Perceptions and Barriers of Survivorship Care in Asia: Perceptions From Asian Breast Cancer Survivors

Abstract

PurposeWith the long-term goal to optimize post-treatment cancer care in Asia, we conducted a qualitative study to gather in-depth descriptions from multiethnic Asian breast cancer survivors on their perceptions and experiences of cancer survivorship and their perceived barriers to post-treatment follow-up.MethodsTwenty-four breast cancer survivors in Singapore participated in six structured focus group discussions. The focus group discussions were voice recorded, transcribed verbatim, and analyzed by thematic analysis.ResultsBreast cancer survivors were unfamiliar with and disliked the term “survivorship,” because it implies that survivors had undergone hardship during their treatment. Cognitive impairment and peripheral neuropathy were physical symptoms that bothered survivors the most, and many indicated that they experienced emotional distress during survivorship, for which they turned to religion and peers as coping strategies. Survivors indicated lack of consultation time and fear of unplanned hospitalization as main barriers to optimal survivorship care. Furthermore, survivors indicated that they preferred receipt of survivorship care at the specialty cancer center.ConclusionBudding survivorship programs in Asia must take survivor perspectives into consideration to ensure that survivorship care is fully optimized within the community.

Practitioners’ perspectives on community-based breast cancer survivorship care in Singapore: A focus group study

“…Community practitioners perceived that BCSs lacked confidence in community‐based care to manage cancer survivorship issues. This finding was consistent with results of a recent focus group study conducted by our research group involving 24 BCSs in Singapore (Chan et al., ). In that study, BCSs shared that they were not confident in follow‐up cancer care with GPs.…”

“…However, over‐reliant on treatment protocols may potentially lead to negligent of patients’ preferences. For example, cancer survivors may prefer undergoing alternative therapies to manage post‐chemotherapy‐associated symptoms (Chan et al., ), which may not be routinely recommended in the treatment protocols. To ensure that patients are agreeable and compliant to prescribed treatment, community practitioners should allow catering personalised therapies to survivors that are beyond treatment protocols.…”

“…For example, cancer survivors may prefer undergoing alternative therapies to manage post-chemotherapy-associated symptoms (Chan et al, 2016), which may not be routinely recommended in the treatment protocols. Breast cancer survivors with active chronic comorbidities (e.g.…”

“…However, a community‐based survivorship care model is also challenged by GPs’ lack of specialised experience in cancer care (Dawes et al., ; Dulko et al., ; Neuman et al., ; Virgo, Lerro, Klabunde, Earle, & Ganz, ) and their lack of time to counsel patients about survivorship issues (Dulko et al., ; Neuman et al., ). In Singapore, cancer survivors have expressed concerns that GPs may not be adequately trained to handle the complexity of their conditions (Chan et al., ).…”

Optimizing Survivorship Care Services for Asian Adolescent and Young Adult Cancer Survivors: A Qualitative Study

“…[18][19][20] However, the current provision of survivorship care services remained inconsistent and unorganized in the Asia-Pacific region, including high-resource countries like Singapore where services are segregated by cancer types without age specificity. [21][22][23][24][25] As AYA cancer survivors experience a higher psychosocial distress and morbidity burden compared with their cancer-free peers, this segregation would result in services that do not comprehensively and adequately address the unique age-related challenges AYA face. 26 Thus, a change is needed for better management of AYA survivors' needs to improve their quality of life.…”