Cancer Survivorship Care Insert Presenter Name Insert Presenter

Cancer Survivorship Care [Insert Presenter Name Insert Presenter Institution]

Objectives • Define survivorship and describe the need for survivorship care • Discuss the Commission on Cancer standards for implementing survivorship care planning • Identify the key components of a cancer survivorship care • List patient and health care professional educational resources

Survivorship • What is survivorship? – NCI definition • Health and life of individual from end of treatment until the end of life • Covers physical, psychosocial and economic issues • Includes access to care and follow-up treatment, late and long-term effects of treatment, second cancers and quality of life • Includes family, friends and caregivers NCI, 2014

The Need for Survivorship Care • Rapidly growing population of survivors • Survivors experience unmet physical, psychosocial, practical and spiritual needs • Inconsistent coordination of care and communication between oncologists and primary care providers • Significant long-term and late effects • Complexity of care, co-morbid conditions

Cancer Survivor Needs Ferrell & Grant, 2004, reproduced with permission in the American Cancer Society’s Cancer Treatment & Survivorship Facts & Figures, 2012

Common Long-Term / Late Effects by Treatment Type Treatment Long-term side effects Late side effects Chemotherapy Fatigue Premature menopause Sexual dysfunction Neuropathy “Chemo brain” Kidney failure Vision/cataracts Infertility Liver problems Lung disease Osteoporosis Reduced lung capacity Second primary cancers Radiation therapy Fatigue Skin sensitivity Lymphedema Cataracts Cavities and tooth decay Cardiovascular disease Hypothyroidism Infertility Lung disease Intestinal problems Second primary cancers Surgery Sexual dysfunction Incontinence Pain Body image disturbance Functional disability Infertility IOM , 2006, Mayoclinic. com

Cancer and Comorbidities Psychosocial Stress (anxiety, depression, insomnia, cognitive deficiency) Heart Disease, Hypertension, Stroke Cancer Arthritis Emphysema, Asthma, COPD Osteoporosis Diabetes Overweight / Obesity Smith et al, 2008.

Psychosocial Late Effects • While only a significant minority of cancer survivors will meet criteria for a mental health disorder, the majority of survivors will experience psychosocial distress at a level that is significant, but does not meet criteria for a psychiatric disorder

Institute of Medicine Report In 2006, the IOM issued a groundbreaking report that described core components of survivorship care and recommended a treatment summary and follow up care plan be given to every cancer patient. Also, the plan should be clearly explained. IOM, 2006.

Co. C Standard 3. 3: Survivorship Care Plan • • Contact info of treating institutions/providers Diagnosis, stage Treatment modality and details Need for adjuvant therapy and details Long-term and late effects Schedule of follow up visits, tests & screening Information on emotional health & physical wellness

Survivorship Care Plans © American Society of Clinical Oncology Used with permission Source: http: //www. cancer. net/survivorship/follow-care-after-cancertreatment/asco-cancer-treatment-and-survivorship-care-plans

Source: LIVESTRONG Foundation: www. LIVESTRONG. org

Basic Elements of Survivorship Care Prevention of cancer and late effects Surveillance for recurrence screening for new cancers Identification of interventions for consequences of cancer and its treatment Coordination between oncology specialists and primary care providers IOM, 2006

Importance of Follow Up Care Prostate Exams Colonoscopy Mammograms Pap smear Skin checks Lung screening (if indicated) • Thyroid exam • • • Lipid checks Blood sugar check Blood pressure Vaccinations Bone density checks • Weight check • Distress screening • • •

LIVESTRONG Essential Elements Source: LIVESTRONG Foundation: www. LIVESTRONG. org

Patient Education Resources

Patient Education Resources

Online Academy Executive Training on Navigation and Survivorship • • Covers the nuts and bolts of navigation and survivorship program development and implementation CE credits for nurses and social workers tinyurl. com/GWOnline. Academy

Cancer Survivorship E-Learning Series

Cancer Survivorship Clinical Practice Guidelines National Comprehensive Cancer Network • By topic: anxiety and depression, cognitive function, exercise, fatigue, immunizations and infections, pain, sexual function (female/male), sleep disorders American Cancer Society Survivorship Care Guidelines for Primary Care Providers American Society of Clinical • By topic: Oncology neuropathy, fatigue, anxiety and depression, fertility preservation • Holistic: Surveillance, screening, long term and late effects, health promotions • Prostate currently available • Breast, Colorectal, Head & Neck to be released in 2015

References • • • Commission on Cancer (Co. C). Accreditation Committee Clarifications for Standard 3. 3 Survivorship Care Plan, 2014. Ferrel B & Grant M. City of Hope, Beckman Research Institute, 2004. GW Cancer Institute. Breast Cancer Survivorship in Washington, DC: A Gap Analysis and Recommendations for Action. Unpublished Report, 2014 a. GW Cancer Institute. Oncology Patient Navigator Core Competencies, 2014 b. Institute of Medicine (IOM). From Cancer Patient to Cancer Survivor: Lost in Transition, 2006. LIVESTRONG Foundation. The Essential Elements of Survivorship Care: A LIVESTRONG Brief, 2011. Mayo Clinic. Cancer Survivors: Late Effects for Cancer Treatment. n. d. http: //www. mayoclinic. org/diseases-conditions/cancer/in-depth/cancersurvivor/art-20045524 National Cancer Institute. Facing Forward: Life After Cancer, 2014. Smith A et al. Cancer, Comorbidities and Health-Related Quality of Life of Older Adults. Health Care Finance Review, 2008.

Questions? [Insert contact information of presenter]