scholarly journals Development, Implementation, and Patient Perspectives of the Women’s Integrative Sexual Health Program: A Program Designed to Address the Sexual Side Effects of Cancer Treatment

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Lori A. Seaborne, MPAS, PA-C ◽  
Megan Peterson, DNP ◽  
David M. Kuschner, MD ◽  
Janelle Sobecki, MD, MA ◽  
Joanne K. Rash, MPAS, PA-C
Keyword(s):  
Side Effects ◽  
Sexual Health ◽  
Cancer Treatment ◽  
Patient Perspectives ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Survivorship Care ◽  
Cancer Treatments ◽  
Sexual Side Effects ◽  
After Cancer

Background: Advanced practitioners (APs) are a growing demographic in survivorship care. One goal of survivorship care is to manage consequences of cancer treatments. Sexual dysfunction from prior therapies can impact quality of life. Advanced practitioners are perfectly poised to provide care for sexual problems. This article will describe the development and implementation of the Women’s Integrative Sexual Health (WISH) program by APs within a comprehensive cancer center and describe patient perspectives of care provided. Methods: Two physician assistants working in gynecologic oncology at the University of Wisconsin Carbone Cancer Center implemented a program to address sexual side effects of cancer treatment. An online survey was sent out to all patients seen in the WISH program since inception. Results: Between November 2013 and July 2019, 228 patients were seen in the WISH program. A total of 113 women responded (median age: 53 years, range: 31–77; 68% postmenopausal; response rate: 53.8%). Most had breast (57%) or gynecologic (32%) cancers. When asked how helpful the WISH program was, 88% reported that it was at least somewhat helpful. Almost all (95%) reported they would recommend the WISH program to other women. Conclusion: The WISH program enhances comprehensive survivorship care of female cancer survivors. Women report they benefit from care for sexual issues after cancer treatments. Advanced practitioners working in oncology are uniquely positioned to educate themselves, take leadership roles in the development and implementation of programs, and provide care to women affected by sexual side effects after cancer.

scholarly journals Gaps and delays in survivorship care in the return-to-work pathway for survivors of breast cancer—a qualitative study

2019 ◽  
Vol 26 (3) ◽  
Author(s):  
K. Bilodeau ◽  
D. Tremblay ◽  
M.J. Durand
Keyword(s):  
Breast Cancer ◽  
Side Effects ◽  
Return To Work ◽  
Clinical Pathways ◽  
Care Plan ◽  
Survivorship Care Plan ◽  
Survivorship Care ◽  
Cancer Treatments ◽  
Need Support ◽  
After Cancer

Introduction The number of survivors of breast cancer (bca) in Canada has steadily increased thanks to major advances in cancer care. But the resulting clientele face new challenges related to survivorship. The lack of continuity of care and the side effects of treatment affect the resumption of active life by survivors of bca, including return to work (rtw). The goal of the present article was to outline gaps and delay in survivorship care in the rtw pathway of survivors of bca.Methods This qualitative interpretative descriptive study recruited 9 survivors of bca in the province of Quebec. Interviews were conducted at the end of cancer treatments (n = 9), 1 month before rtw (n = 9), and after rtw (n = 5). In an iterative process, a content analysis was performed.Results The interviews highlighted gaps in survivorship care and the paucity of dedicated resources for cancer survivors. Participants received neither a survivorship care plan nor information about cancer survivorship (for example, transition to a new normal, side effects, rtw).Conclusions Support for survivors of bca resuming their active lives has to be optimized. We suggest that health professionals have to intervene at 1, 3, and 6 months after cancer treatment. At those points, survivors of bca need support for side-effects management, the rtw decision, resource navigation, and reintegration of daily activities. Also, delay in clinical pathways seems to be longer, and much attention is needed to accompany the transition to a “normal life” after cancer.

