Rehab a.o'rourke


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Rehab a.o'rourke

  1. 1. Cancer Survivorship:Cancer Survivorship: A New BeginningA New Beginning Arlene O’Rourke APRN
  2. 2. Core Components of aCore Components of a Survivorship Care PlanSurvivorship Care Plan • Treatment Summary • Follow-up Plan of Care
  3. 3. Treatment SummaryTreatment Summary • Demographics/Contact information Care providers, treatment location, contact information of facility • Disease specifics Diagnosis, Pathology, Stage of disease
  4. 4. Treatment SummaryTreatment Summary • Treatment specifics • Surgery: date, procedure, persistent and/or possible late effects • Chemotherapy/biotherapy: dates, regimen, clinical trials, agents, doses, supportive care, persistent or possible late effects • Hormonal therapy: dates, agents, doses, persistent and possible late effects • Radiation: dates, sites, type, dose, persistent or possible late effects • Symptoms to report
  5. 5. Follow-Up Care PlanFollow-Up Care Plan • Cancer surveillance visit and test schedule • Acute/long term toxicity/expected course of recovery • Actual and potential late effects and screening recommendations • Subspecialty referrals including psychosocial • General health promotion • Cancer related resources
  6. 6. GuidelinesGuidelines • • NCCN- f.guidelines.asp • • Journey Forward-
  7. 7. The Survivorship VisitThe Survivorship Visit • Comprehensive-medical/surgical/family history, psychosocial status, ROS, PE, current health behaviors • Evaluate • Educate • Intervene for potential and actual late effects, disease prevention and health promotion
  8. 8. Models of CareModels of Care • Shared Model • Risk Based follow-up • Disease specific clinics • Institution-based programs
  9. 9. Barriers to Survivorship CareBarriers to Survivorship Care • Finances • Educated and dedicated personnel • Lack of acceptance and/or integration with disease- based or general oncology programs or practice • Space • Complexity of survivorship care • Lack of clear, evidenced-based guidelines on proper management • Limited knowledge of evolving management of co- morbidities
  10. 10. Issues to ConsiderIssues to Consider • The ideal model for survivorship care does not exist at this time • Models may be different in academic medical centers where care is often diseased-based and community cancer programs where 80-85% of patients receive care • Care plans must eliminate redundant and unnecessary care • Must assure excellent cancer follow up care and general primary care- outcome improvement
  11. 11. Why Cancer Survivor Clinics?Why Cancer Survivor Clinics? • Increasing numbers of cancer survivors • Complex care required by cancer survivors • The need for the oncology community to educate patients and providers about survivorship issues to adequately transition cancer survivors back to their PCPs • Supply and demand
  12. 12. Future DirectionsFuture Directions • Improve the quality of life for patients and their families with a diagnosis of cancer • Develop community based interdisciplinary cancer survivorship program to support and care for the patient and family. • Alleviate the burden of cancer care in long-term survivors to reflect the decreasing supply of oncologists and primary care providers • Perform research that demonstrates improvement in outcomes associated with cancer survivorship clinic care