Surveillance or symptom management? Insights from 5 years of caring for survivors.
Authors: Amy Elizabeth Shaw, Peg Jo Jennings-Shaw
Journal: Journal of Clinical Oncology (2017)

Article Tools Care Coordination and Financial Implications Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.2017.35.5_suppl.44 Journal of Clinical Oncology - published online before print March 21, 2017 Surveillance or symptom management? Insights from 5 years of caring for survivors. Amy Elizabeth ShawxAmy Elizabeth ShawSearch for articles by this author, Peg Jo Jennings-ShawxPeg Jo Jennings-ShawSearch for articles by this author Show More St. Joseph Health Medical Group, Santa Rosa, CA; Santa Rosa Memorial Hospital, St. Joseph Health Regional Cancer Care, Santa Rosa, CAAbstract Disclosures https://doi.org/10.1200/JCO.2017.35.5_suppl.44 Abstract Abstract44Background: One of the most widely held definitions of cancer Survivorship is that it begins "at the time of diagnosis and for the balance of life" (NCCS). An emphasis on providing Survivorship Care Plans (SCP), pushes many Survivorship Programs toward long-term surveillance and care planning for patients who have completed treatment. The needs of survivors who are in the period between diagnosis and completion of treatment are not addressed by SCP. In 2011, our multidisciplinary oncology group hired a board-certified Family Physician to develop a Survivorship Program that would serve the needs of cancer patients at the time of diagnosis and for the balance of life. We report here on what we have learned about our survivors after the first 5 years of caring for them. Methods: Cancer patients were referred to the program by oncology specialists, community physicians, or by patient self-referral. De-identified data for each case were entered into a database including cancer type, stage, treatment, age at diagnosis and at first visit, and primary reason for referral (surveillance, symptom management, or assistance with complex medical decision making). Results: During the 5-year period, 994 patients were seen, median age 61 years (min 26, max 94). Breast cancer was the most common (86%). Patients were referred for surveillance (46%), symptom management (49%), or decision-making (5%). Patients referred for surveillance decreased from 62 to 22%. Patients referred for symptom management increased from 36 to 57%. Patients referred for decision-making increased from 2 to 21%. Patients referred for symptom management were younger (median age 60 vs 63), more likely to have stage II, III, or IV disease (53 vs 34%), and more recently diagnosed (median 1 vs 4 years) than patients referred for surveillance. Conclusions: Over the past 5 years our patients' needs have forced our program to evolve away from surveillance and prevention for early-stage, lower risk patients at the end of their treatment. We are now focused primarily on managing the adverse treatment-related symptoms for patients with higher stage disease. We have observed that patients require and desire survivorship care throughout their cancer experience, not just at the end of treatment.© 2017 by American Society of Clinical Oncology