Management of Cancer and Health After the Clinic Visit: A Call to Action for Self-Management in Cancer Care

Abstract

Individuals with cancer and their families assume responsibility for management of cancer as an acute and chronic disease. Yet, cancer lags other chronic diseases in its provision of proactive self-management support (SMS) in routine ‘everyday’ care leaving this population vulnerable to worse health status, long-term disability and poorer survival. Enabling cancer patients to manage the medical, emotional consequences, and lifestyle/work changes due to cancer and treatment is essential to optimizing health and recovery across the continuum of cancer. In this paper, the Global Partners on Self-Management in Cancer (GPS) puts forth six priority areas for action. Action 1: Prepare patients/survivors for active involvement in care. Action 2: Shift the care culture to support patients as partners in co-creating health and embed self-management support in everyday health care provider practices and in care pathways. Action 3: Prepare the workforce in the knowledge and skills necessary to enable patients in effective self-management and reach consensus on core curricula. Action 4: Establish and reach consensus on a patient reported outcome system for measuring the effects of self-management support and performance accountability. Action 5: Advance the evidence and stimulate research on self-management and self-management support in cancer populations. Action 6: Expand reach and access to self-management support programs across care sectors and tailored to diversity of need, and stimulation of research to advance knowledge. It’s time for a revolution to better integrate self-management support as part of high quality, person-centered support and precision medicine in cancer care to optimize health outcomes, accelerate recovery and possibly improve survival.

Experiences of people affected by cancer during the outbreak of the COVID-19 pandemic: an exploratory qualitative analysis of public online forums

“…In addition and related to the limited access to the healthcare system, an important number of threads corresponded to people suspecting symptoms related to cancer, who sought advice or similar experiences from their peers. We believe that the themes identified in this paper can be used by clinicians when they assess patients' fears and concerns and provide education and self-management support [38].…”

Rationale and Design of a Telehealth Self-Management, Shared Care Intervention for Post-treatment Survivors of Lung and Colorectal Cancer

“…Ongoing relationships with the healthcare system are needed to manage posttreatment care and require long-term planning rather than acute, prescriptive relationships [29]. Being adequately prepared for post-treatment self-management can empower cancer survivors and improve their confidence in managing their overall healthcare [49,50]. For cancer survivors, selfmanagement skills building should include coaching patients on signs and symptoms of recurrence, cancer prevention, posttreatment symptoms, and comorbidities [36].…”

“…In addition to addressing survivor needs, self-management skills building is a key component of personalized cancer follow-up care [49]. In the UK and Australia, where survivorship care is a national initiative, preliminary evidence points to self-management skills training as the driving factor for personalized follow-up based on risk [55].…”

The Generalization of Conscious Attentional Avoidance in Response to Threat Among Breast Cancer Women With Persistent Distress

“…Future studies and interventions could provide AB modification through promoting active goal-oriented attention search ( Mogg and Bradley, 2016 ; Lam et al, 2018 ) to focus individuals’ attentional resources on the threat itself for threat habituation, or challenge pre-existing dysfunctional schema through information disconfirmatory processes to reduce threat salience, or modify threat appraisal through enhancing cancer patients’ coping self-efficacy, all of which perhaps promote the use of active coping approach for better distress management. For example, provision of self-management support (SMS), which has been recently listed as a priority area for action in cancer care, including interventions to boost patients’ self-efficacy and improve coping capacity, perhaps enables them in effective self-management and optimizes health outcomes ( Howell et al, 2020 ). However, in practice, it remains challenging to ensure healthcare professionals actually offer such support.…”