Structuring survivorship care: discipline-specific clinician perspectives

Gage, Elizabeth A.; Pailler, Megan E.; Zevon, Michael A.; Ch’ng, James; Groman, Adrienne; Kelly, Maureen; Panagakis, Christina; Wilding, Gregory E.; Yasko, Joyce M.; Gruber, Marcia

doi:10.1007/s11764-011-0174-x

Cited by 28 publications

(30 citation statements)

References 12 publications

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“…Some researchers have suggested that the response to these varying interpretations is to develop a universally accepted definition of cancer survivorship based on the premise that the lack of a formal definition impacts the point at which patients are offered survivorship-specific care [23]. Our view differs: we feel that service provision should depend upon individual characteristics such as cancer type, stage, treatment, and individual preferences for follow-up and not a specific temporal window.…”

Section: One Proposed Solutionmentioning

confidence: 99%

Defining cancer survivorship: a more transparent approach is needed

2011

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The use of the term 'cancer survivor', its acceptability and its interpretation amongst people living past a cancer diagnosis and primary treatment is relatively understudied. There may be numerous interpretations of cancer survivorship amongst people living past cancer, and some individuals may not relate to the term. DISCUSSION AND IMPLICATIONS FOR CANCER SURVIVORS: Instead of working towards a universal definition of cancer survivorship, we suggest that researchers and policy makers use operational descriptions when discussing the diverse population of people living past a cancer diagnosis.

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Section: One Proposed Solutionmentioning

confidence: 99%

Defining cancer survivorship: a more transparent approach is needed

2011

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“…CCS are usually transitioned to this unit when they are aged over 18 years and off-therapy for at least 5 years. The choice to transfer the follow-up from a pediatric to an adult environment follows the trend of international literature (11,14,15) because of the availability of diagnostic services and consultants more suitable to the patient's age. Furthermore, transition into an adult-focused care may have a beneficial effect on the psychological growth and development of the patients, who, in most cases, seem to be heavily dependent on their parents before transition (16).…”

Section: Introductionmentioning

confidence: 99%

Endocrine health conditions in adult survivors of childhood cancer: the need for specialized adult-focused follow-up clinics

Brignardello

Felicetti

Castiglione

et al. 2013

European Journal of Endocrinology

153

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Background: Survival rates among childhood cancer survivors (CCS) have enormously increased in the last 40 years. However, this improvement has been achieved at the expense of serious late effects that frequently involve the endocrine system. Aim: To evaluate the cumulative incidence of endocrine diseases in a cohort of long-term CCS. Materials and methods: We analyzed the clinical data of 310 adults, followed for a median time of 16.0 years after the first cancer diagnosis. The monitoring protocols applied to each patient were personalized on the basis of cancer diagnosis and previous treatments, according to the Children's Oncology Group guidelines. Results: The cumulative incidence of endocrine late effects steadily increased over time. At the last follow-up visit available, 48.46% of females and 62.78% of males were affected by at least one endocrine disease. The most common disorders were gonadal dysfunction, primary hypothyroidism, and GH deficiency (GHD). The main risk factors for endocrine disease were male sex (hazard ratio (HR)Z1.45, 95% confidence interval (95% CI) 1.05-1.99), radiotherapy (HRZ1.91, 95% CI 1.28-2.84), hematopoietic stem cells transplantation (HRZ3.11, 95% CI 2.23-4.34), and older age at cancer diagnosis (HRZ1.89, 95% CI 1.25-2.85). Male sex was associated with a higher risk of gonadal disorders, whereas radiotherapy specifically increased the risk of GHD and thyroid dysfunction. Conclusions: Endocrine disorders among CCS have a high prevalence and increase over time. Thus, endocrinologists need to cope with an increasing demand for health care in a field that is still little developed and that, in perspective, could also be extended to some selected types of adult cancer survivors.

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“…15 Thus, in the United States (US), Europe, Australia and Canada a number of new models for adult survivors are being implemented and evaluated. 10,16-19 Each has a different approach based on the patient population, type of follow-up and type of provider. In some institutions and practices, the clinic is disease-specific, such as a breast cancer survivor clinic.…”

Section: The Evolution Of Models Of Carementioning

confidence: 99%

Risk-Based Health Care, the Cancer Survivor, the Oncologist, and the Primary Care Physician

McCabe

Partridge

Grunfeld

et al. 2013

Seminars in Oncology

130

107

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Cancer survivors face substantial risks for morbidity, reduced quality of life, and premature mortality related to the cancer itself and/or the interventions undertaken to control cancer. Risk-based care that involves a personalized systematic plan of periodic screening, surveillance, and prevention relevant to the cancer experience is recommended to address the comprehensive health needs of the growing population of cancer survivors. Risk-based care and coordination between oncology and primary care providers have been identified as important metrics of quality cancer survivorship care. Various models of survivorship care, treatment summaries and survivorship care plans have been promoted as methods to facilitate communication among providers across care transitions and improve survivor access to quality survivorship care. However, research supporting the feasibility of implementing these practices and their effectiveness in enhancing health outcomes is limited. This article reviews key concepts underpinning clinical and research initiatives endeavoring to improve access to quality care among long-term survivors and summarizes results of intervention studies implementing these elements in transitioning survivors from oncology to primary care providers for long-term follow-up care.

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Structuring survivorship care: discipline-specific clinician perspectives

Cited by 28 publications

References 12 publications

Defining cancer survivorship: a more transparent approach is needed

Defining cancer survivorship: a more transparent approach is needed

Endocrine health conditions in adult survivors of childhood cancer: the need for specialized adult-focused follow-up clinics

Risk-Based Health Care, the Cancer Survivor, the Oncologist, and the Primary Care Physician

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