Cancer Survivorship Care Research Articles

Skin cancer treatment environment and survivorship resources among sexual and gender minority patients: results of the OUT National Cancer Survey.

Sexual and gender minority (SGM) cancer survivors face unmet care needs in accessing cancer health information and social support despite high satisfaction with treatment. SGM patients often delay care due to concerns of discrimination in healthcare settings, though the care experiences of SGM skin cancer survivors are less known. SGM individuals, particularly sexual minority men, report higher skin cancer prevalence and related risk behaviors than heterosexual men. This study aims to describe SGM skin cancer survivors' perceptions of the care environment and availability of SGM-specific survivorship resources. We conducted a secondary analysis of data from the OUT: National Cancer Survey conducted from September 2020 to March 2021. Among 2,528 survey respondents, 96 self-reported a history of skin cancer, with 33% having keratinocyte carcinomas (KC) only and 67% having melanoma. While 69% reported treatment in welcoming environments, 91% noted the absence of welcoming cues. Only 23% used social support specific to cancer survivorship, despite 62% valuing access to LGBTQI+-inclusive survivorship support. KC survivors reported less access to SGM-specific cancer information compared to melanoma survivors. These findings highlight gaps in dermatologic care for SGM skin cancer survivors. Dermatologists can address these needs by developing targeted health education resources, integrating identity-affirming information into care plans, and establishing inclusive environments through visible LGBTQI + cues and training staff in identity-affirming care. While limited by a small sample size, underrepresentation of gender and racial-ethnic minorities, and reliance on unvalidated survey tools, this study highlights the significant lack of data on SGM skin cancer survivors' experiences. We provide valuable insights into the unmet care needs of SGM skin cancer survivors. Future research should build on this foundational evidence to further examine differences in care experiences across skin cancer types and treatment settings, aiming to optimize support for SGM patients.

The role of statins in breast cancer survivors.

As breast cancer survival rates improve, cardiovascular disease (CVD) has become a critical concern among survivors due to co-morbidities and the cardiotoxic effects of cancer treatments. The risk of developing CVD in this population may surpass the risk of cancer recurrence. This review aims to analyze existing research on the use of statins in breast cancer survivors, focusing on their potential role in mitigating cardiovascular risk and cancer recurrence. The review begins by exploring the shared mechanisms underlying the development of both heart disease and breast cancer. It then examines the evidence for the role of statins in reducing cancer therapy-related cardiac dysfunction (CTRCD) and breast cancer recurrence, highlighting findings from the literature on their anti-inflammatory and lipid-lowering effects. The analysis reveals that statins may offer benefits beyond their traditional cardiovascular applications. Evidence suggests that statins could reduce the risk of CTRCD and potentially lower the risk of breast cancer recurrence. Statins demonstrate promising potential in providing dual benefits for breast cancer survivors by mitigating CVD risk and possibly reducing the likelihood of cancer recurrence. However, additional studies are required to better understand the specific role of statins in breast cancer prevention and survivorship care.

Reconfiguring Priorities: Breastfeeding Decision-making Among Young Breast Cancer Survivors.

Breast cancer survivors face unique challenges in breastfeeding decisions. Limited research exists on the experiences and decision-making processes of young women with breast cancer regarding breastfeeding. To explain the decision-making processes of young women with breast cancer in relation to breastfeeding throughout the cancer trajectory. A constructivist grounded theory approach was used. Semistructured interviews were conducted with 12 women diagnosed with breast cancer and 8 healthcare professionals. Data were analyzed using constant comparative analysis. The core category "Reconfiguring Priorities: The Secondary Role of Breastfeeding in the Context of Breast Cancer in Young Women" emerged, encompassing 3 subcategories: (1) scars over time, (2) omitting breastfeeding in oncological care, and (3) self-management of breastfeeding. Breastfeeding decision-making among young breast cancer survivors is not driven by conscious will but by a constant struggle with the conditioning factors of the oncological process: mortality and toxicity of drugs to breast milk. The lack of professional support leads women to develop their own strategies for managing breastfeeding, marked by ambivalence between motivations and personal challenges. Healthcare professionals should integrate breastfeeding discussions into oncological care for young breast cancer survivors. Specialized lactation consultants with oncology expertise should be incorporated into the care team. Peer support programs can provide valuable guidance based on lived experiences, empowering women to make informed decisions about breastfeeding after breast cancer.

