Cancer survivorship in the primary care setting: A new medical school elective.

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 15-15 ◽  
Author(s):  
Miklos C. Fogarasi ◽  
Gerald R Berg ◽  
Roy P Eichengreen
Keyword(s):  
Small Group ◽  
Cancer Survivorship ◽  
Concept Maps ◽  
Role Playing ◽  
Course Evaluation ◽  
Professional Staff ◽  
Care Plan ◽  
Biomedical Science ◽  
Survivorship Care Plan ◽  
Group Setting

15 Background: Responding to calls for education in Cancer Survivorship, the Frank H. Netter MD School of Medicine introduced new content using an interactive student elective for Y2 medical students with the goal of improving medical knowledge and confidence in caring for survivors. Methods: Learning objectives and course content were developed based upon the ASCO curriculum (ASCO Core Curriculum for Cancer Survivorship Education Shapiro, CL et al, Journal of Oncology Practice Feb 2016 Vol. 12 (2) p 145-e117). Seven medical and one biomedical science student enrolled to complete the Sep-Dec 2016 course. Weekly sessions, facilitated by an Oncologist, utilize independent and collaborative learning, small group role playing, concept maps, algorithms and multiple case scenarios to identify and analyze key issues of survivorship. Co-facilitators with varied expertise and cancer survivors are invited weekly. Successful completion requires active participation, reading and discussion of required articles, contributing to a Glossary, and constructing a Survivorship Care Plan after independently interviewing a cancer survivor. A pre/post course questionnaire and reflective writing is used to assess change in knowledge and attitudes. Results: Weekly attendance was excellent, and students remained highly engaged. Sessions involving a geneticist, social worker, hospice nurse or APRN were well received. Students built a Glossary of cancer-terms, and practiced “Skills of the Week”. Pass/fail data and questionnaire data are pending, as the course is ongoing. Conclusions: Teaching cancer survivorship is feasible for Y2 students. Motivation and interest in the topic is high for this self-selected course. Based upon early observations and feedback the small group setting is valuable for interactions with survivors and inter-professional staff. Students recognize complex social factors influencing survivors’ care and combine knowledge from prior molecular biology, genetics, and physiology classes with the humanistic aspects of patient-centered care. If course evaluation data confirms its value, this curriculum may serve as one element of a multi-level graduate/post-graduate curriculum in Survivorship education.

Growing a cancer survivorship care plan program.

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 58-58
Author(s):  
Claire Michelle Sutherby (Bennett)
Keyword(s):  
Cancer Survivors ◽  
Cancer Survivorship ◽  
The United States ◽  
Primary Treatment ◽  
Care Plan ◽  
Survivorship Care Plan ◽  
Close Monitoring ◽  
Survivorship Care ◽  
Oncology Nurse ◽  
Nurse Navigator

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.

Partnership in Cancer Survivorship Optimization (PICASSO) project: An Indian Cancer Society (ICS) initiative for cancer survivorship program in India.

2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 46-46
Author(s):  
Purna Arun Kurkure ◽  
Vandana Salil Dhamankar ◽  
Shreya Joshi ◽  
Shekhar Jha ◽  
Sheila Nair ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Cancer Survivorship ◽  
Role Model ◽  
Technical Assistance ◽  
Career Guidance ◽  
Psychosocial Support ◽  
Care Plan ◽  
Holistic Care ◽  
Survivorship Care Plan ◽  
Cancer Society

46 Background: Ugam is a support group of childhood cancer survivors from After Completion of Treatment (ACT) clinic at Tata Memorial Hospital (TMH), functioning under umbrella of Indian Cancer Society (ICS), not for profit organisation. Ugam’s mission is empowerment of survivors and advocacy. ACT-Ugam has provided role model for holistic care to cancer survivors.Project PICASSO (Partnership in Cancer Survivorship Optimization) is developed by ICS to promote & facilitate paediatric cancer unit (PCU) based ACT clinic & provide psychosocial support for holistic care of cancer survivors across the country. Methods: A survey was conducted for identifying the survivorship practices in pediatric cancer units (PCU) in Mumbai based hospitals to identify the partners who will setup PCU based ACT clinic. ICS will provide professional and technical assistance to ACT Clinic survivors to enable them to live a productive life. This will include identifying survivor’s need, psycho social counseling, career counseling / aptitude tests, registering them as Ugam members, funding for education if required, soft skills development programme for job readiness, facilitating job placements, survivorship care plan & information material. Ugam database was reviewed for its experience in the field so far to extrapolate the services to partner institutes under PICASSO. Results: Project PICASSO was launched by ICS in May 2016. Among five Mumbai based PCUs who participated in survey, only one (TMH) has organized survivorship program. Communication is ongoing for launch of the project with other units. Total Ugam members- 280 ( 2009 to date), male:female 195:85. Career guidance and aptitude testing provided to > 50 survivors, job placements 9, educational & vocational scholarships through ICS and by referring to other sources > 100. International scholarships to present at conferences: 5. Conclusions: Existing model of Ugam is marching towards fulfillment of its mission of empowerment and advocacy. Expansion of Ugam activities to include more survivors from other partnering units will lead to development of a national care model for cancer survivors.

