QOL assessment integrated into the clinical care of cancer survivors to identify needs and direct care.

6611 Background: Validated survey tools have been used to measure the quality of life (QOL) of patients treated for cancer, however, there are newer studies that have shown both an improvement in QOL, and improvement in overall survival using these tools. We integrated the Functional Assessment of Cancer Therapy – General Population (FACT-GP v.4) to direct the deployment of resources and interventions to improve the care of patients who have completed potentially curative therapy for cancer. Methods: This is an observational study of patients who received cancer therapy with curative intent in the last 18 months. The FACT-GP was administered by an RN via telephone. Patients contacted received and reviewed a Survivorship Care Plan (SCP) as defined by the American College of Surgeons Committee on Cancer. Patients who had a total score less than 60 on FACT-GP and/or had a score less than 12 on the Emotional Well-Being subscale (EWB) were considered high-risk and were referred to the Survivorship MDC for in-person evaluation. Results: From 10/1/2018 to 12/31/2018, 114 patients were referred to the cancer survivorship program. Of these, 64 (56%) patients had FACT-GP administered and were evaluated. 45 of these (70%) only completed the FACT-GP and received an SCP. 21 patients had a total score less than 60 and/or an EWB sub-score less than 12 and were identified as high-risk. 15 (72%) patients were seen in MDC, 4 (19%) patients were seen in conjunction with a scheduled appointment by the MDC team, 2 (9%) patients refused further evaluation. 66.7% of patients in the survivorship program were referred to Oncology Behavioral Health compared to 18.2% of all oncology patients. Survivorship patients in the cohort had a baseline utilization of the emergency department (ED) of 4.1% (10 of 241) from 1/1/2018 to 9/30/2018 and 0 (0 of 64) after the initiation of the intervention from 10/1/2018 to 12/31/2018. Conclusions: Integrating a validated QOL tool (FACT-GP) as a therapeutic intervention is feasible and may both identify needs and direct services for cancer survivors while possibly decreasing ED utilization. Clinical trial information: NCT03835052.

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The Bon Secours St. Francis Cancer Survivorship Program: A model for community-based multidisciplinary survivorship care.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.3_suppl.45 ◽

2016 ◽

Vol 34 (3_suppl) ◽

pp. 45-45

Author(s):

Kaitlin Bomar ◽

Nicole Vickery ◽

Meagan Duggan ◽

Tina Redenz ◽

Tracey Lukker ◽

...

Keyword(s):

South Carolina ◽

Cancer Survivors ◽

Well Being ◽

Academic Community ◽

Care Plan ◽

Survivorship Care Plan ◽

Cancer Center ◽

Team Approach ◽

Survivorship Care ◽

Community Based

45 Background: In 1974, Giulio D' Angio,MD, stated “Cure Is Not Enough” and the concept of Survivorship was ignited. Multidisciplinary survivorship clinics have since become a mainstay of many pediatric cancer programs; few such clinics exist in adult cancer programs, especially in community practice. We report on the development of a survivorship care plan and a community-based clinic designed to provide guideline-driven after care for cancer survivors. Methods: An overview of the vision and mission of the Bone Secours St. Francis Cancer Center Survivorship Program is provided. Descriptive analysis of the components and metrics of success are provided, in the context of accrediting organizations requirements for current and future goals for survivorship care. Results: BSSF, which is a non-academic, community-based cancer program, and receives over 1300 referrals annually from a referral population of 1.32 million in 10 counties. St. Francis , accredited by both the Commission on Cancer and National Accreditation Program for Breast Centers, has been providing cancer‐related services to the Upstate South Carolina region for a decade. The survivorship program at St. Francis is a STAR‐certified program and is a patient‐centered service provided in a comprehensive and coordinated multidisciplinary team approach, including integrated psychologic care. A custom survivorship care plan was developed and efforts, including successes and barriers, to implementation of plans for all cancer survivors in accordance with CoC and NAPBC goals are addressed. Conclusions: The BSSF Cancer Center Survivorship Program has developed a practical, yet comprehensive SCP, which is risk-adapted and guideline-driven in order to provide customized survivorship education and monitoring. The MDC provides comprehensive evaluations and recommendations in order to maximize health and well-being of patients navigating life after cancer diagnosis and treatment. Our efforts have demonstrated that survivorship clinics of this nature can be established and successful in a non-academic community setting.

