What are survivorship care plans failing to tell men after prostate cancer treatment?

The Prostate ◽  
2021 ◽  
Vol 81 (7) ◽  
pp. 398-406
Author(s):  
Youngjee Choi ◽  
Katherine C. Smith ◽  
Aishwarya Shukla ◽  
Amanda L. Blackford ◽  
Phuoc T. Tran ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Treatment ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Prostate Cancer Treatment ◽  
Care Plans

Prostate cancer survivorship care plans: What we are failing to tell men after treatment?

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 311-311
Author(s):  
Youngjee Choi ◽  
Katherine C. Smith ◽  
Aishwarya Shukla ◽  
Amanda L. Blackford ◽  
Phuoc T. Tran ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Side Effects ◽  
Bone Density ◽  
Cancer Treatment ◽  
Radiation Oncology ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Care Plans ◽  
Psa Testing

311 Background: Survivorship care plans (SCPs) present essential information about cancer treatment and follow-up recommendations for cancer survivors. We describe the completeness of prostate cancer SCPs and evaluate guideline concordance of follow-up recommendations. Methods: We analyzed 125 prostate cancer SCPs from an academic and community cancer center, abstracting demographics, cancer/treatment details and follow-up recommendations. Follow-up recommendations were compared to national guidelines. Results: Content provided in >90% of SCPs included cancer TNM stage; PSA at diagnosis; radiation treatment details (98% of men received radiation); and PSA monitoring recommendations. Potential treatment-specific side effects were listed for 69% of men who had surgery, 78% for androgen deprivation therapy (ADT) and 97% for radiation. The presence of post-treatment symptoms were noted in 67% of plans – several ADT-related side effects (e.g., bone thinning, cognitive changes, muscle atrophy) were noted for 0/21 men who completed all ADT. Guidelines recommend an annual digital rectal exam (DRE) with no physical exam otherwise specified. No SCPs specified DRE, but all 68 SCPs at the community site recommended at least annual follow-up visits with urology, radiation oncology, and primary care. Only 5/57 SCPs at the academic site specified follow-up visits (radiation oncology every 6 months). Guidelines recommend PSA testing every 6-12 months (optional 3 months if high risk) for 5 years, then annually; while duration was not specified in any SCPs, if applied to the first 5 years, 91% of SCP recommendations were guideline concordant, 7% suggested oversurveillance, and 2% were incomplete. In men who received ADT, guidelines recommend assessing bone density (by imaging or FRAX score), and goal testosterone level. Of 80 men who completed or had ongoing ADT, 2% were recommended for bone density imaging (0 had FRAX scores) and 19% for testosterone levels. Conclusions: SCP content is more complete for demographic and treatment summary information with gaps in addressing treatment effects and follow-up recommendations beyond PSA testing. These findings highlight the need to improve the quality of information in SCPs. Clinical trial information: NCT03035773.

Assessing key stakeholders' knowledge, needs, and preferences for cancer survivorship care plans.

2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 30-30
Author(s):  
Leah L. Zullig ◽  
Callie Berkowitz ◽  
Julie Miller ◽  
Katherine Ramos ◽  
Rowena Dolor ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Cancer Treatment ◽  
Survivorship Care Plans ◽  
Informational Needs ◽  
Survivorship Care ◽  
Structured Interviews ◽  
Care Plans ◽  
Screening And Surveillance ◽  
Cancer Specialists ◽  
Fidelity Implementation

