The KU Wichita Center for Breast Cancer Survivorship

Judy Johnston, MS, RD/LDResearch Instructor

Department of Preventive Medicine and Public Health, KUSM-W

Program Director, KU Wichita Center for Breast Cancer Survivorship

Utilizing the CDC definition of “Cancer Survivor”

• Those diagnosed with cancer

and

• Those affected by the diagnosis:– family members

– friends

– caregivers

Cancer Survivorship: Survive Cancer and Live. Centers for Disease Control and Prevention, Department of Health and Human Services. Division of Cancer Prevention and Control . APR04

Addressing Multiple Categories of Survivorship Challenges

• Physical

• Emotional

• Social

• Spiritual

• Financial

Hudson et al. Identifying Key Questions to Advance Research and Practice in Cancer Survivorship Follow-Up Care: A Report From the ASPO Survivorship Interest Group Cancer Epidemiology July 2009

Models of Survivorship Care Currently Being Tested

• Community-based shared care model– The PCP refers the patient to the oncologist for cancer therapy and

periodic follow-up consultation– PCP provides ongoing maintenance of co-morbid diseases and health-

maintenance care– Cancer survivorship care plan is provided to the PCP by the oncologist

• Disease-specific cancer survivorship programs at academic institutions

• Comprehensive survivorship programs at academic institution– consultative option– advanced practitioner clinician-led survivor clinic– specialized multidisciplinary survivorship program

Oeffinger KC, McCabe MS. Models for delivering survivorship care. J Clin Oncol 2006;24:5117–24.

KU-Wichita Center for Breast Cancer Survivorship

Cypress Medical Park, Wichita• Comprehensive survivorship program• Tailored care plans• Research-supported health promoting behavioral options• Patient navigation• Rural access• Education & Research• Community partnerships

Funded in part through generous grants from Susan G. Komen for the Cure Mid-Kansas Affiliate

Coordination of Survivorship Care

• Communication among all members of the care team– Survivor

– Oncologist

– Breast Surgeon

– Radiation oncologist

– Primary Care Physician

– Survivorship Center Staff

• Non-duplication of services

• Connecting survivors to existing community support services

Activated Patients• Tailored care plans

– ASCO Survivorship Forms

– Additional assessment and follow-up of potential late side effects of treatment

• Patient communication

Hewitt ME, Greenfield S, Stovall E; National Cancer Policy Board (U.S.). Committee on Cancer Survivorship: Improving Care and Quality of Life. From cancer patient to cancer survivor: lost in transition. Washington (DC): National Academies Press; 2006.

Major Research Questions about Survivorship

• What are the most common late effects?• Who is at risk for late effects?• Can treatment-related injury to normal tissue be

prevented/reversed?• What % of survivors will have recurrent or second

malignancies?• Who should be following these survivors to detect

disease recurrence?• What constitutes ‘optimal surveillance” and what is the

cost of such follow-up care?• Do medical, psychosocial or behavioral interventions

reduce morbidity in these populations?