Goals for this Talk Understand what Survivorship Care in Oncology is - PDF document

5/1/2018 Goals for this Talk Understand what Survivorship Care in Oncology is and be able to answer the following questions when asked by friends, family members, or random strangers: Who is a survivor? What does “survivorship” mean? What is a Survivorship Care Plan? Why is Survivorship Care important for patients? Diversity and Survivorship We have no cookie-cutter cancer patients. And, so, we have no cookie-cutter cancer survivors! We are all a unique (and diverse!) combination of what we’re born with, who we’ve grown up with, In short, we are all a culmination of all our individual experiences. where we’ve been, what we’ve learned, Survivorship is about acknowledging what we’ve done AND our physical bodies. what you’ve been through, who you are now, and making a plan for moving forward. “I’m not a survivor yet, it’s only been 4 months.” “Am I really a survivor, it’s only been 10 years?” “I can’t be a survivor until my doctor says I’m cured.” 1

5/1/2018 Definition of a “Survivor” Definition of “Survivorship” Any person with a history of cancer, from the time The time in the life of any person with a of diagnosis to the end of their life. history of cancer, from the time of diagnosis to the end of their life. Cancer Treatment & Survivorship Facts and Figures, ACS, 2017 Cancer Treatment & Survivorship Facts and Figures, ACS, 2017 Sometimes people who have never been through cancer treatment don’t The Good and The Bad understand that… Finishing treatment for Screening tests are better, early screening numbers are increasing, and treatment is more effective so: More people are surviving their cancer! cancer is not like Cancer survivors are living longer! getting your But living longer post cancer treatment also means: Living longer with the side effects of treatment. braces off. Longer monitoring for late and long term side effects. In 1985 Dr. Fitzhugh Mullan said: Poss ssib ible La Late and and Lon Long T Term Side Ef Side Effect ects Anxiety Pain Anemia “The challenge of overcoming cancer is not only to Depression Bleeding or clotting Muscles and joint stiffness find therapies that will prevent or arrest the disease Distress Peripheral neuropathy issues quickly, but also to map the middle ground of Decreased concentration Sleep problems Bone density loss survivorship and minimize its medical and social Memory loss Fatigue Nausea Spiritual distress hazards.” Changes in taste Hair changes Fear of recurrence Constipation Lymphedema Post-traumatic stress disorder “It is as if we have invented sophisticated techniques Diarrhea Weight loss to save people from drowning, but once they have Urinary problems Heart Disease Weight gain Lung dysfunction Change in body image been pulled from the water, we leave them on the dock Financial toxicity Changes in vision to cough and splutter on their own in the belief we Insurance problems Skin changes Premature menopause have done all that we can.” Changes in hearing Medication management Infertility Role changes Secondary cancers Sexual dysfunction School and/or work issues Relationship and intimacy issues Dr. Mullan is the Founding President of the National Coalition for Cancer Survivorship. 2

5/1/2018 Commission on Cancer (CoC): IOM’s From Cancer Patient to Cancer Survivor: Lost in Transition (2006) Standard 3.3 This Report Stated that Every Survivor Should: Patients treated with curative intent should receive a survivorship care plan which includes: Receive a treatment summary and care plan at the end of treatment A summary of what happened during active cancer Understand prevention, surveillance, and detection treatment of: Recommendations for follow-up care and surveillance New and recurrent cancers testing Potential late and long term side effects of cancer and its Referrals for support services the patient may need treatment going forward Have coordination of care between specialists and Any other information pertinent to the survivor’s short- primary care providers to ensure that their health and long-term survivorship care needs are met Goals Set For Oncology CoC: Standard 3.3 (cont’d) Providers: The CoC and the National Accreditation Program Care plans should be for Breast Centers want 50% or more of all “…given and discussed with the patient upon eligible patients (per their criteria) to receive a completion of active, curative treatment.” Survivorship Care Plan. “…clearly and effectively explained.” To be compliant with the CoC and NAPBC, most care plans should be given within 6 months after treatment has ended and within 1 year from diagnosis. Goal Set By the Survivorship How SCPs are given varies Clinic at TCCC: ALL patient should be given the chance to achieve the best I feel certain that for every 50 oncology clinics that care quality of life possible after cancer treatment. for patients, there are at least 50 ways of giving survivorship care plans! So, ALL eligible patients and every patient who wants a visit regardless of when they finished treatment or the SCPs can be given by a nurse, or a provider (including stage of their cancer, should have access to a physicians, nurse practitioners and physician assistants) Survivorship Clinic Visit because… The Tri-Cities is unique because we have the Cancer Center which is owned by all three local hospital systems That’s Just Good Patient Care (and that’s what really matters) 3

5/1/2018 5 FAQs Regarding Survivorship Clinic at TCCC Survivorship Clinic Visits Addresses the unique needs of survivors 1. How d How does a es a pati tient g t get s t sched heduled? TCCC patients, outside referrals, self referrals Created and run by a nurse practitioner (that’s me!) 2. Doe 2. Does i insu surance co cover S Survivorship vi visits? Coordinates care between oncology and primary care Yes! (but everyone is encouraged to check with their individual plan) At TCCC, it is targeted towards survivors who have completed their acute, curative cancer treatment but all 3. Wh 3. What ha happens be before a a vi visit? patients are welcome to request a visit. All information pertaining to the cancer diagnosis, treatment, and potential late and long term effects are compiled. Medical records are thoroughly reviewed to gain an understanding of Ideal time to be seen is ~3-4 months after acute treatment is each patient and their unique circumstances. completed, however patients are welcome to request a visit no matter how long ago they completed treatment. 5 FAQs Regarding Meet Natalie Knockers Survivorship Clinic Visits 4. What h happens d ns during ng a a visit? Patient receives a treatment summary, focused assessment of current symptoms, referrals to services as needed as well as follow-up care and testing recommendations. 5. Wha 5. What ha happen ppens after after a a visit visit? A copy of the treatment summary, Long-Term Health Recommendations, Resources and Education (The Survivorship Care Plan) and my chart note are shared with the patient’s primary care, medical oncologist and radiation oncologist, as well as any other providers the patient requests. Home Home Surgeon’s Medical Oncologist’s 4

5/1/2018 Home All Done! Radiation Oncologist’s (go back to normal life, right?) Home Survivorship Clinic 3-4 Months Later… 5

5/1/2018 Just to recap… Home Survivorship Clinic The purpose of receiving a Survivorship Care Plan is: To understand what you’ve been through. To discuss your current side effects. To review potential late side effects of your specific treatments. To learn how best to take care of yourself going forward, including surveillance and screening recommendations, Healthy lifestyle information and resources are also given. To make sure all of your providers know how best to take care of you in the future given your specific history of cancer and your specific cancer treatment. The Biggest Challenge for Survivorship What you can do to help… Care in South-Eastern Washington Talk to people you know about Survivorship care is so new that often survivorship and why it’s an important times people in the community, part of cancer care! including patients, don’t understand its importance. And feel free to call or email me with any questions you may have. (509) 737-3372, lisarootvik@tccancer.org 6

5/1/2018 Lisa Lisa C C.S. Root ootvik, A ARNP (509 (509) 737-3 737-3372 lisar arootvik@ ootvik@tccanc ccancer.or org Thank you for coming today! If you, or anyone you know, is interested in a Survivorship Clinic visit, please call my nurse, Rebecca, at (509) 737-3483. Questions? Question s? 7