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Promotion of self-management for post treatment cancer survivors: evaluation of a risk-adapted visit

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Abstract

Purpose

The LIFE Cancer Survivorship Program at NorthShore University HealthSystem provides risk-adapted visits (RAV) facilitated by an oncology nurse during which a survivorship care plan (SCP) is provided and discussed. In this report, we describe and evaluate RAV in promoting individualized health care and self-management during survivorship transition.

Methods

Patients complete a post-RAV questionnaire at their RAV and another ≥1 year after their RAV.

Results

One thousand seven hundred thirteen (1713) RAVs, majority for breast cancer, occurred from January 2007 to March 2014. One thousand six hundred fifteen (1615) “day-of” post-RAV questionnaires were completed. Respondents scaled statements as strongly agree/agree/disagree/strongly disagree. Combined strongly agree/agree ratings are 94 % felt more confident in communicating information about their treatments to other health care providers, 90 % felt more comfortable recognizing signs/symptoms to report to providers, and 98 % had a better appreciation for community programs/services. Of 488 respondents (RAV January 2007 to December 2012 n = 1366) to a questionnaire at least 1 year after the RAV, nearly 100 % found SCP useful to summarize medical information, 97 % to reinforce follow-up, 85 % to recognize symptoms of recurrence, 93 % to identify healthy lifestyle practices, 91 % to assist in identifying resources for support, 72 % discussed their SCP with their healthcare provider, and 97 % made at least one positive lifestyle change.

Conclusions

Participation in LIFE RAV following treatment helps survivors to guide future self-care behavior. Data suggest that benefits may persist 1 year after the visit and support the feasibility of a nurse-led RAV to establish a SCP in cancer survivors.

Implications for Cancer Survivors

Combined provision and discussion of SCPs help survivors construct a useful understanding of their cancer experience and may promote long-term self-management.

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References

  1. Hewitt M, Greenfield S, Stovall E. From cancer patient to cancer survivor: lost in transition. Washington DC: Institute of Medicine and National Research Council of the National Academies, National Academies Press; 2005.

    Google Scholar 

  2. Institute of Medicine: Cancer Survivorship Care Planning: Institute of Medicine Fact Sheet 2005. http//www.iom.edu/∼/media/Files/Report%20Files/2005/From-Cancer-Patient-to-Cancer-Survivor-Lost-in-the-Transition/factsheetcareplaning.pdf

  3. McCabe M, Bhatia S, Oeffinger K, Reaman GH, Tyne C, Wolins DS, et al. American society of clinical oncology statement: achieving high quality cancer survivorship care. J Clin Oncol. 2013;31:631–20.

    Article  PubMed  Google Scholar 

  4. Parekh AK, Kronick R, Tavenner M. Optimizing health for persons with multiple chronic conditions. JAMA. 2014;312:1199–200.

    Article  PubMed  CAS  Google Scholar 

  5. Davies NJ, Batehup L. Towards a personalized approach to aftercare: a review of cancer follow-up in the UK. J Cancer Surviv. 2011;5:142–51.

    Article  PubMed  Google Scholar 

  6. Loprinzi PD, Cardinal BJ, Si Q, Bennett JA, Winters-Stone M. Theory based predictors of follow-up exercise behavior after a supervised exercise intervention in older breast cancer survivors. Support Care Cancer. 2012;20:2511–21.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Anderson AS, Steele R, Coyle J. Lifestyle issues for colorectal cancer survivors-perceived needs, beliefs and opportunities. Support Care Cancer. 2013;21:35–42.

    Article  PubMed  Google Scholar 

  8. Nissen MJ, Tsai ML, Blaes AH, Swenson KK, Koering S. Effectiveness of treatment summaries in increasing breast and colorectal cancer survivors’ knowledge about their diagnosis and treatment. J Cancer Surviv. 2013;7:211–8.