”Being ill was the easy part”: exploring cancer survivors’ reactions to perceived challenges in engaging with primary healthcare

ABSTRACT Purpose Cancer survivors experience barriers to primary healthcare (PHC) services. The aim was to explore reactions to and opinions about perceived challenges associated with PHC access and quality among cancer survivors in Sweden, including how they have acted to adapt to challenges. Methods Five semi-structured focus group interviews were conducted with cancer survivors (n = 20) from Skåne, Sweden, diagnosed with breast, prostate, lung, or colorectal cancer or malignant melanoma. Focus groups were mixed in regard to diagnosis. Data were analysed using a descriptive template analysis approach. Results In light of perceived challenges associated with access to adequate PHC, participants experienced that they had been forced to work hard to achieve functioning PHC contacts. The demands for self-sufficiency were associated with negative feelings such as loneliness and worry. Participants believed that cancer survivors who lack the ability to express themselves, or sufficient drive, risk missing out on necessary care due to the necessity of being an active patient. Conclusions The findings highlight negative patient experiences. They have implications for the organization of care for cancer survivors as they indicate a need for more efficient post-treatment coordination between cancer specialist care and PHC providers, as well as increased support for patients leaving primary cancer treatment.

Musical Efficacy in Medical Humanities Care - Focusing on a Case of Music Care for Cancer Survivors

Musical Efficacy in Medical Humanities Care - Focusing on a Case of Music Care for Cancer Survivors

Implementation of Regular Lifestyle Counseling During Long-Term Follow-Up Care of Childhood Cancer Survivors: Monocentric Prospective Study.

Many childhood cancer survivors (CCS) develop treatment-related late effects, including an increased risk of obesity and metabolic syndrome. A healthy lifestyle can reduce the risk of associated comorbidities. Therefore, at-risk CCS could benefit from lifestyle counseling during regular long-term follow-up (LTFU). We implemented a new form of care to decrease the long-term morbidity among CCS and to gain new insights into the lifestyle of those patients. Over a 1-year study period, lifestyle counseling was integrated into LTFU care. Metabolic disorders, including hypercholesterolemia, diabetes mellitus, overweight or underweight, and low activity levels, were assessed as screening parameters for various risk groups. The perspectives of CCS, physicians, and sports scientists were compared to identify those with the highest needs. Each lifestyle counseling included general recommendations for physical activity, as well as an assessment of individual preferences for and barriers to the implementation of a healthy lifestyle. A follow-up appointment after 1 month was performed. Of the 155 CCS aged 18 to 63 years (n=100, 65% female and n=55, 35% male), 112 (72%) had an indication for lifestyle counseling, identified by physicians, sports scientists, or the CCS themselves. Metabolic disorders affected 45% (n=70) of these CCS, and 46% (n=72) did not meet recommended activity levels. A total of 120 (77%) CCS received lifestyle counseling, including 8 initially uninterested individuals who became open to recommendations. Those with intensive cancer treatment history showed the greatest need. A total of 65 (54%) CCS were advised to change their lifestyle in both areas (diet and exercise) while 51 (43%) CCS received recommendations for only exercise (n=43 CCS, 36%) or diet (n=8 CCS, 7%). A total of 4 (3%) CCS, although interested in counseling, received no advice, as they already met the recommendations. Follow-up revealed high adherence to recommendations and successful integration into daily lives. In total, 97% (n=150) of survivors indicated that the provision of lifestyle counseling during LTFU would be generally beneficial. Incorporating specialized health care professionals such as sports scientists into survivorship care enhances the multidisciplinary approach of LTFU care. Promoting a healthy lifestyle by offering guideline-based lifestyle counseling is broadly accepted among CCS and may reduce long-term morbidity.

