ASCO Expanding Tools To Document Chemotherapy Treatment And Survivor Care For Cancer Patients

Main Category: Cancer / Oncology
Article Date: 27 Sep 2007 - 19:00 PDT

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The American Society of Clinical Oncology (ASCO) is expanding its tools to improve documentation and coordination of cancer treatment and survivorship care by developing a chemotherapy treatment plan and summary template for breast cancer patients.

Cancer is the number-one disease killer for people under age 85 in the United States. In 2007, more than 178,480 women in the United States will be diagnosed with breast cancer, and more than 40,460 women will die from the disease. The goal of the breast cancer treatment plan and summary (available at http://www.asco.org/treatmentsummary) is to improve communication among oncologists, patients and other care providers to better manage breast cancer patients' treatment across health care settings. It will also make gathering data to evaluate and improve quality of care and patient outcomes more accurate and efficient.

The new breast cancer treatment plan and summary template joins a colorectal treatment template published online earlier this year. ASCO is continuing to develop and test treatment plans and summaries for additional cancer diagnoses, including lung cancer.

The chemotherapy treatment plan, which the oncologist is to fill out before the patient begins receiving chemotherapy, maps out the patient's planned treatment. The treatment summary, developed after treatment is complete, describes what care the patient actually received. Some of the core elements of the treatment plan and summary include:

- Diagnosis, including the cancer site, histology and stage
- A summary of the chemotherapy and other treatment that is planned and actually delivered
- The reason treatment was stopped or modified
- Information on appropriate follow-up care and relevant providers
- Evidence-based survivorship and surveillance guidelines from ASCO

Since 1990, the number of women who have died of breast cancer has declined steadily each year. To improve care for the increasing number of cancer survivors, ASCO developed the Breast Cancer Survivorship Plan that can be added to the treatment summary to provide clarification on necessary follow-up care, including physical exams, post-treatment mammography, breast self-examination, and pelvic examinations.

"The adjuvant treatment plan and summaries and the breast cancer survivorship plan are not only tools for oncologists, but also an educational resource for patients," said Patricia Ganz, MD, professor of health services and medicine at the UCLA School of Public Health and director of the Division of Cancer Prevention and Control Research at the Jonsson Comprehensive Cancer Center. "We expect that discussion of the plan with the patient, and sharing of the information with her primary care provider, will improve coordination of follow-up care after primary breast cancer treatment."

The breast cancer treatment plan and summary have been field tested by practices, Dr. Ganz added, to ensure that the most useful information is being tracked and patients are consistently receiving quality care. All ASCO treatment plan and summary templates are published in modifiable forms, allowing oncologists to customize and adapt them to suit their own practices.

ASCO also is promoting integration of the treatment plan and summaries into oncology electronic health records (EHRs). "After Hurricane Katrina, the need for durable, transportable medical records became increasingly obvious," said ASCO President Nancy Davidson, MD, director of the Breast Cancer Program at the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University in Baltimore, Maryland.

"Cancer patients in particular need to have access to their medical records," Dr. Davidson added. "ASCO developed these templates as a standard for an oncology patient's EHR. It would be very complicated if every oncology office is out there designing their own version of an EHR."

The treatment plan and summary are not intended to replace detailed chart documentation, including complete patient histories or chemotherapy flow sheets. No single treatment plan can be appropriate for all patients; treating oncologists assume responsibility for tailoring the treatment summary to meet individual patient's needs.

The American Society of Clinical Oncology (ASCO) is the world's leading professional organization representing physicians of all oncology subspecialties who care for people with cancer. ASCO's nearly 25,000 members from the United States and abroad set the standard for patient care and lead the efforts to discover more effective cancer treatments, increase funding for clinical and translational research, and, ultimately, improve cancer care for the estimated 10 million people diagnosed with cancer worldwide each year. ASCO publishes the Journal of Clinical Oncology (JCO), the preeminent, peer-reviewed, medical journal on clinical cancer research, and produces People Living With Cancer (http://www.PLWC.org), a comprehensive consumer Web site providing oncologist-vetted cancer information to help patients and families make informed health-care decisions.

American Society of Clinical Oncology