Cancer care today often provides state-of-the-science biomedical treatment, but fails to address the psychological and social (psychosocial) problems associated with the illness. This failure can compromise the effectiveness of health care and thereby adversely affect the health of cancer patients. Psychological and social problems created or exacerbated by cancer-including depression and other emotional problems; lack of information or skills needed to manage the illness; lack of transportation or other resources; and disruptions in work, school, and family life-cause additional suffering, weaken adherence to prescribed treatments, and threaten patients' return to health. Today, it is not possible to deliver high-quality cancer care without using existing approaches, tools, and resources to address patients' psychosocial health needs. All patients with cancer and their families should expect and receive cancer care that ensures the provision of appropriate psychosocial health services. Cancer Care for the Whole Patient recommends actions that oncology providers, health policy makers, educators, health insurers, health planners, researchers and research sponsors, and consumer advocates should undertake to ensure that this standard is met.
Health has been conceptualized by world and national health organizations (WHO, CDC, Healthy People 2010) as more than the absence of disease. It involves a focus on physical, psychosocial, and functional aspects of life as well as the prevention of future illnesses. At this point in the development of quality health care for cancer survivors, there is sufficient knowledge and expert opinion to push efforts forward to improve the health of cancer survivors. Clearly there is more research in the most prevalent forms of cancers (e.g., breast cancer) than others that provide us with guidance on how to optimize their health, but there are data on other forms of cancers that can also better inform practice. There may also be general care practices that can cut across cancer types. There has been an emergence of epidemiological and clinical research in cancer survivors that can form the basis for a revolution in the quality and nature of health care that survivors receive. This book not only provides the reader with diverse perspectives and data but also integrates this information so it can serve as the foundation necessary to improve and maintain the health of cancer survivors. Reporting of symptoms to health care providers is a complex, multi-determined problem influenced not only by the pathophysiology but also, as we have learned over the years through pain research, by societal, cultural, and biobehavioral factors. This book will consider this important aspect of follow-up for millions of cancer survivors because of the strong reliance on symptom reporting for clinical decision making. In order for us to generate meaningful and effective treatment, we need to better understand the symptom experience in cancer survivors. This book provides much information that will assist us to better understand and manage this complicated end point. The presenting problems need to be articulated and “conceptualized” as clearly as possible by both parties so appropriate actions can be taken. Since health care costs are a major concern for patients, payers, and providers, this area will also be addressed in all the relevant sections. In taking an interdisciplinary perspective, this book illustrates the importance of a team approach to the improvement of health care and associated health, well-being, and functioning in cancer survivors. The 17 chapters cover critical topics of which physicians and providers of all types must be aware in order to provide the most comprehensive and responsive care for cancer survivors. All of the clinical care chapters include case studies to illustrate the real-world application of these approaches in cancer survivors. Information about sources of referral both within and outside the traditional health care communities will be provided in tabular form. There is no other text that provides both an overview of the problems and their challenges, case illustrations of direct application, and the reality of reimbursement for such care. The editors hope that there may be no need for the clinician or the survivor to adapt to a “new normal” if the presenting problems are understood and handled from an interdisciplinary perspective as outlined here.
The 2006 Institute of Medicine (IOM) consensus study report From Cancer Patient to Cancer Survivor: Lost in Transition made recommendations to improve the quality of care that cancer survivors receive, in recognition that cancer survivors are at risk for significant physical, psychosocial, and financial repercussions from cancer and its treatment. Since then, efforts to recognize and address the unique needs of cancer survivors have increased, including an emphasis on improving the evidence base for cancer survivorship care and identifying best practices in the delivery of high-quality cancer survivorship care. To examine progress in cancer survivorship care since the Lost in Transition report, the National Cancer Policy Forum of the National Academies of Sciences, Engineering, and Medicine held a workshop in July 2017, in Washington, DC. Workshop participants highlighted potential opportunities to improve the planning, management, and delivery of cancer survivorship care. This publication summarizes the presentations and discussions from the workshop.
