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Cancer Survivorship Overview

Cancer Survivorship Overview. Objectives. The learner will be able to: Identify the challenges related to survivorship care. Discuss the nursing roles related to caring for cancer survivors in various healthcare settings. US Cancer Survivor Estimates: Site.

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Cancer Survivorship Overview

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  1. Cancer Survivorship Overview

  2. Objectives The learner will be able to: • Identify the challenges related to survivorship care. • Discuss the nursing roles related to caring for cancer survivors in various healthcare settings.

  3. US Cancer Survivor Estimates: Site Data source: Ries LAG, Melbert D, Krapcho M, Mariotto A, Miller BA, Feuer EJ, Clegg L, Horner MJ, Howlader N, Eisner MP, Reichman M, Edwards BK (eds). SEER Cancer Statistics Review, 1975-2004, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2004/, based on November 2006 SEER data submission, posted to the SEER web site, 2007.

  4. US Cancer Survivor Estimates: Age Data source: Ries LAG, Melbert D, Krapcho M, Mariotto A, Miller BA, Feuer EJ, Clegg L, Horner MJ, Howlader N, Eisner MP, Reichman M, Edwards BK (eds). SEER Cancer Statistics Review, 1975-2004, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2004/, based on November 2006 SEER data submission, posted to the SEER web site, 2007.

  5. Survivorship Defined • Ideal • Individuals who are 5 or more years beyond diagnosis • Anyone who has been diagnosed with cancer through the balance of his or her life (NCCS) • Including friends, family members and caregivers • Pragmatic • Period in which patients treated with curative intent have completed their initial therapy and require follow-up care • Period until recurrence, second cancer, or death and may include some ongoing treatment, such as hormonal therapy

  6. Current Focus on Survivorship • Rapidly growing population of survivors due to advances in diagnosis and treatment • Greater emphasis on patient-centered issues by the medical community- quantity AND quantity of life • Increasing expectations by patients for good quality of life • Rapid increase in the number of elderly Americans • Cancer as a chronic disease • Economy - individuals working longer • Health care reform • Reassessment of our care delivery models in general • Focus on cost as it relates to quality

  7. Affordable Health Care Act • Accountable Care Organizations • The ability to provide, and manage with patients, the continuum of care across different institutional settings, including at least ambulatory and inpatient hospital care and possibly post acute care; • The capability of prospectively planning budgets and resource needs; and • Sufficient size to support comprehensive, valid, and reliable performance measurement.

  8. The Future of Nursing Report • Remove scope of practice barriers • Expand opportunities for nurses to lead and diffuse collaborative improvement efforts • Prepare and enable nurses to lead change to advance health • Full partners with physicians in redesigning health care

  9. Cancer and its TreatmentDomains of Concern Related to Survivorship • Physical/medical • Organ toxicity and second cancers • Psychological • Fear of recurrence, anxiety and depression • Social • Changes in relationships, economic and education issues • Existential and spiritual • Loss or deepened meaning in life • Informational • Need for ongoing, comprehensive information

  10. The Cancer Control Continuum Source: From Cancer Patient to Cancer Survivor: Lost in Transition; page 24, Box 2-2.

  11. Institute of Medicine Report • Establish survivorship as a distinct phase of care • Implement survivorship care plans • Build bridges between oncology and primary care • Develop and test models of care • Develop and evaluate clinical practice guidelines • Institute quality of survivorship measures • Strengthen professional education • Expand use of psychosocial and community support services • Invest in survivorship research Executive Summary From Cancer Patient to Cancer Survivor: Lost in Transition. Washington, D.C.: The National Academies Press; 2006.

  12. Listening to Survivors • 53% reported secondary health problems • Chronic pain • Sexual dysfunction • Relationship difficulties • Fertility issues • Fear of recurrence • Depression • Financial & job related concerns • 49% reported • Non-medical cancer related needs not met Wolff SN, Hichols C, Ulman D, et al. Survivorship: an unmet need of the patient with cancer – implications of a Survey of the Lance Armstrong Foundation (LAF) [abstract]. Proc Am Soc Clin Oncolo 2005; 23(suppl):6032.

  13. Nurses and Survivorship Nursing Roles Survivorship Care Clinical care Education Counseling Advocacy • Care provider • Educator • Counselor • Advocate

  14. Nursing Roles in Survivorship • Care provider • Educator • Counselor • Advocate

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