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Are there Gaps in Your Cancer Post-treatment Care?

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There are 12 million cancer survivors in the U.S., and with one-in-three women and one-in-two men expected to be diagnosed with cancer at sometime during their lifetime, that number is expected to double by 2016. Providing long-term care for survivors will become increasingly challenging with looming shortages of oncology specialists and primary care physicians (PCPs), a new report says.

Faced with a growing survivor population, researchers wanted to know if current cancer survivors are receiving care for long-term and late medical effects of cancer or its treatment, as well as psychosocial support, and having their other diseases or conditions managed as they transition from acute care to post-treatment.

The "Survey of Physicians Attitudes Regarding the Care of Cancer Survivors" asked both groups of doctors several questions about providing cancer survivorship care, including the doctors' confidence in their knowledge about such care, and cancer surveillance practices. The results of the first national representative survey of doctors found major differences in knowledge, attitudes and practices of oncologists and PCPs. These differences pose "significant barriers" to survivors’ coordinated care.

Most people transition to primary care physicians following their cancer treatment, so says the findings of the doctor survey are “of considerable concern,” says the study’s lead author, Arnold L. Potosky, Ph.D., director of health services research at Georgetown Lombardi Comprehensive Cancer Center.

“What the survey tells us is that many doctors, particularly primary care doctors don't have a high level of confidence in their own knowledge of some aspects of survivorship care, and many oncologists believe that PCPs are not adequately prepared to provide such care. We also see some evidence of knowledge deficits in both physician groups in terms of guideline-based care for survivors," says Dr. Potosky.

Dr. Sharon L. Bober, a psychologist and director of the Sexual Health Program in Pediatric Oncology at Dana-Farber Cancer Institute in Boston speaking at a recent survivorship symposium said, the most common problems encountered by cancer survivors include sexual dysfunction, urinary incontinence, and fatigue, “but few clinicians are asking about these conditions, and even few are treating them,” reports OBG Management.

Julia Rowland, Ph.D., director of the Office of Cancer Survivorship at the National Cancer Institute(NCI) and a co-author of the study says, it’s critical that PCPs and oncologists get “more training and education on cancer survivorship.”

“This might include identification of who may be best equipped to provide different aspects of care. Use of a survivorship care plan has the potential to serve as a valuable tool for helping to improve communication about as well as coordination of care between specialists and primary care physicians for survivors who are post-treatment,” she said.

The authors suggest cancer survivors, upon finishing treatment, meet with the treating oncologist to summarize the care received and outline appropriate follow-up care based on personal treatment history. They add, patients should find out what aspects of care to expect from the oncologist and the primary care physician respectively. The study is published online in the July 25, 2011, Journal of General Internal Medicine.

Lynette Summerill, an award-winning writer and scuba enthusiast lives in Scottsdale, Arizona. In addition to writing about cancer-related issues for EmpowHER, her work has been seen in newspapers and magazines around the world.

Sources: Differences Between Primary Care Physicians’ and Oncologists’ Knowledge, Attitudes and Practices Regarding the Care of Cancer Survivors. A.L. Potosky, Paul J.K. Han, J. Rowland, C.N. Klabunde, T. Smith, N. Aziz, C. Earle, J.Z. Ayanian, P.A. Ganz and M. Stefanek. Journal of General Internal Medicine. DOI:10.1007/s11606-011-1808-4. Published online July 25, 2011. http://www.springer.com/medicine/internal/journal/11606
abstract: http://www.ncbi.nlm.nih.gov/pubmed/21785923?dopt=Abstract

Cancer survivors have many complaints not addressed by their physicians. Janelle Yates. OBG Management, Vol. 23 No. 7. July 2011. Accessed online:

Reviewed July 26, 2011
By Michele Blacksberg R.N.
Edited by Shannon Koehle

Add a Comment2 Comments

Thanks for posting your comment Pat.

July 27, 2011 - 11:45am
Expert HERWriter Guide Blogger

Thanks for bringing attention to this important topic Lynette. The media image the public sees of strong, healthy, athletic, fully made-up and photogenic women running races while singing a happy tune about surviving cancer is a grossly distorted picture of cancer survivorship.

The challenges of identifying needs, locating appropriate care, obtaining funding, fighting insurance providers and pushing through many other obstacles are many. While some oncologists may state concerns about PCPs not being able to provide adequate care, the reality is many oncologists don't provide it either, and there are hospitals boasting about their exceptional cancer care while only focusing on the front end of the journey and leaving their own patients hanging.

In order to have a good survivorship plan, patients today often have to build their own plan and support team. There are many online resources to help do this. Survivors can also benefit from seeking resources beyond their own specific diagnosis to meet their needs. As examples of this, although I am living with a blood cancer - leukemia, I have found warm, welcoming and expert support through the local group for women with ovarian cancer and through Livestrong, The Wellness Community and other organizations which support all cancer patients and caregivers.

The medical system tends to isolate us by diagnosis, which helps us get to the right degree of expert clinical care. As survivors, however, we have many common needs and the more we work together to share information, resources and support, the better. Many of the strongest people I know are cancer survivors. They may not have special songs or run races but they are the ones who help others live better lives and that's what really matters.

July 27, 2011 - 9:05am
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