors treated with breast conserving therapy report relatively good QOL between 2 and 12 years post-treatment, although they continued to experience physiological issues (which could be exacerbated by age), and anxieties about their cancer. Healthcare professionals should continually assess for ongoing cancer-related side effects even years after completing treatment. Funding: This research was supported by ‘Imi Hale Native Hawaian Cancer Network (U54 CA153459).

scholarly journals The impact of lymphedema on health-related quality of life up to 10 years after breast cancer treatment

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Mads G. Jørgensen ◽  
Navid M. Toyserkani ◽  
Frederik G. Hansen ◽  
Anette Bygum ◽  
Jens A. Sørensen
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Cancer Treatment ◽  
Breast Cancer Treatment ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
The Impact

AbstractThe impact of breast cancer-related lymphedema (BCRL) on long-term quality of life is unknown. The aim of this study was to investigate the impact of BCRL on health-related quality of life (HRQoL) up to 10 years after breast cancer treatment. This regional population-based study enrolled patients treated for breast cancer with axillary lymph node dissection between January 1st 2007 and December 31th 2017. Follow up and assessments of the included patients were conducted between January 2019 and May 2020. The study outcome was HRQoL, evaluated with the Lymphedema Functioning, Disability and Health Questionnaire, the Disabilities of the Arm, Shoulder and Hand Questionnaire and the Short Form (36) Health Survey Questionnaire. Multivariate linear logistic regression models adjusted for confounders provided mean score differences (MDs) with 95% confidence intervals in each HRQoL scale and item. This study enrolled 244 patients with BCRL and 823 patients without BCRL. Patients with BCRL had significantly poorer HRQoL than patients without BCRL in 16 out of 18 HRQoL subscales, for example, in physical function (MDs 27, 95%CI: 24; 30), mental health (MDs 24, 95%CI: 21; 27) and social role functioning (MDs 20, 95%CI: 17; 23). Age, BMI, BCRL severity, hand and dominant arm affection had only minor impact on HRQoL (MDs < 5), suggesting a high degree of inter-individual variation in coping with lymphedema. This study showed that BCRL is associated with long-term impairments in HRQoL, especially affecting the physical and psychosocial domains. Surprisingly, BCRL diagnosis rather than clinical severity drove the largest impairments in HRQoL.

Quality of life in long-term childhood cancer survivors and the relation of late effects and subjective well-being

2004 ◽  
Vol 13 (1) ◽  
pp. 49-56 ◽  
Author(s):  
Sigrid Pemberger ◽  
Reinhold Jagsch ◽  
Eva Frey ◽  
Rosemarie Felder-Puig ◽  
Helmut Gadner ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cancer Survivors ◽  
Childhood Cancer ◽  
Late Effects ◽  
Well Being ◽  
Childhood Cancer Survivors ◽  
Subjective Well Being

scholarly journals END-OF-LIFE CARE PREFERENCES AND WELL-BEING IN LONG-TERM CARE RESIDENTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S669-S669
Author(s):  
Kelly Shryock ◽  
Jacinta Dickens ◽  
Anisha Thomas ◽  
Suzanne Meeks
Keyword(s):  
Quality Of Life ◽  
Positive Affect ◽  
End Of Life ◽  
End Of Life Care ◽  
Long Term Care ◽  
Well Being ◽  
Life Care ◽  
Term Care

Abstract Research on end-of-life care in nursing homes comes largely from the viewpoint of staff or family members. We examined patient perspectives on end-of-life care, preferences for care, and quality of life in long-term care settings. We hypothesized that fulfillment of the Self Determination Theory (SDT) needs of autonomy, competence, and relatedness would be related to better well-being and that the degree to which end-of-life care preferences are seen as possible in the setting would be related to SDT need fulfillment and well-being. Preliminary data, collected from older individuals at the end of life (over 55, presence of significant chronic disease, in long term care setting) (n= 72), demonstrated that autonomy, competence, and relatedness measures were moderately and significantly correlated with well-being as measured by life satisfaction, higher positive affect, lower negative affect, and overall quality of life measures The degree to which residents believed that their end-of-life care preferences could be honored in the setting was also significantly correlated with autonomy, competence, relatedness, positive affect, and psychological quality of life. These results are consistent with SDT and suggest that if long term care settings can promote autonomy, connection, and competence in making end of life decisions, possibly by discovering and fulfilling preferences for end of life care, individuals who end their lives on those settings have potential for greater satisfaction and happiness. These results suggest that SDT is a useful framework for ongoing research on how to improve the end of life experiences of older adults in long term care.

scholarly journals Symptom Experience and Quality of Life of Patients with Breast Cancer Receiving Chemotherapy in Bangladesh

2016 ◽  
Vol 15 (2) ◽  
pp. 201-206
Author(s):  
Mosammat Shamsun Naher Begum ◽  
Wongchan Petpichetchian ◽  
Luppana Kitrungrote
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Medical Science ◽  
Well Being ◽  
Significant Negative Correlation ◽  
Moderate Level ◽  
Self Report ◽  
Symptom Experience ◽  
Breast Cancer Patients

Background: The present study was aimed to the relationships between symptom severity and distress and quality of life (QoL) of patients receiving chemotherapy for breast cancer.Objectives and methodology: A total number of 132 patients, attending both In-patient and Out-patient department and fulfilling the recruitment criteria were included in the study. A self-report questionnaire was used to collect data from the eligible participants by the primary investigator. The data were analyzed by using descriptive and inferential statistical tools. Results: On average, the participants of the study experienced seventeen symptoms with moderate level. The level of QoL of the participants was at moderate level (M=2.02, SD=0.39). Among all the subscales, the physical well-being had the lowest score and social well-being had highest score. Symptom experience and quality of life showed significant negative correlation. Conclusion: The patients with breast cancer would experience high symptoms during a 7-day period after receiving chemotherapy of the previous cycle. Nurses need to perform full measurement of multiple symptoms when care for breast cancer patients after the administration of chemotherapy.Bangladesh Journal of Medical Science Vol.15(2) 2016 p.201-206

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