Psychological Treatment of Individual Sexual Dysfunction

2020 ◽  
pp. 115-138
Author(s):  
Daniela Wittmann
Keyword(s):  
Side Effects ◽  
Cancer Treatment ◽  
Intimate Relationships ◽  
Psychological Treatment ◽  
Sexual Relationships ◽  
Sexual Side Effects ◽  
After Cancer ◽  
Biopsychosocial Assessment ◽  
Physical Changes ◽  
Biomedical Interventions

Cancer patients struggle with sexual problems after cancer treatment. They often discover the sexual side effects after treatment and must learn how to manage their bodies, which now function differently, and work to continue to be sexually active with their partners. Recovering confidence in their ability to function in their sexual relationships means that they must grieve for their sexual losses, understand their new sensitivities, manage altered body capacities, and develop an expanded sexual repertoire. In their relationships, they must learn to communicate about their needs. If they are single, anxiety about starting a new relationship must be managed through the development of confidence that they can still be good lovers despite their altered sexual function. A thorough biopsychosocial assessment helps identify physical changes, psychological vulnerabilities, and relationship areas that will have to be addressed to maintain sexual viability and satisfaction. Psychosocial as well as biomedical interventions are needed in guiding patients toward recovering an ability to function well sexually. Reliance on multiple relevant disciplines and addressing couple issues can lead to patients’ renewed confidence and satisfactory functioning in their intimate relationships after cancer treatment.

scholarly journals Long-Term Survivorship Care After Cancer Treatment: A New Emphasis on the Role of Rehabilitation Services

2018 ◽  
Vol 99 (1) ◽  
pp. 10-13 ◽  
Author(s):  
Nicole L Stout ◽  
Julie K Silver ◽  
Catherine M Alfano ◽  
Kirsten K Ness ◽  
Laura S Gilchrist
Keyword(s):  
Cancer Treatment ◽  
Rehabilitation Services ◽  
Survivorship Care ◽  
After Cancer

Livelihood vs. Life: The Occupational Well-Being of Women Musician Survivors of Breast Cancer

2012 ◽  
Vol 27 (1) ◽  
pp. 15-20 ◽  
Author(s):  
Sarah Schmalenberger ◽  
Charles E Gessert ◽  
Jean E Giebenhain ◽  
Lisa D Starr
Keyword(s):  
Breast Cancer ◽  
Side Effects ◽  
Cancer Treatment ◽  
Body Movement ◽  
Well Being ◽  
Physical Symptoms ◽  
Breast Cancer Treatment ◽  
Upper Body ◽  
Long Term Effects ◽  
Cancer Treatments

The Life and Livelihood Study was designed to describe and understand the experience of women musicians treated for breast cancer. This report focuses on Phase I of the study, a web-based survey that examined subjects’ physical symptoms and side effects following breast cancer treatment. Subjects were recruited nationally, using advertisements in musicians’ publications and presentations at national meetings. Subjects were asked about specific side effects or symptoms they had experienced, their severity and duration, and the effects of symptoms on their capacity to make music. Subjects were also asked what aspect of their breast cancer treatment they associated with each symptom and were invited to provide comments. A total of 321 individuals logged on: 100 met all inclusion criteria. Of these, 90 completed the entire survey. Commonly reported symptoms included fatigue (70%), problems with cognition (53%), limitations in upper body movement (51%), and pain (45%). Many reported that their symptoms were of moderate or greater intensity, and that they persisted for >12 months or were ongoing. The survey documented that many subjects experienced diminished capacity to function as musicians, especially due to pain, limitations in upper body and extremity movement, numbness in the chest and/or arms, contracture/fibrosis, and shortness of breath. These findings are consistent with emerging studies that describe long-term effects of breast cancer treatments. In planning for breast cancer treatment, rehabilitation and survivorship, consideration should be given to how treatment is likely to affect fitness for ongoing professional work.

