Needs change, but long-term survivors still require care

There are more than 11 million cancer survivors currently living in the U.S., and that figure is expected to nearly double in the next decade. Sixty-four percent of adults diagnosed with cancer today will be alive in five years, and 75% of childhood cancer survivors will live for 10 years or more.

Survivor clinics to help these patients are needed, but establishing and operating enough clinics to support 11 million patients is a challenge, especially in the current economic climate. With hundreds of community cancer clinics having shut their doors over the last three years, remaining centers may shy away from adding a new program.

Survivor programs do not have to be a huge burden. In 2006, Patricia Ganz, MD, established the University of California, Los Angeles-Livestrong Survivorship Center of Excellence. The center is one of eight established by the Lance Armstrong Foundation. The foundation's funds have helped to develop programs at the comprehensive cancer center as well as in community-based programs. Each setting has a different model of care.

 

Today, the UCLA center is staffed by a psychologist, adult nurse practitioner, and pediatric oncologist specializing in the care of long-term childhood cancer survivors. Dr. Ganz spoke with Oncology News International about some of the key elements to keep in mind when establishing a survivorship program.

Dr. Ganz is the director of cancer prevention and control research at the Jonsson Comprehensive Cancer Center, UCLA. She is an American Cancer Society Clinical Research Professor.

Patient = survivor
Dr. Ganz said that ideally, all patients should have their initial treatment planned as if they are going to be a long-term survivor. For example, preserving fertility must be considered before treatment starts. Post-treatment, she recommends that every patient be given a survivorship care plan to serve as a coordination-of-care road map that details the person's cancer-related health history from diagnosis through treatment and describes potential late effects.

This care plan can help cancer survivors move more smoothly through through the healthcare system.

"We focus on the psychosocial first, doing a 'depression screener' to pick up people who are depressed, or even some who are suicidal," Dr. Ganz said. "Then we look at any late effects of cancer treatment: residual fatigue, cognitive problems, and weight gain, which is a big problem."

This care plan may also include recommendations for improving psychosocial well-being and referrals for counseling as appropriate for sexual difficulties or the need for genetic counseling.

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