Continuity of care of colorectal cancer survivors at the end of treatment: the oncology–primary care interface

Abstract

Most CRC survivors are satisfied when their primary care provider becomes responsible for follow-up care. However, this is less true for those who are having more challenges in recovery. These survivors should ensure that information transfer and support services are identified that will smooth this transition.

Cancer survivorship: Advancing the concept in the context of colorectal cancer

“…Survivors' may find themselves in a position where they are no longer able to engage in the work or activities they enjoyed prior to diagnosis due to the physical consequences of CRC (Anderson et al, 2013;Domati et al, 2011;Gordon et al, 2008;Grant et al, 2011;Hanly et al, 2013;McCaughan et al, 2012;Sisler et al, 2012;Thong et al, 2011a;Tofthagen, 2010). The precarious nature of employment caused survivors financial distress, in turn contributing to poorer psychological well-being (Baravelli et al, 2009;Gordon et al, 2008;Grant et al, 2011;Lundy et al, 2009).…”

“…The multitude of healthcare providers, variance in models of care provision, and fragmentation of healthcare meant this could be a protracted and complex experience (Baravelli et al, 2009;Gordon et al, 2012;Haggstrom et al, 2009;Sisler et al, 2012;Snyder et al, 2008a, b). Survivors may attend multiple physicians for followup care, including a medical oncologist, a radiation oncologist, a surgeon, a gastroenterologist and a primary care practitioner, each with different objectives for survivorship care (Baravelli et al, 2009;Haggstrom et al, 2009).…”

“…Like other tumour groups, CRC survivors may experience pain, sleep disturbance and fatigue (Anderson et al, 2013;Domati et al, 2011;Grant et al, 2011;Grimmett et al, 2011;Jansen et al, 2011;McCaughan et al, 2012;Peddle et al, 2008a;Phipps et al, 2008;Schneider et al, 2007;Shun et al, 2011;Sisler et al, 2012;Stein et al, 2009;Thong et al, 2011bThong et al, , 2013. However, side-effects particular to CRC survivors include weight changes; sexual dysfunction (erectile problems, vaginal dryness, dyspareunia), upper gastrointestinal disturbances (food intolerance, nausea, vomiting, loss of appetite), and bowel dysfunction (constipation, diarrhoea, abdominal cramping, flatulence, incontinence, urgency, frequency) (Anderson et al, 2013;Bailey et al, 2015;Caravati-Jouvenceaux et al, 2011;Den Oudsten et al, 2012;Di Fabio et al, 2008;Ellis et al, 2010;Grant et al, 2011;Grimmett et al., 2011;Jansen et al, 2011;Lynch et al, 2008b;McMullen et al, 2008;Milbury et al, 2013;Nikoletti et al, 2008;Phipps et al, 2008;Ramirez et al, 2009;Ristvedt and Trinkaus, 2009;Sanoff et al, 2015;Schneider et al, 2007;Serpentini et al, 2011;Sisler et al, 2012;Thong et al, 2011aThong et al, , 2011b…”

“…Survivors face new challenges specific to the nature of their disease, encompassing bowel management, ostomy care, health promotion, diet and lifestyle advice, requiring significant practical and psychological support to facilitate adjustment (Anderson et al, 2013;Haggstrom et al, 2009;Ho et al, 2015;McGowan et al, 2013;McMullen et al, 2008;Nikoletti et al, 2008;Pullar et al, 2012). Other unmet information and healthcare needs were similar to those of survivors of other forms of cancer, and included information about diagnosis, investigations, treatments, prognosis, medication management, surveillance, follow-up care, genetic risk, management of chronic side-effects, return to work, financial concerns and who to contact should cancer-related problems arise (Bains et al, 2012;Baravelli et al, 2009;Esplen et al, 2007;Faul et al, 2012;Nikoletti et al, 2008;Sisler et al, 2012;Tofthagen, 2010;Vadaparampil et al, 2010). CRC survivors may feel that information and support needs are not adequately met by HCP's due to reduced contact with healthcare staff following treatment Haggstrom et al, 2009;McCaughan et al, 2012;Palmer et al, 2013;Phipps et al, 2008;Sisler et al, 2012;Tofthagen, 2010).…”

The Experiences of Cancer Survivors While Transitioning from Tertiary to Primary Care

“…There have been calls by leaders in survivorship research to address the paucity of evidence about patient-centred transitions in survivorship care, but large gaps in the literature remain 23,24 . Previous studies [24][25][26][27][28][29] have explored the experiences of survivors with pcp-delivered survivorship care, but none have examined the transition to the pcp. It is imperative to address that knowledge gap because it is well recognized that transitions in care for cancer survivors often have negative implications 1 .…”