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Assessing the impact of an online survivorship program.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.3_suppl.e285 ◽

2016 ◽

Vol 34 (3_suppl) ◽

pp. e285-e285

Author(s):

Helayne Waldman ◽

Shani Fox

Keyword(s):

Cancer Survivors ◽

Support Groups ◽

Well Being ◽

Dietary Guidelines ◽

Care Plan ◽

Survivorship Care Plan ◽

Institute Of Medicine ◽

Plan Implementation ◽

Knowledge And Attitude ◽

The Impact

e285 Background: In the report From Cancer Patient to Cancer Survivor: Lost in Transition (2006), the Institute of Medicine identified follow-up of cancer survivors as a missing link in cancer care and made recommendations to the medical establishment to fill that gap. So far, studies of recommendation effectiveness have revolved around survivorship care plan implementation. However, a 2013 study indicated that use of SCPs is still more the exception than the rule. Methods: We have created a unique online program that is intended to address two key mandates of the IOM report: 1) Educationfor theprevention of recurrent and new cancers, and 2) Self-carestrategiesto help deal with consequences of cancer and its treatment i.e. lymphedema, fatigue; [and] psychological distress. Dr. Helayne Waldman and Dr. Shani Foxhave fashioned an online, real time, 12 week education and support program for cancer survivors, the first of its type in the U.S. The focus of the content is on maintaining wellness after treatment and includes topics such as physical activity, dietary guidelines, inflammation control and stress management. The program also contains a coaching component, where participants track their activities and share information via live discussion and interactive blogs. Results: We have established a framework for gathering, analyzing and reporting our data. Our target sample size is 40-50 participants. At the program’s outset we will administer a 20 question self-assessment to test participants’ knowledge of self-care practices and attitudes about their current state of wellness. At the program’s end in December we'll readminister in order to measure the change in both knowledge and attitude. We’ll then conduct an analysis of the data, and will report our findings at the ASCO meeting in January. Conclusions: We believe that education and support for survivors is critical to their physical and emotional well-being. Unfortunately, there is currently no program available to do this in a live, interactive format from the comfort of one’s home. We believe PCPs, hospital support groups and other non-profits will find this type of program to be an invaluable resource in serving to educate and manage the concerns of cancer survivors and to move closer to realizing the promise of the IOM report.

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Fear of recurrence among cancer survivors.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.10053 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. 10053-10053 ◽

Cited By ~ 2

Author(s):

Rachel B Jimenez ◽

Giselle Katiria Perez ◽

Julia Rabin ◽

Daniel Hall ◽

Katharine Quain ◽

...

Keyword(s):

Cancer Therapy ◽

Cancer Survivors ◽

Emotional Distress ◽

High Risk Patient ◽

Fear Of Recurrence ◽

Fear Of Cancer Recurrence ◽

Care Plan ◽

Survivorship Care Plan ◽

Cancer Type ◽

Care Plans

10053 Background: Fear of cancer recurrence (FoCR) following definitive cancer therapy is often reported by patients, but little is known about who is most likely to be impacted, how FoCR influences emotional distress, and what interventions may mitigate patients’ FoCR. We sought to determine the prevalence of FoCR among cancer survivors and to evaluate potential predictors of FoCR in this population. Methods: As part of a comprehensive supportive care needs assessment, we evaluated the prevalence of FoCR among patients receiving follow-up cancer care at our institution as well as factors associated with FoCR. Elevated FoCR was measured with a single item: “I worry about my cancer coming back” rated on a 4-point Likert scale (1 = “not at all” to 4 = ”very much”); responses of 3 or 4 were considered positive for FoCR. Descriptive statistics were used to characterize patterns of FoCR. Chi-square and Fisher’s exact tests compared differences in emotional, clinical, and demographic characteristics between participants with and without FoCR, as well as interest in and knowledge of survivorship services. Results: Of 636 patients who completed the survey, 318/636 (50.0%) patients had curable cancer and had either completed cancer therapy or were completing maintenance treatment. On inquiry, 167/318 (53%) reported FoCR. Those with FoCR were more likely to be female (p < 0.002) and under the age of 70 (p < 0.003). They were also more likely to be sad (25% vs. 14%, p < 0.015), anxious (40% vs. 21% p < 0.0005), feel uncertain about the future (30% vs. 14%, p < 0.0005), have problems managing stress (26% vs. 13%, p < 0.003), and were more likely to worry about dying (55% vs. 8%, p < 0.0001) and to fear another cancer (74% vs. 8% p < 0.0001). Education level, cancer type, knowledge of and interest in support services, and survivorship care plan receipt were not associated with FoCR. Conclusions: Patient FoCR is prevalent among more than half of survivors of cancer and is associated with emotional distress that is insufficiently addressed by survivor care planning and supportive services. Clinicians can and should screen for and address this issue. Future research is needed to develop and test interventions, beyond care plans, to address FoCR in both low risk and high risk patient populations.

