Define Survivorship Demonstrate understanding of the history of cancer survivorship State the requirements of the Commission on Cancer of the American College of Surgeons Standard of Survivorship
According to the National Cancer Institute, a Survivor is: One who remains alive and continues to function during and after overcoming a serious hardship or life- threatening disease. In cancer, a person is considered to be a survivor from the time of diagnosis until the end of life.
Include family and friends Begins when treatment ends Do not include patients with metastaic disease Is considered living with, through and beyond a cancer diagnosis
1985-Fitzhugh Mullen Seasons of Survivorship ◦ Acute Survivorship ◦ Extended Survivorship ◦ Permanent Survivorship
1986-The NCCS was founded to advocate for cancer survivors
1996-The Office for Cancer Survivorship of the National Cancer Institute was established to focus on research into issues facing individuals with cancer.
2005-The Institute of Medicine published their report on cancer survivorship
Psychological Distress Sexual Dysfunction Infertility Impaired organ function Cosmetic changes Limitations in mobility, communication and cognition
Recognizing Survivorship as a distinct phase of cancer care Ensuring delivery of appropriate survivorship care Expanding research efforts in survivorship Eliminating discrimination and adverse effects on employment Ensuring access to good health insurance
In 2008, Dr. Kenneth Miller revisited Dr. Mullen’s Seasons of Survival. With earlier diagnoses and more effective treatment, more people are living through and beyond cancer and many are now living with cancer as a chronic disease.
Acute Survivorship: ◦ Time of Diagnosis ◦ Time of treatment
Transitional Survivorship-Immediately after treatment ends
Extended Survivorship-Those who have completed treatment, are living with cancer as a chronic disease or are in remission because of ongoing treatment
Permanent Survivorship- ◦ Cancer free and asymptomatic ◦ Cancer free with long term/late problems ◦ Develop secondary cancers unrelated to early treatment ◦ Have secondary cancers related to treatment
Written in 2012 to be implemented in 2015, this standard requires: ◦ A Survivorship Care plan prepared by the principal provider ◦ Given to the patient on completion of treatment ◦ Contains a record of the care receivedwith a follow up plan
In September of 2014, the CoC released clarifications to the standard that was to be implemented in January of 2015 A survey had been done to all member organizations and only 37% of responders were “completely confident” that their program would be able to implement the standard by January 63% of organizations felt this was the most difficult new standard to implement
The standard is only for patients receiving curative treatment The survivorship requirement is now being rolled out gradually over five years Cancer programs have more flexibility in choosing who will create the plan and who should distribute the plan to patients Minimum information to be included in the plans was clarified
Treatment summary ◦ Contact information of treating institutions and providers ◦ Specific diagnosis, including histological type ◦ Surgery ◦ Chemotherapy ◦ Radiation ◦ Ongoing toxicity or side effects of treatment ◦ Genetic or hereditary risk factors/Genetic Testing Results
Follow up care plan: ◦ Oncology team member contacts ◦ Schedule of related clinical visits ◦ Cancer Surveillance tests for recurrence ◦ Cancer screening tests for early detection and who will be responsible for ordering ◦ Need for Ongoing adjuvant therapy Name of Therapy Planned Duration Expected Side effects
Academic Center Community Hospital Primary Care Medical Group County Hospital
What’s Next? Life After Cancer Treatment Journey Forward ASCO Cancer Treatment Summary Prescription for Living LIVESTRONG Care Plan
Is a distinct phase of cancer treatment Was first recognized by the IOM in 2005 Effects almost 14 million cancer survivors today Is being phased in as a CoC standard beginning in 2015