    Article  PubMed  Google Scholar 

  9. Boyajian RN, Grose A, Grenon N, Roper K, Sommer K, Walsh M, et al. Desired elements and timing of cancer survivorship care: one approach may not fit all. J Oncol Pract. 2014;10:e293–8.

    Article  PubMed  Google Scholar 

  10. Snyder CF, Herman JM, White SM, Luber BS, Blackford AL, Carducci MA, et al. When using patient reported outcomes in clinical practice the measure matters: a randomized controlled trial. J Oncol Pract. 2014;10:e299–306.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Salz T, Baxi SS, Blinder VS, Elkin EB, Kemeny MM, McCabe MS, et al. Colorectal cancer survivors’ need and preferences for survivorship information. J Oncol Pract. 2014;10:e277–82.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Mayer DK, Gerstel A, Leak AN, Smith SK. Patient and provider preferences for survivorship care plans. J Oncol Pract. 2012;8:e80–6.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Baker R, Denniston M, Smith T, West M. Adult cancer survivors: How are they fairing at about a year after diagnosis? Cancer. 2005;104(11):2565–76.

    Article  PubMed  Google Scholar 

  14. Mayer DK, Nekhlyudov L, Snyder CF, Merrill JK, Wollins DS, Shulman LN. American society of clinical oncology clinical expert statement on cancer survivorship care planning. J Oncol Pract. 2014;10:345–51.

    Article  PubMed  Google Scholar 

  15. Dulko D, Pace CM, Dittus KL, Sprague BL, Pollack LA, Hawkins NA, et al. Barriers and facilitators to implementing cancer survivorship care plans. Oncol Nurs Forum. 2013;40:573–80.

    Article  Google Scholar 

  16. Institute of Medicine (IOM).Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis. Washington, DC: National Academies Press. 2013. http://www.iom.edu/reports/2013/delivering-high-quality-cancer-care-charting-a-new-course-for-a-system-in-crisis.aspx

  17. Shaw RJ, McDuffie JR, Hendrix CC, Edie A, Lindsey-Davis L, Nagi A, et al. Effects of nurse-managed protocols in the outpatient management of adults with chronic conditions: a systematic review and meta-analysis. Ann Intern Med. 2014;161:113–21.

    Article  PubMed  Google Scholar 

  18. Cooper C, Depledge J. Cytotoxic chemotherapy: what do community nurses need to know? Brit J Comm Nurs. 2004;9:26–32.

    Article  Google Scholar 

  19. Virgo KS, Lerro CC, Klabunde CN, Earle C, Ganz PA. Barriers to breast and colorectal cancer survivorship care: perceptions of primary care physician and medical oncologist in the United States. J Clin Oncol. 2013;31:2322–36.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Forsythe LP, Parry C, Alfano CM, Kent EE, Leach CR, Haggstrom DA, et al. Use of survivorship care plans in the United States: associations with survivorship care. J Natl Cancer Inst. 2013;106:1579–87.

    Article  Google Scholar 

  21. Wright JD, Hershman DL. Measure for measure: the cost of improving quality. J Natl Cancer Inst. 2014; doi:10.1093/jnci/dju266

  22. Blanch-Hartigan D, Forsythe LP, Alfano CM, Smith T, Nekhlyudov L, Ganz PA, et al. Provision and discussion of survivorship care plans among cancer survivors: results of a nationally representative survey of oncologist and primary care physicians. J Clin Oncol. 2014;32:1578–85.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Hahn EE, Ganz PA. Survivorship programs and care plans in practice: variations on a theme. J Oncol Pract. 2011;7:70–5.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Demark-Wahnefried W, Aziz NM, Rowland JH. Riding the crest of the teachable moment: promoting long-term health after the diagnosis of cancer. J Clin Oncol. 2005;23:5814–30.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Neff R, McCann AL, Carpenter K, Mesenberg J, O’Malley DM. Survivorship care and weight management: Assessing patient attitudes and preferences toward provider involvement [Abstract e20589]. J Clin Oncol. 2014;32(suppl; abstr e20589) Retrieved from http://meetinglibrary.asco.org/content/135191-144

  26. American Institute for Cancer Research/World Cancer Research Fund: Food, Nutrition, Physical Activity and the Prevention of Cancer: A Global Perspective. Washington DC, American Institute for Cancer Research, Research. 2007. http://www.dietandcancerreport.org/cancer_resource_center/er_full_report_english.php

  27. Kushi LH, Doyle C, McCullough M, et al. American Cancer Society guidelines on nutrition and physical activity for cancer prevention. CA Cancer J Clin. 2012;62:30–67.