The Role of Oncology Clinical Nurse Specialists in Enhancing Cancer Survivorship Care: A Comprehensive Review of Global Implementation Challenges and Opportunities

Background: The role of oncology clinical nurse specialists (CNS) has become increasingly vital in the landscape of cancer care, especially as healthcare systems adapt to the growing demands of cancer survivorship. These advanced practice nurses provide critical support throughout the cancer journey, emphasizing symptom management, patient education, and coordination of care. Methods: This literature review employed a Rapid Evidence Assessment methodology, focusing on peer-reviewed articles published between 2022 and 2023. The review analyzed the global implementation of the oncology CNS role, examining various healthcare systems and the unique challenges associated with this position. Results: The findings indicate that oncology CNSs significantly enhance patient outcomes, including reduced hospitalizations and improved quality of life for cancer patients. In the UK, for instance, data revealed a substantial decrease in non-acute hospitalizations among lung cancer patients under CNS care. Qualitative research highlighted the emotional support provided by CNSs, which is crucial for patients navigating complex treatment regimens. Challenges identified include role ambiguity, insufficient training, and systemic barriers that hinder effective practice. Conclusion: The oncology CNS role is essential for improving cancer care delivery, yet it faces significant challenges that limit its potential. To optimize the impact of CNSs, healthcare systems must clearly define their responsibilities, enhance training programs, and foster collaboration among multidisciplinary teams. This review underscores the need for further research to fully understand the contributions of oncology CNSs in diverse healthcare settings, as well as to identify strategies for overcoming existing barriers.

The living centre: an innovative open-access model of breast cancer survivorship care.

People affected by breast cancer experience a multitude oftoxicities and unmet needs across physical, cognitive, psychosocial, and economic domains that adversely impact their quality of life. High-quality and diverse supportive care is required to improve outcomes and rehabilitation for people affected by breast cancer. However, the availability and access to high-quality supportive care services is limited due to factors including cost and demand. As such, many people affected by breast cancer do not receive optimal supportive care. The Think Pink Foundation facilitates free-of-charge supportive care services to breast cancer survivors, their families, and caregivers through 'The Living Centre'. Think Pink seeks to provide a high-quality survivorship care model that overcomes barriers associated with the economic burden of cancer. Within its suite of services, The Living Centre offers ongoing exercise classes, creative therapy, support groups, specialist breast cancer nurse consultations, wellness services, and education support through face-to-face and online service provision. This paper outlines the development, model of care, service provision, and planning for future outcomes and economic evaluation of The Living Centre as a supportive care model for others to consider establishing in their local context. This paper may therefore directly inform the development of cancer survivorship care services globally to increase equitable access to optimal supportive care.

User Experience and Extended Technology Acceptance Model in Commercial Health Care App Usage Among Patients With Cancer: Mixed Methods Study.

The shift in medical care toward prediction and prevention has led to the emergence of digital health care as a valuable tool for managing health issues. Aiding long-term follow-up care for cancer survivors and contributing to improved survival rates. However, potential barriers to mobile health usage, including age-related disparities and challenges in user retention for commercial health apps, highlight the need to assess the impact of patients' abilities and health status on the adoption of these interventions. This study aims to investigate the app adherence and user experience of commercial health care apps among cancer survivors using an extended technology acceptance model (TAM). The study enrolled 264 cancer survivors. We collected survey results from May to August 2022 and app usage records from the app companies. The survey questions were created based on the TAM. We categorized 264 participants into 3 clusters based on their app usage behavior: short use (n=77), medium use (n=101), and long use (n=86). The mean usage days were 9 (SD 11) days, 58 (SD 20) days, and 84 (SD 176) days, respectively. Analysis revealed significant differences in perceived usefulness (P=.01), interface satisfaction (P<.01), equity (P<.01), and utility (P=.01) among the clusters. Structural equation modeling indicated that perceived ease-of-use significantly influenced perceived usefulness (β=0.387, P<.01), and both perceived usefulness and attitude significantly affected behavioral intention and actual usage. This study showed the importance of positive user experience and clinician recommendations in facilitating the effective usage of digital health care tools among cancer survivors and contributing to the evolving landscape of medical care.