Follow-Up after Cancer Treatment—Evidence Gaps and Trends in Survivorship Care

2021 ◽  
pp. 105-117
Author(s):  
Beverley Lim Høeg ◽  
Pernille Envold Bidstrup ◽  
Susanne Oksbjerg Dalton ◽  
Lena Saltbæk
Keyword(s):  
Cancer Treatment ◽  
Survivorship Care ◽  
After Cancer

scholarly journals Complementary and Alternative Medicine Use at a Comprehensive Cancer Center

2016 ◽  
Vol 16 (1) ◽  
pp. 104-109 ◽  
Author(s):  
Qianlai Luo ◽  
Gary N. Asher
Keyword(s):  
Alternative Medicine ◽  
Cancer Patients ◽  
Cancer Diagnosis ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Medicine Use ◽  
Energy Medicine ◽  
Cam Use ◽  
After Cancer ◽  
Oncology Providers

Background. Complementary and alternative medicine (CAM) use is common among cancer patients, but the majority of CAM studies do not specify the time periods in relation to cancer diagnoses. We sought to define CAM use by cancer patients and investigate factors that might influence changes in CAM use in relation to cancer diagnoses. Methods. We conducted a cross-sectional survey of adults diagnosed with breast, prostate, lung, or colorectal cancer between 2010 and 2012 at the Lineberger Comprehensive Cancer Center. Questionnaires were sent to 1794 patients. Phone calls were made to nonrespondents. Log binomial/Poisson regressions were used to investigate the association between cancer-related changes in CAM use and conversations about CAM use with oncology providers. Results. We received 603 (33.6 %) completed questionnaires. The mean age (SD) was 64 (11) years; 62% were female; 79% were white; and 98% were non-Hispanic. Respondents reported the following cancer types: breast (47%), prostate (27%), colorectal (14%), lung (11%). Eighty-nine percent reported lifetime CAM use. Eighty-five percent reported CAM use during or after initial cancer treatment, with category-specific use as follows: mind-body medicine 39%, dietary supplements 73%, body-based therapies 30%, and energy medicine 49%. During treatment CAM use decreased for all categories except energy medicine. After treatment CAM use returned to pretreatment levels for most CAMs except chiropractic. Initiation of CAM use after cancer diagnosis was positively associated with a patient having a conversation about CAM use with their oncology provider, mainly driven by patient-initiated conversations. Conclusions. Consistent with previous studies, CAM use was common among our study population. Conversations about CAM use with oncology providers appeared to influence cessation of mind-body medicine use after cancer diagnosis.

Using practice algorithms to deliver cancer survivorship care.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e19625-e19625
Author(s):  
Guadalupe R. Palos ◽  
Fran Zandstra ◽  
Ludivine Russell ◽  
Jacklyn J Flores ◽  
Yvette DeJesus ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Cancer Survivors ◽  
Psychosocial Functioning ◽  
Phase 1 ◽  
Comprehensive Cancer Center ◽  
Cancer Site ◽  
Cancer Center ◽  
Survivorship Care ◽  
Disease Specific

e19625 Background: Clinical practice algorithms provide a framework to guide providers’ practice in delivering care to long-term cancer survivors. Here we describe how algorithms were developed in a comprehensive cancer center and types of metrics used to evaluate their feasibility. Methods: Survivorship practice algorithms were based on a multidisciplinary care approach successfully used to build screening and treatment algorithms. This model consisted of four phases: development, adoption, implementation, and evaluation of algorithms. Phase 1, expert clinicians and researchers identified and agreed upon a specific cancer site. Group-consensus and literature reviews/syntheses were used to determine eligibility criteria to transition patients to survivorship care. Phase 2, reviews and approval processes were conducted by credentialing and regulatory committees to ensure adoption of the algorithms into clinical practice. Phase 3, pilot programs were conducted to implement the algorithm(s) in disease-specific survivorship clinics. Phase 4, metrics to evaluate progress included the number of algorithms and providers’ use of and adherence to the algorithms. Results: Between 09/2008 – 12/2011, nine multidisciplinary disease-specific survivorship clinics were operationalized. Thirty-seven practice algorithms were developed to provide survivorship care based on each survivor’s specific needs. The algorithms’ framework included: 1) surveillance for recurrent or new primary malignancies; 2) primary and secondary cancer prevention recommendations; 3) management of toxicities and latent treatment effects; and 4) assessment of psychosocial functioning. Conclusions: Practice algorithms provide an organized plan to deliver comprehensive and holistic care to long-term survivors. Given the projected increase in cancer survivors, further research is needed to determine how practice algorithms impact providers’ practice and survivors’ outcomes.

Long-term cancer survivorship care: On the radar screen?

