Cancer Survivorship - A Case Study - Balancing Curative Care with Quality of Life

2. Case Study
Screening
Diagnosis
Treatment
Survivorship

3. Diagnosis
•Stage IIIA ER+ HER2- Cancer of the Left Breast
Screening
Diagnosis
Treatment
Survivorship

4. Treatment
•Left mastectomy with bilateral DIEP reconstruction
•Right prophylactic mastectomy and left axillary node dissection
•Chemotherapy  Taxol/Carbo
•Antihormonal Therapy  5 years
Screening
Diagnosis
Treatment
Survivorship

5. 12 months later…
•Range of motion complications <30%
•Chronic discomfort 54%
•Infertility <50%
•Cardiovascular disease <30%
•Lymphedema 15-20%
•Chronic fatigue 99%
•Anxiety & depression >70%
•Financial burden 43%
Screening
Diagnosis
Treatment
Survivorship

6. Distress Screening
•If additional information was obtained…
•Marital status
•Employment history
•Personal history
•Family history
Screening
Diagnosis
Treatment
Survivorship

7. Survivorship Program
Screening
Diagnosis
Treatment
Survivorship
•Distress Screening
•Multidisciplinary Team
•Transitions consult
•Surveillance

8. Key Players
Genetic
Counseling •Family history
Rehab •Rotator cuff issues
Medical
Oncology
•Neoadjuvant
chemotherapy
Plastic
Surgery
•Staged
reconstruction
Fertility •Family planning
Cardiology •Vessel salvage

9. Elements of Success
•Maintained range of motion
•Fertility preserved
•Successful CABG
•Improved fatigue
•No radiation effects
•No chronic pain
•Ability to work
•Survivor mentor
Screening
Diagnosis
Treatment
Survivorship

10. Multidisciplinary Team
Communication is key!

11. Transitions Consult
•Education
•Health promotion
•Surveillance
•Care plan & treatment summary
•Support services
Screening
Diagnosis
Treatment
Survivorship

12. 12 months later…
•Anxiety
•Difficulties at work
•Body image
•Sexual dysfunction
•Coping mechanisms
•Fear of recurrence
Screening
Diagnosis
Treatment
Survivorship

13. What can be done?
•Patient education
•Physician communication
•Psychosocial support
•Health promotion

14. THANK YOU