Unit 11: Survivorship Survivorship begins at the time of diagnosis. Today there are over 16.5 million cancer survivors in the United States of America.

Cancer is the name for a group of more than 100 diseases in which cells grow out of control and invades other tissues in the body. It destroys the DNA of a cell. One-half of all men and one-third of all women will develop cancer at some point in their life.

The rate of a cancer diagnosis fell by 0 The rate of a cancer diagnosis fell by 0.8% between the years of 2003 and 2007. However, by the year 2050 it will increase for minorities by 99%.

Road of Cancer A plan of medical care will be made for each individual patient with the aid of their medical team which will include medical oncologists, radiation oncologists and surgical oncologists.

Module 1 : Long Term Effects Diagnosis Crisis period Patient's understanding Communication Family/caregivers Existential concerns Treatment Surgery Chemotherapy Radiation Hormone Therapy Immunotherapy Clinical Trials

Effects of Treatment Patients compliance Coping skills Financial concerns Practical assistance Cultural considerations End of Treatment High anxiety Continued survelliance Physical limitations Family considerations Financial/return to work

Normalization May require long period of time. Sexual dysfunction Chemo-brain Loss of hair, organs, or other body parts. Incontinence Lymphadema Psychosocial Normalization - “New Normal” Grief process Fear of recurrence Body image Difficulty sleeping

Practical concerns also are part of the long term effects of cancer Practical concerns also are part of the long term effects of cancer. Patients often have trouble with health and life insurance issues.

Module 2: Rehabilitation Grieve for your losses Cope with your disease. Cope with the stigma. “New normal.” Utilize resources; ie, support groups, counseling or even psychiatrists Renew relationships Gain control Utilize your unique cultural values, spiritual values and goals. Re-evaluate your priorities

Rehabilitation Relaxation Tai-Chi Cognitive strategies Exercise Sleep Hygiene Counseling Support Groups Nutrition Cognitive Behavior Therapy Lunch 'n Learn Celebrate Life Cancer Survivors' Conference

Module 3: Patient Advocacy Helping with future appointments Help with financial issues Continue with patient access to future treatment Employment Health, Disability and Life Insurance Options Insurance Navigation Genetics and the Law Cancer Community Resources Healthcare Reform

National Organizations American Cancer Society National Coalition for Cancer Survivorship Patient Advocate Foundation Specific cancer organizations

Module 4: Long Term Follow-up Once you have been daignosed with cancer, you are always considered to be a cancer patient. Medical professionals will view you in this light.

Long Term Follow-Up Regular medical check-ups Medical history should be maintained Possible future side effects Future drugs you may be taking Maintain health and well-being Individualized treatment care plan/Survivorship Plan

Final Preparations Will Trust Living Will Five Wishes

Advance Health Directives should be created at the time of diagnosis Advance Health Directives should be created at the time of diagnosis. Your records should be documented and kept in a safe place. You should give a copy of these to your health care provider. The Federal Patient Self- Determination Act requires all facilities that receive Medicare, Medicaid to discuss health care directives with newly admitted patients. This law also requires the directives to be part of your medical record.

Recurrence Process new information about treatment options Uncertain outcomes Conflicts with family and staff about treatment Maintaining hope in view of realism Creative solutions to financial issues Emotional crises

Terminal Illness Re-evaluate spiritual focus Help with information Constantly reassess goals Another psycho-social assessment is needed. Palliative care Hospice

Maintain a certain quality of life Cope with deteriorating physical condition Existential issues and how they relate to individual's culture Plan for surviving members