Cancer Survival as a Social Practice: A Study of Selective Indian Women Cancer Narratives

Researching the survival trajectories of cancer survivors, through their narratives, is indeed crucial for understanding the multifaceted dimensions of their experiences. Within the Indian subcontinent, where cultural, societal, and healthcare dynamics differ widely, studying cancer narratives of female survivors offer a unique perspective. Women often face specific challenges related to gender roles, stigma, access to healthcare, and support systems. Understanding how female cancer survivors navigate through these challenges and develop strategies for survival can benefit both healthcare practices and social support structures. The four primary texts taken for analysis come under the genre of illness narratives: Anita Moorjani’s Dying to Be Me: My Journey from Cancer, to Near Death, to True Healing (2012), Neelam Kumar’s To Cancer with Love: My Journey of Life (2015), Manisha Koirala’s (with Neelam Kumar) Healed: How Cancer Gave Me a New Life (2018) and Lisa Ray’s Close to the Bone (2019) are analytically reviewed for the study. Theoretical perspectives from the survivorship theory of Alex Broom and Katherine Kenny have created a framework to analyse the survival trajectory in this research. Exploring how women perceive and cope with the news of their cancer diagnosis, including their emotional responses, fears, and uncertainties makes cancer survival a social practice rather than an individual struggle. The study also identifies the strategies and resources women utilise such as spirituality, peer support, information-seeking, or maintaining a positive outlook. It examines the long-term effects of cancer survivorship, like recurrence, survivorship care, body image, relationships, and existential concerns. By delving into these themes, the research understands the experiences of female cancer survivors to reduce stigma and inspire hope for others facing similar challenges.

Oncology and Primary Care Involvement in Breast Cancer Survivorship Care More Than 5 Years After Initial Treatment.

Very little is known about primary care involvement in the care of cancer survivors beyond the initial 5 years post-treatment when transitioning to primary care is guideline-recommended for many survivors. The ICanCare study is a longitudinal survey of women diagnosed with breast cancer in 2014-2015 identified in the Georgia and Los Angeles SEER registries. Women were surveyed during initial treatment and again approximately 6 years later in survivorship (2021-2022; n = 1,412, 60% response rate). Respondents were asked which provider led their survivorship care (oncology, shared care, primary care provider [PCP]) and PCP management of eight common survivorship issues (range, 0-32). Multivariable-adjusted associations of participant characteristics with survivorship care delivery and PCP management of survivorship issues were evaluated using logistic and linear regression models, respectively. Over half of the women (57.2%) reported oncologist-led survivorship care delivery, 20.5% shared care, and 22.4% PCP-led. PCP management of survivorship issues was moderate (mean, 11.4, 95% CI, 11.0 to 11.8) and was highest (often/always discussed) for medication management (50.1%), improving physical activity (49.1%), and chronic disease management (43.6%). Greater confidence in PCP's ability to manage survivorship care (v no or little confidence) was associated with PCP-led delivery (P = .01) and more PCP management of survivorship issues (P < .0001). In this diverse cohort of breast cancer survivors, primary care involvement in survivorship care delivery and management of common survivorship issues remains low even more than 5 years after completing treatment and little variation was seen across survivor sociodemographic or clinical characteristics. Confidence in PCP ability to manage survivorship care was found to be important and may represent an opportunity to foster transition to primary care-led survivorship care delivery.