30 Background: Survivorship care plans (SCPs) are individualized documents that summarize cancer treatment received and provide guidelines for monitoring and maintaining survivors’ health. While SCPs are intended to facilitate care coordination, they are rarely used in the primary care setting. We aimed to understand the informational needs and delivery preferences of PCPs, cancer survivors, cancer specialists, and nurses related to SCPs. Methods: We conducted semi-structured interviews with a purposeful sample of PCPs (n = 10), cancer specialists (n = 5), nurses (n = 5), and cancer survivors (n = 5). After reviewing a sample SCP based on the published ASCO template, participants were asked about acceptability, appropriateness, feasibility, fidelity, implementation, and sustainability. De-identified transcripts were qualitatively analyzed using NVivo software. Results: 25 interviews were completed (RR 45%). Emergent themes included informational needs and delivery preferences. Informational needs include clarifying roles and responsibilities of allied professionals; the roles of the PCP for follow-up care should be clear, outlined and with content summarizing their responsibilities regarding screening, and surveillance. Additionally, SCPs should emphasize side and late effects of cancer treatment for the benefit of patients and providers. Delivery preferences include using sustainable and accessible electronic formats to improve provider communication and streamlining documentation for the intended audience. Electronic SCPs could be frequently updated with pertinent information about patient needs and care over time. Conclusions: Understanding the needs and preferences of PCPs may address current limitations of SCPs in coordinating survivor care. Future SCPs may be electronic and accessible, with content and guidance targeted to the PCP’s role.

Survivorship needs after head and neck cancer treatment.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 10062-10062
Author(s):  
Callie Berkowitz ◽  
Deborah H. Allen ◽  
Jennifer Tenhover ◽  
Leah L. Zullig ◽  
Jonathan E. Fischer ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Head And Neck Cancer ◽  
Cancer Treatment ◽  
Head And Neck ◽  
Neck Cancer ◽  
Primary Care Providers ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Care Plans

10062 Background: Head and neck cancer (HNC) survivors experience significant sequelae of treatment, including long-term physical side effects and ongoing surveillance for recurrence and secondary malignancy. Given the complicated trajectory of HNC survivors, survivorship care plans educating patients and their caregivers about treatment and recovery may be beneficial. However, little is known about patients’ knowledge gaps related to survivor issues. Methods: Through a prospective anonymous self-administered survey, we evaluated the baseline knowledge of HNC survivors regarding common post-treatment issues and mediating factors. Forty-one HNC patients within 3 months of completing treatment participated between July-November 2016. Descriptive statistics were used to characterize patient responses. Results: Patients had undergone a variety of treatment modalities: radiation (97%), chemotherapy (71%), and surgery (39%). 85% of patients had primary care providers, 56% had regular dental care, and 44% had dental insurance. 78% had caregivers. HNC survivors’ correct responses to side-effect (SE) knowledge questions were lowest for items regarding hearing loss (15%), sleep (33%), tiredness (38%), and anxiety (49%). Only 28% correctly identified cancer risk with alcohol intake. 87% correctly linked tobacco products to cancer recurrence. Patients were most interested in learning via discussions with nurse or doctor (76%) followed by reading written materials (61%), and researching online (32%). Most patients desired to learn more about their cancer (73%), short-term SE (80%), and long-term SE (77%). Conclusions: Our study demonstrated clear gaps in knowledge and healthcare access that may inform targeted, individualized survivorship care plans. Patients had the largest knowledge deficits for alcohol use and recurrence, hearing loss after treatment, and a variety of emotional effects of cancer treatment. These topics should be addressed during delivery of survivorship care plans and surveillance encounters to improve survivorship knowledge.

Perceptions on caring for adult survivors of childhood cancer in the primary care setting

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 9568-9568
Author(s):  
J. Sima ◽  
S. M. Perkins ◽  
D. A. Haggstrom
Keyword(s):  
Internal Medicine ◽  
Primary Care ◽  
Cancer Treatment ◽  
Childhood Cancer ◽  
General Internal Medicine ◽  
Late Effects ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
General Internal ◽  
Care Plans

