Program Offers Lifeline To Those Lost In The Transition From Cancer Patient To Cancer Survivor

Main Category: Cancer / Oncology
Article Date: 04 Oct 2008 - 0:00 PDT

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At the end of her chemotherapy treatment for breast cancer, Sylvia Ott-Durkin of Schaumburg, Ill., found herself facing an unsettling quandary.

"Finishing chemo was exciting but then I was confronted with the next step," said Ott-Durkin, a young mother of two. "My appointments were gone and I couldn't see my doctor as much as I wanted to. I felt like I was in limbo. I was done with treatment. I was a survivor, and yet, what's the next step?"

Ott-Durkin wasn't alone. Currently, 10.8 million Americans are cancer survivors, a number that has tripled since 1971, according to the American Cancer Society. About 1 million additional people a year are expected to enter the ranks of those who can expect to live indefinitely due to the advances made in cancer research, diagnosis and treatment.

"Oftentimes, after their treatment, cancer survivors were left questioning who they were supposed to see for long-term, follow-up care," said Dr. Patricia Robinson, assistant professor of medicine, hematology/oncology, Loyola University Chicago Stritch School of Medicine. "Oncologists now recognize that there are cancer survivors walking around. Their medical, financial and emotional needs have to be addressed. Survivorship is a unique facet of cancer care."

To help fill those needs, the Cardinal Bernardin Cancer Center has established the Cancer Survivorship Program, one of the first of its kind in the Midwest. The program features a multidisciplinary team of oncologists, nurses, psychologists, nutritionists, genetic counselors, social workers, pastoral care ministers and financial counselors working together to provide for the physical, mental and spiritual needs of survivors and their families and loved ones. Also, as part of a major academic medical center, the program gives cancer survivors access to leading-edge treatment options that are not available at other institutions.

"The idea for the program stems from the needs and requests of cancer patients themselves," said Robinson, who is also the director of the Cancer Survivorship Program. "We see patients who are done with their treatment and are transferring care from the oncologist to the primary care physician."

Once survivors complete their cancer treatment, they are often unaware of the increased health risks they may face. Survivors can experience fatigue, decreased physical performance and wrestle with sexual and fertility problems. Survivors also face a higher risk of developing a second malignancy from the same risk factors that may have caused their first cancer, such as smoking or certain genetic conditions. Surgery, chemotherapy, radiation and hormone treatments also heighten their risks.

"Fifty percent of cancer patients are expected to live 5 years beyond their diagnosis," said Robinson, whose program mainly serves survivors of breast, colorectal and lung cancers. "However, people who survive cancer are 14 percent more likely than the general population to develop a new cancer."

Patients who come to the program are first screened by a nurse who reviews their past cancer diagnosis and treatment history, lists possible complications and assists them in completing paperwork. Patients next meet with a psychologist who is skilled in responding to the psychological issues related to a diagnosis of cancer.

"Cancer is unique. Patients often struggle with the question of, 'Is this going to recur?' said Dr. Patricia Mumby, associate professor, psychiatry and behavioral neurosciences, Stritch School of Medicine, and clinical psychologist for the Cancer Survivorship Program. "To help ease their fears and anxiety we perform quality-of-life screenings to identify patients' individual needs, which help us to decide on the right care team for them."

Patients next undergo a physical exam, laboratory tests and screenings for any complications that may have had from past treatments. At the end, patients are given a written, one-page summary that includes their initial diagnosis, type of cancer, treatment regimens, possible side effects, surveillance recommendations for secondary malignancies and a follow-up plan, which is updated over time. A copy of this plan is sent to the patient's referring physician or primary caregiver.

"If you go back to your primary care physician without a treatment plan, you may not be screened as frequently for cancer issues. If you stay with your medical oncologist, other primary issues may be overlooked," Robinson said. " I usually say to patients that we complement and complete their oncology care."

Loyola University Health System
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United States
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