Exploring disparities in post-cancer treatment instructions: an analysis of rural vs. urban breast cancer survivors in Missouri using BRFSS data

BackgroundThere are more than 4 million breast cancer survivors in the United States. With continuing improvements in early detection and treatment, the number of breast cancer survivors will only continue to increase. Breast cancer survivors face a lifetime risk of long-term or late-effects from cancer treatments, thus post-cancer treatment care, referred to as survivorship care, is critical. Social determinants of health, including where a breast cancer survivor lives, may impact cancer survivorship care. Our purpose was to evaluate the relationship between rural/urban status and receipt of cancer survivorship care and instructions for Missouri breast cancer survivors using state-level data from a nationwide telephone survey—the Behavioral Risk Factor Surveillance System (BRFSS).MethodsMissouri included the BRFSS Cancer Survivorship Module in 2014, 2016, 2018, and 2020. Module items ask cancer survivors about receipt of a “post-cancer-treatment summary” and “follow-up instructions.” We hypothesized chances of receipt of both components would differ among four level Rural–Urban Commuting Area (RUCA) Code groups (Rural, Small-Town, Micropolitan, Metropolitan). Data from 430 breast cancer survivors over four survey years were combined and grouped according to RUCA status. Using a logistic model with a multilevel approach (after sampling weights calibration), the relationship between receipt of survivorship instructions and RUCA group was examined.Results46% of Missouri breast cancer survivors reported receipt of complete survivorship instructions. Compared to rural breast cancer survivors, micropolitan breast cancer survivors had 5.9 times higher odds of receiving survivorship instructions (p < 0.0001).ConclusionsLess than half of respondents reported receiving complete post-cancer treatment instructions. More urban respondents were more likely to receive instructions than their rural counterparts which raises questions about the quality of post-treatment care between rural and urban survivors. A sophisticated and purposeful approach to mitigating potential disparities is warranted. Receipt of cancer survivorship care plans may be impacted by rurality/urbanicity. Clinicians caring for cancer survivors living in rural or urban settings must continue to be diligent with providing personalized survivorship care.

General Practitioners' Experiences With Implementing Colon or Prostate Cancer Survivorship Care in Primary Care: A Cross-Sectional Survey Nested Within Two Randomized-Controlled Trials.

To evaluate general practitioners' (GPs) experiences with providing cancer survivorship care and explore readiness for implementation. This cross-sectional survey study was nested within two randomized-controlled trials conducted in the Netherlands between 2015 and 2023, comparing GP- with specialist-led survivorship care for patients with colon or prostate cancer. An adapted version of the normalisation measure development (NoMAD) survey was distributed among participating GPs. NoMAD assesses the implementation of complex interventions and includes seven items on experiences (score ranges, 0-10) and 19 core items (expressed as % agreement). Higher scores indicate greater normalization, that is, embedding in primary care. In total, 214 GPs participated (response rate, 69%). The overall experience with providing survivorship care was 7.0 ± 1.6 for prostate cancer and 6.4 ± 1.8 for colon cancer. Lowest scores were seen for willingness to provide care (5.9 ± 2.4 and 5.0 ± 2.5, respectively), expected future involvement (6.6 ± 2.0 and 5.6 ± 2.5), and appropriateness of involvement (6.4 ± 2.1 and 5.6 ± 2.7). GPs in both trials agreed (±75%) there was potential value for patients, but not for their own work (±50%). Survivorship care for colon cancer was often perceived as different from usual care (74%). GPs' self-reported knowledge of care was high in the prostate cancer trial (62%), but not in the colon cancer trial (41%). GPs from both trials agreed that they could easily integrate management of physical and psychosocial effects into their work (±70%), but integrating routine check-ups was rated less positively (±55%). Financial compensation was deemed necessary (±80% agreed). Twenty-one percent was willing to provide care for other cancer types. GPs recognize value of providing survivorship care for patients, but experiences differ on the basis of cancer type. Implementation of prostate versus colon cancer survivorship care appears more feasible.