9568 Background: Encouraging cure rates for childhood cancers have resulted in a population of adult childhood cancer survivors (CCS) that are at risk for late effects of cancer-directed therapy. Late effects often occur when CCS are older and receive routine medical care from internists and family practitioners. Our study identifies facilitators and barriers to providing optimal late effects screening as well as evaluating information sources primary care providers (PCPs) perceive as useful, including cancer treatment summaries, survivorship care plans, and Children's Oncology Group (COG) guidelines. Methods: We sampled 1,500 randomly selected general internal medicine and family practice physicians from the American Medical Association Physician Masterfile for a nationwide mail survey. We received 351 surveys with data. Using chi-squared tests or t-tests to compare responders and non-responders we found a higher response rate for family practice (30.2%) compared to general internal medicine (16.5%) (p<.0001). Results were tabulated for descriptive purposes and linear regression and logistic regression were used for the multivariable modeling. Results: Most (84–86%) PCPs stated that they had never received a cancer treatment summary or survivorship care plan; despite this, greater than 90% thought these documents would be useful. Most PCPs (93%) had never used COG guidelines, but 86% agreed that they would follow their recommendations. A minority of PCPs perceived that their medical training was adequate to recognize late effects of chemotherapy (27.6%), cancer surgery (36.6%), and radiation therapy (38.1%). Conclusions: PCPs have a low level of awareness about the medical problems of CCS; receive inadequate training to recognize late effects; and infrequently utilize, cancer treatment summaries, survivorship care plans, and COG guidelines. By evaluating the perceptions of PCPs, we have identified problematic areas for future investigation and have begun to lay the groundwork for incorporating follow-up care for CCS into routine general medical practice. No significant financial relationships to disclose.

Relationship of age and cancer treatment to receiving treatment summaries and survivorship care plans in female young adult cancer survivors.

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 55-55
Author(s):  
Ksenya Shliakhtsitsava ◽  
Sally A. D. Romero ◽  
Samantha Roberts ◽  
Irene Su
Keyword(s):  
Bone Marrow ◽  
Cancer Survivors ◽  
Cancer Treatment ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Care Plans ◽  
Young Adult Cancer Survivors ◽  
Younger Age ◽  
Adult Cancer Survivors ◽  
Young Adult Cancer

55 Background: For cancer survivors who were diagnosed with cancer during childhood, adolescence and young adulthood years, transitioning into survivorship and post-cancer treatment care remains challenging and may be aided by treatment summaries (TS) and/or survivorship care plans (SCP). Little research has been conducted on receipt of SCP and/or TS from the patient perspective. The objective of this study was to determine patient- and cancer-specific characteristics that are associated with receipt of SCP and/or TS (SCP/TS). Methods: 240 female young adult cancer survivors (YCS) between ages 18-44 were recruited to a national cohort study on reproductive health and completed a web-based survey that included report of receiving SCP and TS. We used logistic regression models to estimate odds ratios (OR) for characteristics associated with receipt of SCP/TS. Results: Mean age (standard deviation) was 32.8 (5.8) years; mean age at cancer diagnosis was 27.2 (7.1) years. Forty-eight (20%) participants were diagnosed with cancer at < 21 years of age. Only 47% of participants reported receipt of SCP/TS. In unadjusted analyses, current age, younger age at diagnosis, education level, receiving chemotherapy and receiving bone marrow transplant were significantly associated with report of SCP/TS receipt. In multivariable analyses, survivors diagnosed at younger age ( < 21 years) had 2-fold higher odds of SCP/TS receipt (OR 2.0, 95% CI 1.0-3.9). Chemotherapy treatment (OR 2.3, 95% CI 1.2-4.6) and bone marrow transplantation (OR 7.2, 95% CI 1.5-33.3) were also significantly associated with SCP/TS receipt. Conclusions: A significant proportion of YCS do not recall receiving a TS or SCP to aid in the transition to post-cancer treatment survivorship care. Receipt of these documents is not uniform across the young cancer survivor population. Improved integration of TS and SCP into cancer survivorship care is needed.

1077: A Novel Apoptosis-Inducing Gene and its Application in Prostate Cancer Treatment

2004 ◽  
Vol 171 (4S) ◽  
pp. 284-284
Author(s):  
Yi Lu ◽  
Jun Zhang ◽  
Ben Beheshti ◽  
Ximing J. Yang ◽  
Syamal K. Bhattacharya ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Treatment ◽  
Prostate Cancer Treatment
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