In the United States, approximately 14 million people have had cancer and more than 1.6 million new cases are diagnosed each year. However, more than a decade after the Institute of Medicine (IOM) first studied the quality of cancer care, the barriers to achieving excellent care for all cancer patients remain daunting. Care often is not patient-centered, many patients do not receive palliative care to manage their symptoms and side effects from treatment, and decisions about care often are not based on the latest scientific evidence. The cost of cancer care also is rising faster than many sectors of medicine--having increased to $125 billion in 2010 from $72 billion in 2004--and is projected to reach $173 billion by 2020. Rising costs are making cancer care less affordable for patients and their families and are creating disparities in patients' access to high-quality cancer care. There also are growing shortages of health professionals skilled in providing cancer care, and the number of adults age 65 and older--the group most susceptible to cancer--is expected to double by 2030, contributing to a 45 percent increase in the number of people developing cancer. The current care delivery system is poorly prepared to address the care needs of this population, which are complex due to altered physiology, functional and cognitive impairment, multiple coexisting diseases, increased side effects from treatment, and greater need for social support. Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis presents a conceptual framework for improving the quality of cancer care. This study proposes improvements to six interconnected components of care: (1) engaged patients; (2) an adequately staffed, trained, and coordinated workforce; (3) evidence-based care; (4) learning health care information technology (IT); (5) translation of evidence into clinical practice, quality measurement and performance improvement; and (6) accessible and affordable care. This report recommends changes across the board in these areas to improve the quality of care. Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis provides information for cancer care teams, patients and their families, researchers, quality metrics developers, and payers, as well as HHS, other federal agencies, and industry to reevaluate their current roles and responsibilities in cancer care and work together to develop a higher quality care delivery system. By working toward this shared goal, the cancer care community can improve the quality of life and outcomes for people facing a cancer diagnosis.
The economic burden of breast cancer for women under 50 in the United States remains largely unexplored, in part because young women make up a small proportion of breast cancer cases overall. To address this knowledge gap, we conducted a web-based survey to compare data from breast cancer survivors 18–39 years of age at first diagnosis and 40–49 years of age at first diagnosis.We administered a survey to a national convenience sample of 416 women who were 18–49 years of age at the time of their breast cancer diagnosis. We analyzed factors associated with financial decline using multivariate regression.Survivors 18–39 years of age at first diagnosis were more likely to report Stage II–IV breast cancer (P < 0.01). They also quit their jobs more often (14.6%) than older survivors (4.4%; P < 0.01) and faced more job performance issues (55.7% and 42.8%, respectively; P = 0.02). For respondents in both groups, financial decline was more likely if the survivor had at least one comorbid condition (odds ratios: 2.36–3.21) or was diagnosed at Stage II–IV breast cancer (odds ratios: 2.04–3.51).
Only more recently has it been realized that the intense effort to care for and cure a child with cancer does not end with survival. Continued surveillance and a variety of interventions may, in many cases, be needed to identify and care for consequences of treatment that can appear early or only after several decades and impair survivors' health and quality of life. The more than two-thirds of childhood cancer survivors who experience late effects-that is, complications, disabilities, or adverse outcomes-as a result of their disease, its treatment, or both, are the focus of this report which outlines a comprehensive policy agenda that links improved health care delivery and follow-up, investments in education and training for health care providers, and expanded research to improve the long-term outlook for this growing population now exceeding 270,000 Americans.
One of the key recommendations of the joint IOM and NRC book, From Cancer Patient to Cancer Survivor: Lost in Transition, is that patients completing their primary treatment for cancer be given a summary of their treatment and a comprehensive plan for follow-up. This book answers practical questions about how this "Survivorship Care Plan," including what exactly it should contain, who will be responsible for creating and discussing it, implementation strategies, and anticipated barriers and challenges.
