Are we meeting the standards for cancer survivor care?

Abstract

98 Background: The Institute of Medicine (IOM), American Society of Clinical Oncology (ASCO), and National Comprehensive Cancer Network (r) (NCCN (r)) have issued standards of care for cancer survivors including development of a cancer treatment summary and coordination with the patient’s primary care provider (PCP) and other providers for follow up care. The author’s NCI-designated cancer center recently developed a survivor program for women with breast cancer and the plan is to expand the program to all cancers. Methods: To find out what physicians or providers are doing at baseline with cancer survivor care, a short 9 question survey was developed with questions based on the NCCN guidelines (r) and standards for survivorship care. These questions were sent to providers in all the disease specific clinics. The survey was sent to a total of 51 providers via email using SurveyMonkey.com and given 2.5 weeks to complete the survey. Results: A total of 51 providers were sent the survey by email and 21 responded (41%). Ten different disease subspecialties within oncology were represented with an average of 15 years of experience with providers seeing an average of 42 survivors per month. Seventy-one percent felt prepared to discuss survivorship care. Greater than 66% discussed prevention and all the providers who responded screened for recurrence or development of second cancers (100%). Greater than 47% screened for late physical and psychosocial effects of treatment. Most of the providers (61%) had interventions for physical but not psychosocial late effects of treatment. The majority of respondents felt that communication was poor between the oncology specialty provider and the patient’s PCP regarding survivorship care. Conclusions: Based on the responses to the survey based on NCCN standards for survivor care, at our institution most of the providers feel capable of discussing survivor care and 100% of those that responded screen for recurrence or second cancers. Providers need more help with interventions for late effects of treatment especially for psychosocial issues. The area that needs the most improvement is communication between specialty provider and PCP about survivorship care.