Improving patient participation in a breast cancer survivorship program at a safety net hospital.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 60-60
Author(s):  
Shakuntala Shrestha ◽  
Pam Khosla ◽  
Janos Molnar ◽  
Maria Eugenia Corona ◽  
Sofia M Garcia
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Cancer Survivorship ◽  
Breast Cancer Survivors ◽  
Safety Net ◽  
Care Plan ◽  
Survivorship Care Plan ◽  
Survivorship Care ◽  
Breast Cancer Survivorship ◽  
Safety Net Hospital

60 Background: To provide comprehensive services and meet Commission on Cancer (CoC) accreditation requirements, we developed and evaluated a customized breast cancer SCP template and delivery model. Objective: To implement and pilot test survivorship care plan (SCP) delivery for breast cancer survivors. Methods: Clinicians at a safety net hospital partnered with investigators at an academic institution to start a breast cancer survivorship care program. We developed an SCP template that is CoC-complaint and responsive to input gathered in 2 focus groups with breast cancer survivors (n = 12) and interviews with staff (n = 8). Oncologists and nurses identified and referred English-speaking women who had completed breast cancer treatment. Participants completed baseline measures prior to receiving individualized SCPs in a survivorship consultation visit with a dedicated APN. In response to high no-show rates, we expanded clinic scheduling to harmonize with participants' other medical appointments. Interim feasibility results for our ongoing study are presented here. Results: A total of 154 patients were screened to reach target enrollment (n= 80) within 20 months. Participant median age was 60 ± 11; 71% were African American, 14% Hispanic; 11% Non-Hispanic White and 92% had household incomes < $20,000. Average times were: 30 ± 13.4 minutes for abstracting patient clinical information in preparation for the survivorship visit; 25 ± 16 minutes for completing individual SCPs; 22±7.65 minutes to review / deliver the SCPs with patients. The difference in no-show rate between first 3-month recruitment period (clinic limited to one day/week) and next 17 months (clinic appointment expanded to accommodate patients' schedule) was statistically significant, p = 0.028. Conclusions: Tailoring SCP templates and delivery models to the needs of a safety net hospital aided the sustainability of a new survivorship clinic. Patient non-adherence to scheduled visits was significantly improved by expanding clinic hours. Significant clinician time was spent preparing SCPs and a level 4 visit (25 minutes) does not adequately reflect this effort. This study is funded by the American Cancer Society, Illinois Division (Grant# 254698).

Integrating cancer survivorship care into allogeneic BMT recovery.

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 39-39 ◽  
Author(s):  
Kelly Bugos ◽  
Sarah Stenger ◽  
Andrea Segura Smith ◽  
Laura Johnston ◽  
Morgan Gross ◽  
...  
Keyword(s):  
Cancer Survivorship ◽  
Late Effects ◽  
Cellular Therapy ◽  
Recovery Period ◽  
Symptom Assessment ◽  
Care Plan ◽  
Survivorship Care Plan ◽  
Survivorship Care ◽  
Long Term Effects ◽  
Post Transplant

39 Background: AlloBMT patients are at risk for chronic morbidity and late effects. Prior to 2015, the Stanford BMT program conducted group classes at three months post-transplant to prepare alloBMT patients and their families for the transition to survivorship, but no formal cancer survivorship program existed. Cancer survivorship care is required by the Foundation for the Accreditation of Cellular Therapy ( FACT). In order to fill this gap, we developed a standardized pathway to survivorship care for alloBMT survivors. Aim: To implement an initial cancer survivorship care consultation with comprehensive symptom assessment, late effects monitoring, and development of a survivorship care plan (SCP) three to six months after alloBMT. Methods: Standard work was implemented including patient introduction to survivorship by the BMT nurses and Advanced Practice Providers [APP] and during group ‘moving home’ class; responsibility for referral to survivorship; metric tracking, and administration of patient survey. The survivorship visit included an evaluation by the patient’s BMT social worker, introduction to post-BMT nurse coordinator and consult with cancer survivorship APP. Eligible patients were alloBMT recipients receiving care in the outpatient setting. Results: From July 28, 2015 to January 25, 2016, 90% (66/72) of eligible alloBMT patients were referred to cancer survivorship by day 100, 66% (42/66) of referred patient s were seen in survivorship clinic by day 180, 33% (22/66) deferred the visit or were unreachable, 1% (2/66) died. Of the 42 patients who received a cancer survivorship visit, 38% (13/42) responded to a post-visit survey. Responses indicated the patients believed their health goals and needs were addressed, and a SCP in the context of a comprehensive visit was valuable. Conclusions: Integrating standardized cancer survivorship care into the alloBMT recovery period is feasible, satisfactory to patients, and adds a structured approach for long-term effects monitoring and treatment. Early experience and patient surveys demonstrate value in an individual visits 3-6 months after alloBMT with a focus on returning to life and goal oriented post-transplant care.