    Article  PubMed  Google Scholar 

  28. Rock CL, Doyle C, Demark-Wahnefried W, Meyerhardt J, Courneya KS, Schwarz AL, et al. Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin. 2012;62:242–74.

    Article  Google Scholar 

  29. Denlinger CS, Ligibel JA, Are M, Baker S, Demark-Wahnefried W, Dzon D, et al. NCCN survivorship: healthy lifestyles, version 2.2014. J Natl Compr Cancer Netw. 2014;12:1222–37.

    Google Scholar 

  30. Denlinger CS, Ligibel JA, Are M, Baker S, Demark-Wahnefried W, Dzon D, et al. NCCN survivorship: nutrition and weight management, version 2. Natl Compr Cancer Netw. 2014;12:1396–406.

    Google Scholar 

  31. Ligibel JA, Alfano CM, Courneya KS, Demark-Wahnefried W, Burger RA, Chlebowski RT, et al. American Society of Clinical Oncology position statement on obesity and cancer. J Clin Oncol. 2014;32:3568–74.

    Article  PubMed  Google Scholar 

  32. Fortmann SP, Burda BU, Senger CA, Lin JS, Whilock EP. Vitamin and mineral supplements in the primary prevention of cardiovascular disease and cancer: an update systematic evidence review for the U. S. Preventive Services Task Force. Ann Intern Med. 2013;159:824–34.

    Article  PubMed  Google Scholar 

  33. Guallar E, Stranges S, Mulrow C, Appel LJ, Miller ER. Stop wasting money on vitamin and mineral supplements. Ann Intern Med. 2013;159:850–1.

    Article  PubMed  Google Scholar 

  34. Protani M, Coory M, Martin JH. Effect of obesity on survival of women with breast cancer: systematic review and meta-analysis. Breast Cancer Res Treat. 2010;123:627–35.

    Article  PubMed  Google Scholar 

  35. Ballard-Barbash R, Friedenreich CM, Courneya KS, et al. Physical activity, biomarkers and disease outcomes in cancer survivors; a systematic review. J Natl Cancer Inst. 2012;104:815–40.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Bradshaw PT, Ibahim JG, Stevens J, et al. Post diagnosis change in body weight and survival after breast cancer diagnosis. Epidemiology. 2012;23:320–7.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Holmes MD, Chen WY, Feskanich D, Kroenke CH, Colditz GA. Physical activity and survival after breast cancer diagnosis. JAMA. 2005;293:2479–86.

    Article  PubMed  CAS  Google Scholar 

  38. Meyerhardt JA, Heseltine D, Niedzwiecki D, Hollis D, Saltz LB, Mayer RJ, et al. Impact of physical activity on cancer recurrence and survival in patients with stage III colon cancer: findings from CALGB 89803. J Clin Oncol. 2006;24:3535–41.

    Article  PubMed  Google Scholar 

  39. Meyerhardt JA, Giovannucci EL, Holmes MD, et al. Physical activity and survival after colorectal cancer diagnosis. J Clin Oncol. 2006;24:3527–34.

    Article  PubMed  Google Scholar 

  40. Demark-Wahnefried W. Cancer survival: time to get moving: data accumulate suggesting a link between physical activity and cancer survival. J Clin Oncol. 2006;24:3517–8.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Richman EL, Kenfield SA, Stampfer MJ, et al. Physical activity after diagnosis and risk of prostate cancer progression: data from the cancer of the prostate strategic urologic research endeavor. Cancer Res. 2011;71:3889–95.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  42. Irwin ML. Weight loss interventions and breast cancer survival: the time is now. J Clin Oncol. 2014;32:2197–9.