Addressing Unanswered Questions in Lung Cancer Survivorship Care—Home-Based Physical Activity After Surgery

Addressing Unanswered Questions in Lung Cancer Survivorship Care—Home-Based Physical Activity After Surgery

PRiSM: Specialist Palliative Care's Role in Cancer Survivorship Model Developing European consensus recommendations on the role of specialist palliative care in cancer survivorship to inform a model of care.

PRiSM: Specialist Palliative Care's Role in Cancer Survivorship Model Developing European consensus recommendations on the role of specialist palliative care in cancer survivorship to inform a model of care.

Combined effects of nutrition, inflammatory status, and sleep quality on mortality in cancer survivors

BackgroundCancer survivors face many challenges in long-term health management, including malnutrition, systemic inflammation, and sleep issues, which significantly affect their survival and quality of life.MethodsA prospective cohort study was derived from the National Health and Nutrition Examination Survey from 2005–2018 harboring 1,908 cancer survivors (weighted population, 11,453,293), of whom 688 deaths (220 from cancer mortality, 468 from non-cancer mortality). The Advanced Lung Cancer Inflammation Index (ALI) was used as a measure of nutritional status and systemic inflammation in cancer patients. Weighted multivariable Cox proportional hazards regression models were utilized to explore the independent and combined effects of ALI and sleep quality on mortality outcomes.ResultsThe participants with a high ALI were more likely to be female, aged 40 to 64 years, non-Hispanic white, and have a higher BMI. We observed that elevated ALI levels were associated with decreased risks of all-cause mortality (Hazard ratio [HR] = 0.601, 95% Confidence interval [CI] = 0.521–0.695, P < 0.001), cancer-specific mortality (HR = 0.659, 95% CI = 0.497–0.870, P = 3.34 × 10–3) and non-cancer-specific mortality (HR = 0.579, 95% CI = 0.478–0.701, P < 0.001). Similarly, better sleep quality (e.g., without sleep troubles) was associated with lower risks of all-cause mortality (HR = 0.761, 95% CI = 0.620–0.933, P = 8.79 × 10–3) and non-cancer-specific mortality (HR = 0.713, 95% CI = 0.572–0.890, P = 2.80 × 10–3). Notably, the joint analysis showed that cancer survivors with higher ALI levels and better sleep quality (e.g., standard sleep duration) had the lowest risks of all-cause (HR = 0.468, 95% CI = 0.352–0.622, P < 0.001), cancer-specific mortality (HR = 0.631, 95% CI = 0.333–0.672, P = 7.59 × 10–3) and non-cancer-specific mortality (HR = 0.440, 95% CI = 0.315–0.615, P < 0.001).ConclusionsThis study suggests that better nutritional and inflammatory status, combined with good sleep quality, may contribute to improved survival among cancer survivors. These results underscore the potential clinical importance of integrating nutritional and sleep quality assessments into the long-term care of cancer survivors to enhance their overall prognosis.

Nurse-delivered brief behavioral treatment for insomnia in cancer survivors: a randomized controlled trial.