Serial concept mapping: A tool to assess the evolution of medical student learning about cancer survivorship.

2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 21-21
Author(s):  
Miklos C. Fogarasi ◽  
Roy P Eichengreen
Keyword(s):  
Primary Care ◽  
Critical Thinking ◽  
Concept Mapping ◽  
Primary Care Physician ◽  
Cancer Survivorship ◽  
Health Care Professionals ◽  
Care Physician ◽  
Care Plan ◽  
Survivorship Care Plan ◽  
Wide Range

21 Background: Concept mapping (CM) fosters meaningful learning yet its use in cancer education is rare. Serial CM as a learning tool may offer novel ways to promote critical thinking about complex medical issues. We introduced CM in our Cancer Survivorship (CS) elective to study the evolution of students’ conceptual learning, to offer feed-back and as a tool for inter-professional and team-based education. Methods: The study was funded by an institutional grant and received IRB exemption. Eleven 2nd year medical students and 2 pre-med students enrolled. Oncologist-lead classes were co-facilitated by a primary care physician, a survivor, caregivers or other health care professionals. Students were trained using cMAPTools on week 1 and applied domains of the Quality of Life (QoL)-CS tool by City of Hope to their CMs. Feedback given after each round of mapping assessed adequate use of CS concepts and creation of meaningful linkages. Results: Map #1 (week 1) tested baseline perceptions. These maps displayed a wide-range of complexity, a largely non-hierarchical structure with rare connections and a sense of overload by the scope of CS issues. Map #2 (week 4) explored physical and spiritual challenges of CS from a primary care physician and a cancer survivor. Here improved maps presented concepts more clearly but linear thinking with limited crosslinks was still observed. Map #3 (week 8) about social aspects of CS followed lively sessions with a social worker and family caregivers. Emerging cross-links reflected a deeper understanding of survivor issues. Final CMs will be based on interviewing a panel of survivors and should aid students in creating a thorough Survivorship Care Plan. Team-based and inter-professional maps were well received. Conclusions: Serial concept mapping exposes progressive understanding of Survivorship issues during a one-semester elective. CM facilitates the learning of relationships among complex survivorship topics. Inter-professional and team-based CM is feasible. By mapping issues to QoL domains, students practice patient-centered critical thinking. Challenges include low reproducibility due to changing concepts, and limited practicality once concepts grow too large.

Perceived value of cancer survivorship care among Asians and Native Hawaiian/Pacific Islanders.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e22522-e22522
Author(s):  
Jared David Acoba ◽  
Sharon Tamashiro ◽  
Marci Chock
Keyword(s):  
Cancer Survivors ◽  
Racial Differences ◽  
Cancer Survivorship ◽  
Native Hawaiian ◽  
Care Plan ◽  
Survivorship Care Plan ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Care Plans

e22522 Background: Numerous studies have evaluated the impact of cancer survivorship care. However, no study to date has focused on Asian or Native Hawaiian/Pacific Islander (NH/PI) cancer survivors. It has been well documented that Asian and NH/PI patients often suffer from inferior cancer outcomes compared to White patients, and differences in their experience with cancer survivorship care could contribute to this disparity. Methods: Surveys were sent to 1410 cancer survivors who were treated at a community cancer center with curative intent and who had received survivorship care plans between Jan 2014 and June 2018. The 26-item questionnaire evaluated patients’ perception of various aspects of their survivorship care plan and follow-up physician visits. All responses were anonymous. Results: Of the 360 patients who responded, 24% were White, 54% Asian, and 13% NH/PI. Compared to Whites, Asian and NH/PI patients were younger (p = 0.004), less educated (p = 0.004), and reported a lower income (p < 0.0005). Among all patients, 62% reported that the survivorship care plan was “very helpful” and 86% rated their satisfaction with physician follow-up visits as “very good” to “excellent.” There were no racial differences in satisfaction with either survivorship care plan or physician follow-up. In a multivariate binary logistic regression, Asians and NH/PI patients were significantly more likely to rate ongoing survivorship care as helpful compared to Whites, OR 4.08 (95%CI, 2.13-7.82). Conclusions: There were no racial differences in patient satisfaction with their survivorship care plans and follow-up care. However, Asian and NH/PI patients valued ongoing cancer survivorship care follow-up significantly more than White patients. Whether more extensive survivorship care would lead to improved outcomes among Asian and NH/PI cancer patients should be investigated further.

Oncology providers’ evaluation of the use of an automatically generated cancer survivorship care plan: longitudinal results from the ROGY Care trial

2013 ◽  
Vol 8 (2) ◽  
pp. 248-259 ◽  
Author(s):  
Kim A. H. Nicolaije ◽  
Nicole P. M. Ezendam ◽  
M. Caroline Vos ◽  
Johanna M. A. Pijnenborg ◽  
Lonneke V. van de Poll-Franse ◽  
...  
Keyword(s):  
Cancer Survivorship ◽  
Care Plan ◽  
Survivorship Care Plan ◽  
Survivorship Care ◽  
Oncology Providers
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