    Article  PubMed  Google Scholar 

  43. Irwin ML , Carmel B, Gross C, Ercolano E, Li F, Yao X, Fiellin M, Capozza S, Rothbard M, Zhou Y, Harrigan M, Sanft T, Schmitz K, Neogi T, Hershman D, Ligibel J. Randomized trial of exercise vs. usual care on aromatase-inhibitor side effects in breast cancer survivors. J Oncol Pract. 2014; doi: 10.1200/JCO.2014.57

  44. Ness S, Kokal J, Fee-Shroeder K, Novotny P, Satele D, Barton D. Concerns across the survivorship trajectory. Results from a survey of cancer survivors. Oncol Nurs Forum. 2013;40:35–42.

    Article  PubMed  Google Scholar 

  45. Halpern MT, Viswanathan M, Evans TS, Birken SA, Basch E, Mayer DK. Models of cancer survivorship care: overview and summary of current evidence. J Oncol Pract. 2015;11:e19–27.

    Article  Google Scholar 

  46. Ganz PA, Yip CH, Gralow JR, Distelhorst SR, Albain KS, Andersen BL, et al. Supportive +care after curative treatment for breast cancer (survivor care): resource allocations in low-and middle-income countries. A Breast Health Global Initiative 2013 consensus statement. Breast. 2013;22:606–15.

    Article  PubMed  Google Scholar 

  47. Parry C, Kent EE, Forsythe LP, Alfano CM, Rowland JH. Can’t see the forest for the care plan: a call to revisit the context of care planning. J Clin Oncol. 2013;31:2651–3.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Earle CC, Ganz PA. Cancer survivorship care: don’t’ let the perfect be the enemy of good. J Clin Oncol. 2012;30:3764–8.

    Article  PubMed  Google Scholar 

  49. American College of Surgeons Commission on Cancer: Cancer Program Standards 2012, Version 1.1: Ensuring Patient Centered Care. Chicago, IL, American College of Surgeons. 2012. http://www.facs.org/cancer/coc/programstandards2012.pdf

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Compliance with ethical standards

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Conflict of interest

Author Thomas Hensing has a consulting role for Boeringer Ingelheim, Roche/Genetech. All authors report no conflict of interest.

Funding

None.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required. The surveys are IRB exempt as the surveys meet all criteria on the IRB quality improvement checklist.

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Authors and Affiliations

  1. Highland Park Hospital, NorthShore University HealthSystem, 777 Park Avenue West Room 1170, Highland Park, IL, 60035, USA

    Carol A. Rosenberg, Carol Flanagan, Bruce Brockstein, Jennifer C. Obel, Leon H. Dragon, Douglas E. Merkel, Elaine L. Wade, Teresa M. Law, Janardan D. Khandekar & Thomas A. Hensing

Authors
  1. Carol A. Rosenberg
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  2. Carol Flanagan
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  3. Bruce Brockstein
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  4. Jennifer C. Obel
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  5. Leon H. Dragon
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  6. Douglas E. Merkel
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  7. Elaine L. Wade
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  8. Teresa M. Law
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  9. Janardan D. Khandekar
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  10. Thomas A. Hensing
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Corresponding author

Correspondence to Carol A. Rosenberg.

Appendices

Appendices

Appendix 1

figure a

Appendix 2. LIFE program “year-out” follow-up survey

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Rosenberg, C.A., Flanagan, C., Brockstein, B. et al. Promotion of self-management for post treatment cancer survivors: evaluation of a risk-adapted visit. J Cancer Surviv 10, 206–219 (2016). https://doi.org/10.1007/s11764-015-0467-6

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  • DOI: https://doi.org/10.1007/s11764-015-0467-6

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