To determine the efficacy of nurse-delivered brief behavioral treatment for insomnia (BBTI) compared to an attention control, in a heterogeneous sample of cancer survivors to reduce insomnia symptom severity. We recruited 132 participants from cancer care clinics, who had an Insomnia Severity Index (ISI) score ≥ 8. Participants were randomized into two groups: an experimental BBTI group and a healthy eating attention control group. Demographics survey at baseline, and sleep-related questionnaires, self-reported sleep diaries, and wrist-worn actigraphy at baseline, 1, 3, and 12months were collected. Statistical analyses used analysis of covariance (ANCOVA) models with two-sided 0.05 nominal significance level for treatment effect for primary outcome of insomnia severity at 1month. Participants were cancer survivors with a mean age of 63.7years, 55% female, 88.6% white, with breast, prostate, colorectal, and lung cancer. Statistically significant group differences were observed at all time points for ISI and sleep quality (ISI effect sizes 0.56, 0.59, and 0.54 respectively). Additionally, at 1month, those in insomnia remission (ISI ≤ 8) were higher for the BBTI (55.1%) compared to the control group (43.3%). Secondary outcomes from sleep diary measures (i.e., sleep efficiency, sleep onset latency, wake after sleep onset) were significant at 1month. The BBTI group was significantly effective in reducing insomnia severity and improving sleep quality over time compared to the control among cancer survivors. Clinical trials identifier: http://ClinicalTrials.gov , NCT03810365. Implementing BBTI in survivorship settings can effectively address and manage insomnia symptoms, thus bridging a crucial gap in care for cancer survivors.

Group medical visits in cancer survivorship care: a scoping review

Abstract Background More than 60% of cancer survivors report unmet physical, psychosocial, and informational needs. The care of cancer survivors includes surveillance, health maintenance monitoring, referral for long-term adverse effects of cancer treatment, and coordination of care. Group medical visits (GMV) include medical care, education, and peer support and can be used to facilitate the delivery of multidisciplinary survivorship care. We aimed to characterize the current state of related research describing the role of GMV in cancer survivorship care. Methods For this scoping review, we searched for published literature using PubMed, Embase, and other resources. We included intervention studies of multidisciplinary care involving GMVs of adult patients with a history of cancer requiring the presence of medical personnel, physicians, advanced practitioners, or oncology nurses. We included studies that focused on broad cancer survivorship care, rather than those using specific modalities, such as yoga, or limited to specific aspects of cancer survivorship care, such as weight loss. We characterized the studies by cancer type, structure of GMVs, and reported outcomes. Results We identified 2311 studies (2122 from PubMed and 189 from Embase). We excluded 1524 duplicates and screened 787 studies for title and abstract review. Finally, 63 studies were retrieved for full-text review, and six were included in this scoping review. Of the included studies, four were non-randomized, and two were randomized. Breast cancer was the most common site (4); other studies included breast and other cancers (1) and hematopoietic transplant cancer survivors (1). There was heterogeneity in the structure and frequency of sessions and the survivorship domains addressed. The outcomes studied included quality of life, healthcare utilization, and costs. Conclusions Limited high-quality research exists on the role of GMV in cancer survivorship. Though shown to be effective in chronic disease, the evidence for the effectiveness of this important and widely used approach in multidisciplinary survivorship care remains inconsistent and preliminary; the literature to date provides a starting point for larger-scale studies of GMV in cancer survivorship care. Implications for Cancer Survivors While Group medical visits are a promising intervention to provide multidisciplinary care, larger studies are needed to support their benefit in the care of cancer survivors.

‘You’d Still be You, and I Still Love You’: Exploring the Impact of Breast Cancer from a Systemic Perspective

This study aimed to increase our understanding of breast cancer survivors’ responses to their illness from a systemic perspective. In-depth semi-structured interviews were completed on 20 women 18-years and older, diagnosed with breast cancer. Themes emerging from the data included a) impact of the diagnosis, b) partner’s and family’s denial of illness and discomfort with emotions, c) sexuality, d) reconstruction, e) dating in the future, f) impact on children and parenting and, g) supportive and unsupportive behavior. The findings highlight the importance of shifting the focus from patient-centered to family-centered care for breast cancer survivors. Clinical implications are included.

Contextual factors that influence adoption and sustainment of self-management support in cancer survivorship care: a practical application of theory with qualitative interviews

BackgroundSelf-management support (SMS) is a recommended component of cancer survivorship care that improves health-related quality of life and reduces healthcare utilisation. However, widespread implementation has been difficult to achieve, with...