Impact of Survivorship-Based Research on Defining Clinical Care Guidelines

Hudson, Melissa M.; Landier, Wendy; Ganz, Patricia A.

doi:10.1158/1055-9965.epi-11-0642

Cited by 30 publications

(31 citation statements)

References 47 publications

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“…Other factors include the number of survivors necessary to be screened for a given duration to prevent one adverse event, the potential harms and benefits of screening to individuals, inventions available and the potential reduction in morbidity and mortality associated with early detection of the health condition. 45, 46 Recommendations for screening for subsequent CNS tumors by neuro-imaging will need to take into account or comment upon optimal intervals for screening neuro-imaging, costs of neuro-imaging and whether earlier detection of the subsequent neoplasm makes an impact upon effectiveness of treatment upon morbidity or mortality. For example, the outcome of patients with high-grade gliomas, including subsequent high-grade gliomas, is very poor.…”

Section: Discussionmentioning

confidence: 99%

Subsequent neoplasms of the CNS among survivors of childhood cancer: a systematic review

Bowers

Nathan

Constine

et al. 2013

The Lancet Oncology

101

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Childhood cancer survivors are at risk for development of subsequent neoplasms of the central nervous system (CNS). Better understanding of the rates, risk factors for and outcomes of subsequent neoplasms of the CNS among survivors of childhood cancer may lead to the development of more informed screening guidelines. Two independent investigators independently performed a systematic search of studies from the MEDLINE and EMBASE databases (1966 – 2012) for studies examining subsequent neoplasms of the CNS among childhood cancer survivors. Articles were selected to answer 3 questions: What is the risk of CNS tumors following radiation to the cranium for a pediatric cancer as compared with the general population? What are the outcomes in children with subsequent neoplasms of the CNS who have been treated with CNS directed radiation for a pediatric cancer? Are outcomes of subsequent neoplasms different from primary neoplasms of the same histology? Our search identified 72 reports, of which 18 publications were included in this review. These studies reported that childhood cancer survivors have an 8.1 – 52.3 times higher incidence of subsequent CNS neoplasms compared with the general population. Nearly all cancer survivors who developed a CNS neoplasm had been exposed to cranial radiation; some studies demonstrate a correlation between radiation dose and risk of subsequent CNS tumors. Five year survival rates for subsequent high-grade gliomas and meningiomas range from 0 – 19.5% and 73 – 100%, respectively, which are similar to those observed in patients with primary gliomas or meningiomas. The quality of evidence was limited by variation in study design, heterogeneity of details regarding treatment and outcomes, limited follow-up and relatively small sample sizes. We concluded that survivors of childhood cancer who were treated with cranial radiation therapy have an elevated risk for subsequent CNS neoplasms. The current literature is insufficient to comment about the potential harms and benefits of routine screening for subsequent CNS neoplasms.

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Section: Discussionmentioning

confidence: 99%

Subsequent neoplasms of the CNS among survivors of childhood cancer: a systematic review

Bowers

Nathan

Constine

et al. 2013

The Lancet Oncology

101

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“…63 A new cancer diagnosis often interrupts existing chronic disease management because patients undergo intensive oncology care for extended periods of time during which attention to other conditions may wane. 64 Further, cancer patients often continue to be followed by oncologists after completion of initial treatment 65–68 with little or no care coordination with PCPs. Thus,care is fragmented 69 and providers siloed, 70–72 resulting in suboptimal care quality.…”

Section: Implications For Clinical Carementioning

confidence: 99%

Achieving Coordinated Care for Patients With Complex Cases of Cancer: A Multiteam System Approach

Lee

Clark

Cox

et al. 2016

JOP

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Cancer patients with multiple chronic conditions pose a unique challenge to how primary care and specialty care teams provide well-coordinated, patient-centered care. Effectiveness of these care teams in providing optimal healthcare depends on the extent to which they coordinate their goals and knowledge as components of a multi-team system (MTS). This paper outlines challenges of care coordination in the context of an MTS, illustrated through the care experience of Mr. Fuentes, a patient in Dallas County’s integrated safety-net system, Parkland. As a continuing patient with chronic illnesses, Mr. Fuentes is managed through one of Parkland’s community-oriented primary care clinics. However, a cancer diagnosis triggered additional needs for augmented coordination between his different provider teams. Further research and practice should investigate the relationships of MTS coordination for shared care management, transfer to and from specialty care, treatment compliance, barriers to care, and health outcomes of chronic co-morbid conditions, as well as cancer control and surveillance.

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“…Access and adherence to breast cancer follow-up care recommendations are particularly critical for Latinas who are likely to be diagnosed at a younger age, at advanced stages, have larger tumors and lower 5-year survival rates [6–8], and present with endocrine distinct breast cancer subtypes (estrogen- or progesterone-) [9–11]. Unfortunately, Latina women diagnosed with breast cancer commonly experience delays in diagnostic and therapeutic care [12–14], are less likely to receive recommended posttreatment cancer follow-up care [7, 12, 14–17], and have inadequate knowledge of and access to cancer follow-up care [14, 18]. Thus, they warrant closer medical monitoring and management due to their increased risk of recurrence, new cancers, and subsequent chronic conditions.…”

Section: Introductionmentioning

confidence: 99%

Quality of cancer follow-up care: a focus on Latina breast cancer survivors

2014

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Introduction Receiving quality cancer follow-up care influences survivorship outcomes. Among Latinas, breast cancer is the number one cause of cancer death; yet Latinas do not receive adequate follow-up care. This study examined quality of cancer follow-up care among Latina breast cancer survivors (BCS) and whether it differs by participant language and healthcare system variables (provider specialty, and medical setting). Methods Two hundred thirty-two (95 English-speaking Latina and 137 Spanish-speaking) Latina BCS were recruited from the California Cancer Registry, hospital cancer registries, and community agencies. Results English-speaking Latina BCS were more likely to report receiving cancer follow-up care at a doctor’s office (p<0.001). BCS without a regular place for cancer follow-up care were more likely to report not seeing a primary care provider (p<0.05) or cancer specialist (p<0.001) in the past 12 months. English-speaking Latina BCS (p<0.001), BCS who saw a cancer specialist in the past 12 months (p<0.001), and received follow-up care at a doctor’s office (p<0.05) reported higher quality of care. Speaking English, having seen a cancer specialist, and receiving follow-up care at a doctor’s office were independently associated with higher quality of care, explaining 44 % of the variance. Conclusions Our study findings suggest that examining the influence of ethnic and linguistic factors on quality of cancer follow-up care is necessary to address health disparities. Improved access to cancer follow-up care for Spanish-speaking Latina BCS is of particular concern. Implication of Cancer Survivors Identifying follow-up care needs of Latina BCS may contribute to providing high-quality care and improved survivorship outcomes.

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Impact of Survivorship-Based Research on Defining Clinical Care Guidelines

Cited by 30 publications

References 47 publications

Subsequent neoplasms of the CNS among survivors of childhood cancer: a systematic review

Subsequent neoplasms of the CNS among survivors of childhood cancer: a systematic review

Achieving Coordinated Care for Patients With Complex Cases of Cancer: A Multiteam System Approach

Quality of cancer follow-up care: a focus on Latina breast cancer survivors

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