Cancer Survivorship in Washington, DC

Oct. 21, 2014

City-wide Patient Navigation NetworkDeena Loeffler, MA

Objectives

• Define survivorship

• Describe challenges for survivors in DC

Survivorship

NCI definition:

“In cancer, survivorship focuses on the health and life of a person with cancer post-treatment until the end of life.”

Source: National Cancer Institute Dictionary of Cancer Terms. Retrieved from: http://www.cancer.gov/dictionary?cdrid=445089

Main Survivorship Challenges

Physical/ Medical

Psychological

Social

Spiritual

Financial

Informational

Breast Cancer Survivor Focus Group: Washington, DC

• Major barriers: physical issues, practical life support, psychological and emotional support, interaction with clinicians

“We need to know what to expect.”

Survivor Barriers

• Ongoing issues with late effects

• General physical issuesPhysical issues

• Navigating financial, insurance and employment issues

Practical life support

• Increased access to psychosocial resources

Psychological & Emotional Support

• Sensitivity from providers

• Quality of communicationInteractions with

Clinicians

Effects for Breast Cancer Survivors• Cardiac issues• Fatigue• Lymphedema• Musculoskeletal

symptoms• Joint pain• Chronic pain,

including neuropathy

• Reproductive and sexual issues

• Recurrence, new breast cancers or other cancers

• Skin changes (due to radiation)

• Anxiety• Depression• Cognitive dysfunction• Decreased satisfaction with

life• Fear of recurrence• Poor body image• Post-traumatic stress disorder

• Employment and financial concerns

• Need for post-treatment education

Post-Treatment Care

Care management

Non-clinical resources

Survivorship care plans

Survivorship care delivery

Evaluating Cancer Survivorship Care Models: Project Overview

• Goal: Compare effectiveness of cancer survivorship models of care on patient-centered outcomes

Compare care models

according to survivor needs

Identify survivor

needs and gaps

Identify current

survivorship practices

Completed Project Activities

Secondary data analysis

Focus groups with survivors

Environmental Scan of

Commission on Cancer-

accredited programs

National Cancer Survivor Survey

Focus Groups

• Focus groups conducted in California, Montana, Illinois, South Carolina, New Jersey and Washington, DC

• Survivors of non-metastatic breast, colorectal or prostate cancer, 1-5 years post diagnosis, had completed active treatment and were diagnosed with cancer at 18 years or older

Identified Needs• Psychological Support

• Social Support

• Support to empower Patients

• Information and Resources

• Productive interaction with clinicians

• Coordination of and transitions in care

• Communication with clinicians

• Provision of full spectrum of care

• Medical home

• Practical life support

CPNN Connection

• Do your patients experience similar issues?

• What do you do to help them navigate these barriers?

• How can we disseminate information from our project to your patients?

Questions?

Thanks!

Deena Loeffler

dloeffler@gwu.edu

survivorship@gwu.edu