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e20567-e20567
Author(s):  
Rutika Mehta ◽  
Rohit Jain ◽  
Lori Rhodes ◽  
Joseph Abraham ◽  
Kenneth David Miller
Keyword(s):  
Cancer Survivors ◽  
Cancer Treatment ◽  
Breast Cancer Survivors ◽  
Demographic Data ◽  
Cancer Center ◽  
Specific Information ◽  
Survivorship Care ◽  
Coordination Of Care ◽  
Long Term Effects

e20567 Background: Long-term cancer survivors require comprehensive care. The purpose of this study was to describe how survivorship care fits into oncologists’ clinical time, and characterize long-term cancer survivors’ problems and oncology follow-up care. Methods: We abstracted 18,882 medical records of unique cancer patient visits during 2010 at a major NCI-designated cancer center and then evaluated survivor care for one week in April, 2010 to characterize how oncologists spend their clinical time. Finally, we selected three subgroups from the survivor population (n≈100 each) of survivors at 1-5 years, 6-10 years, and >10 years after diagnosis. We collected demographic data, purpose of visit, cancer-specific information, late and long-term effects, and type of care delivered, including surveillance for recurrence, intervention, prevention, and coordination of care. Results: In the larger group of 18,882, only 14% of survivors were more than 10 years post-diagnosis. Approximately two-thirds of the survivors were women. Breast cancer survivors comprised 38%, and survivors of hematologic malignancies accounted for 21% of the population. During the one week studied, the majority of oncologists' patients (74%) were actively receiving treatment; only 5% of their patients were 5 or more years post-diagnosis. Second or secondary malignancies were noted in 8% of patients. Late and long-term effects were uncommon. Approximately 25% of survivors beyond five years were observed to have late effects due to cancer treatment, most common being fatigue, neurological endocrine, and cardiac. Of the 300 selected survivors, sixty-two percent received only surveillance care during their visit. Only 3% of these patients received an entire array of survivorship care that included surveillance, intervention, co-ordination and prevention. Conclusions: A small proportion of oncologists’ visits were with long-term cancer survivors (5-14%) of whom only 25% had late or long-term effects of cancer treatment so overall very few of office visits were with long-term survivors who had late and long-term complications. All visits involved surveillance for cancer recurrence but there was little focus on prevention, intervention, and coordination of care for cancer survivors.

Analysis of financial sustainability of survivorship clinics led by advanced practice providers.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 11560-11560
Author(s):  
Maria Alma Rodriguez ◽  
Guadalupe R. Palos ◽  
Katherine Ramsey Gilmore ◽  
Paula A. Lewis-Patterson ◽  
Patricia Chapman ◽  
...  
Keyword(s):  
Physician Assistants ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Advanced Practice ◽  
Survivorship Care ◽  
Manage Care ◽  
Recovery Percentage ◽  
Long Term Survivors ◽  
Delivery Models

11560 Background: Disease specific Survivorship Care Clinics (SCs) have been established within a comprehensive cancer center. Clinics are staffed by Advanced Practice Providers (APPs), Physician Assistants and Advanced Practice Registered Nurses, with experience in the management of each disease type. To determine the sustainability of this model of survivorship care, we analyzed the professional fees’ revenue generated by APPs’ billings for 6 clinics and then compared the APPs’ salaries across all clinics. Methods: A retrospective analysis was conducted of 6 survivorship clinic’s patient volumes and clinic days supported by APPs from 9/1/16-4/30/17. The full FTE salary of the APPs, including benefits were prorated to the time dedicated to each of the SCs. Institutional financial data was used to align professional fees to actual reimbursements received. Salary recovery percentage was calculated as the ratio of reimbursement received to prorated FTE salary. Results: Table shows variation in APPs’ salary commensurate to FTE proportion. Results also indicate there was an average of 99% professional fee recovery. Clinics with an FTE proportion > 0.5 had recovery higher than the anticipated prorated salary, suggesting there is a threshold to maximize efficacy and sustainability. Conclusions: APPs professional fees for care provided to cancer survivors are reimbursable, across disease types or payers, and proportionally supports their salaries. Our findings suggest delivery models based on APPs to manage care of long-term survivors can be self-supporting.[Table: see text]

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