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Survey of cancer survivors' understanding of their cancer care and follow-up plan.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.3_suppl.51 ◽

2016 ◽

Vol 34 (3_suppl) ◽

pp. 51-51

Author(s):

Farhan Shahzad Imran ◽

Caroline Andrews ◽

Kathy Doerner ◽

Brittany Heatherington ◽

Susan Hodes ◽

...

Keyword(s):

Side Effects ◽

Cancer Survivors ◽

Cancer Care ◽

Cancer Recurrence ◽

Cancer Surveillance ◽

Care Plan ◽

Survivorship Care Plan ◽

Curative Intent

51 Background: The follow up care for cancer survivors is often sidelined due to the lack of well-defined guidelines. A “Survivorship care plan (SCP)” has been proposed to summarize key aspects of the cancer care and the future follow-up plan. Cancer survivors who had not received SCP were surveyed to gauge their understanding of their cancer care. Methods: Patients who had completed cancer therapy with curative intent during a 2 year period (2013-2014) were mailed the survey questionnaire. This questionnaire was designed to test understanding of their diagnosis (stage), care team, symptoms of relapse, surveillance plan, and short and long term side effects of their treatment. The Cancer Center’s medical record database was systematically searched to identify subjects. Microsoft Excel was used to calculate descriptive statistics on the quantitative data and frequency counts for the qualitative data. Results: 161 cancer survivors completed the survey of the total 342 mailed. The majority of these patients had breast (92%) cancer. Other cancer survivors had a diagnosis of lung (6%) and colon (2%) cancer. Only 2% patients did not know their cancer diagnosis. 12% patients did not know the stage of their cancer. 98% patients were able to report their surgeons’ name, however 85% and 89% could not recall their medical and radiation oncologist, respectively. 95% patients recalled discussing their follow-up plan with their provider but only 86% patients knew which test(s) should be performed as part of their cancer surveillance. Only 68% patients accurately listed a few symptoms suggesting cancer recurrence, while 62% survivors correctly listed a few potential long term side-effects of cancer treatment. Conclusions: There are several deficiencies in survivors’ understanding of their cancer care. Further research is needed to assess and compare if these deficits can be improved by a SCP document.

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Development and evaluation of a bladder Cancer specific survivorship care plan by patients and clinical care providers: a multi-methods approach

BMC Health Services Research ◽

10.1186/s12913-020-05533-7 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Cheryl T. Lee ◽

Nihal E. Mohamed ◽

Sailaja Pisipati ◽

Qainat N. Shah ◽

Piyush K. Agarwal ◽

...

Keyword(s):

Bladder Cancer ◽

Clinical Care ◽

Care Plan ◽

Survivorship Care Plan ◽

Survivorship Care ◽

Care Providers

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Survivorship care plan preferences of cancer survivors and health care providers: a systematic review and quality appraisal of the evidence

Journal of Cancer Survivorship ◽

10.1007/s11764-015-0452-0 ◽

2015 ◽

Vol 10 (1) ◽

pp. 71-86 ◽

Cited By ~ 39

Author(s):

Dori L. Klemanski ◽

Kristine K. Browning ◽

Jennifer Kue

Keyword(s):

Systematic Review ◽

Health Care ◽

Cancer Survivors ◽

Health Care Providers ◽

Care Plan ◽

Survivorship Care Plan ◽

Survivorship Care ◽

Care Providers ◽

Quality Appraisal

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Colorectal Cancer Survivors' Needs and Preferences for Survivorship Information

Journal of Oncology Practice ◽

10.1200/jop.2013.001312 ◽

2014 ◽

Vol 10 (4) ◽

pp. e277-e282 ◽

Cited By ~ 20

Author(s):

Talya Salz ◽

Shrujal S. Baxi ◽

Victoria S. Blinder ◽

Elena B. Elkin ◽

Margaret M. Kemeny ◽

...

Keyword(s):

Colorectal Cancer ◽

Cancer Survivors ◽

Care Plan ◽

Survivorship Care Plan ◽

Survivorship Care ◽

Cancer History ◽

Colorectal Cancer Survivors

In the absence of a survivorship care plan, colorectal cancer survivors still generally understood their cancer history; however, many lacked knowledge of ongoing risks and prevention.

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