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Research in Review

Chronic Cancer Survivors in Need of Improved Survivorship Care Plans

Survivors of chronic cancer are often not receiving optimal survivorship care plans and follow-up treatment, according to a study published in Cancer (published online June 27, 2017; doi:10.1002/cncr.30862).

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Patients who have survived chronic cancer are often considered incurable but treatable. Nonetheless, the survivorship needs of patients living with chronic cancer and their use of survivorship care plans have been underappreciated and not fully understood.

Christine E Hill-Kayser, MD, department of radiation oncology, University of Pennsylvania, and colleagues conducted an assessment of patient-reported treatment effects, follow-up care, and survivorship care plans for survivors of chronic cancer. A sample of 39,088 survivorship care plans completed for survivors of cancer and patient-assessed with an internet-based tool was examined. The sample was comprised of 5847 chronic cancer survivors, defined as those with chronic leukemia or recurrent/metastatic cancer of another nature.

Patient-reported treatment effects and follow-up care patterns were compared between chronic cancer survivors and survivors who were treated with curative intent. Additionally, responses from a follow-up survey regarding survivorship care plan satisfaction and use were analyzed.

Results of the study showed that chronic cancer survivors were more likely to experience multiple treatment-related effects than survivors treated with curative intent. Among these effects were fatigue, cognitive changes, dyspnea, peripheral neuropathy, lymphedema, and erectile dysfunction.

Researchers found that approximately 50% of chronic cancer survivors were managed entirely by an oncologist, while patients treated with curative intent were significantly more likely to be co-managed by a primary care provider and an oncologist.

Fewer survivorship care plans were created by health care providers for chronic cancer survivors compared with curative intent survivors. Significantly less chronic cancer survivors rated their experience and satisfaction with the internet-based tool as “very good” or “excellent” than curative intent survivors.

Researchers concluded that a substantial number of chronic cancer survivors seeking survivorship support are not having their needs met. “Tools to facilitate participation, communication, and coordination of care are valuable for these patients, and future iterations of survivorship care plans should be designed to address the particular circumstances of living with chronic cancer,” they wrote.—Zachary Bessette

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