Cancer diagnosis and treatment doesn't have to be a passive experience, and it shouldn't be. Dr. Kathryn Schmitz's Moving Through Cancer introduces a 21-day program of strength training and exercise for cancer prevention and recovery. Go from diagnosis to thriving with this empowering guide to using strength training and exercise to improve your mental and physical health before, during, and after cancer diagnosis and treatment. This groundbreaking program will show you how to use exercise and movement to: • Recover more quickly from surgery • Withstand chemotherapy (or other drug treatments) or radiation with fewer side effects • Bounce back to daily life following cancer treatments • Prevent loss of function or fitness due to treatment • Return to work more quickly or stay at work throughout treatment • Protect against late side effects of treatment that come years after diagnosis Leading exercise oncology researcher Dr. Kathryn Schmitz shows you how to prepare for cancer treatment and begin regularly exercising in just 21 days using five key steps: Move, Lift, Eat, Sleep, and Log. Both informative and practical, Moving Through Cancer explains the science of healing and prevention and delivers a paradigm-shifting message for patients, doctors, and caregivers about using exercise to live with and beyond cancer. FOR READERS OF: Anticancer Living and The Cancer-Fighting Kitchen. A PRACTITIONER AND CAREGIVER: Dr. Kathryn Schmitz is a pracademic (practitioner + academic) and a caregiver: In 2010, the publication of one of her trials in The New England Journal of Medicine and the Journal of the American Medical Association overturned years of entrenched dogma and conventional wisdom that told breast cancer survivors to avoid upper body exercise. In 2016, Dr. Schmitz's wife, Sara, was diagnosed with stage 3 squamous cell carcinoma—she is currently NED (no evidence of disease) and cancer free. Moving Through Cancer is inspired by Dr. Schmitz's professional and personal experience with cancer. HELPS PATIENTS AND CAREGIVERS TO COMBAT THE POWERLESSNESS OF THE CANCER JOURNEY: Dr. Schmitz's empowering message will not only resonate with anyone who has been diagnosed with cancer but with their family and loved ones as well. Dr. Schmitz is able to give life back to readers by providing results that include better sleep, better sex, less chemo brain, reduced nausea, and improved recovery. PARADIGM-SHIFTING PROTOCOL: Moving Through Cancer is the center of Dr. Schmitz's campaign to have doctors prescribing exercise to cancer patients as common practice by 2029. THE FIRST MAINSTREAM EXERCISE-FOR-CANCER BOOK: Until now, exercise-for-cancer books have been limited to academic approaches or one-cancer-specific (breast) or one-exercise specific (yoga, pilates) books. Moving Through Cancer is for all cancer patients and survivors and their caregivers. GREAT FOR THE CLASSROOM: Students and teachers will want to use these techniques in their classrooms to provide a better understanding of how to treat cancer patients. Perfect for: 18+, Health enthusiasts, rehab, exercise, academia, medical professionals
This extraordinary resource celebrates and expands on Dr. David Spiegel's discovery that a shared intimacy with mortality creates very different concerns in the patient from those that apply in conventional settings. Spiegel and Classen introduce mental health professionals to the awareness as well as the tools they will need to facilitate groups coping with existential crises. The result is a model for helping that actually helps.
Handbook of Cancer Survivorship Care serves as a practical and concise guide for the multidisciplinary management of cancer survivors. Nearly all of the chapters are authored by a team consisting of a seasoned oncologist and an experienced practitioner who provides direct services in survivorship care. Chapters reflect the importance of interdisciplinary collaboration and cover the high-yield pearls and clinical applications that lead to quality patient care outcomes. Part I discusses the basic concepts of survivorship care, models of care, and clinical tools while addressing late and long-term effects of treatment, screening methods for secondary or recurring tumors, and prevention of disease relapse. Part II includes chapters on cancers commonly seen in community practice, such as breast, prostate, lymphoma, and colorectal. Chapters in Part II provide clinical pearls and disease-specific background, a guide to disease surveillance, instructions for monitoring late effects, early detection tips, and information on psychosocial health, all to better direct clinical assessment and management. With cancer survivors an increasing segment of the healthcare population and survivorship care rapidly evolving, it is paramount that oncologists and other care providers are up-to-date on the clinical strategies, interventions, and recommendations for follow-up care. As a pocket-sized, quick reference, Handbook of Cancer Survivorship Care is an indispensable resource for any healthcare provider – including physicians, nurses, and other practitioners – seeing patients in remission; it covers the must-know points of clinical management and successfully carries over cutting-edge expertise into clinical practice whether it is used at the bedside or in the clinic. Key Features: Includes practical guidance on challenging areas such as addressing psychosocial issues, establishing screening and prevention strategies, managing late effects in cancer survivors and many more Easy-to-read outline format makes referencing in the clinical setting quick and convenient Practical clinical vignettes with self-assessment Q&A accompany chapters in Part II Clinical pearls highlight survivorship guidelines and their application Provides management guidelines and detailed disease surveillance strategies for site-specific cancers Includes digital access to the e-book
