Which doc do you prefer?
As always, let’s start with the good news. Many women with a diagnosis of breast cancer will live long after their diagnosis.1 This is also true for other forms of cancer and has prompted leading medical organizations to support transition of patients after their curative therapy to survivorship programs which offer “comprehensive, coordinated continuing care.”1
Survivorship is one of the biggest buzz words in cancer currently. It turns out that survivorship means different things to different groups of people. It’s different for healthcare providers, patients and governing organizations. Added to the mix is the confusion surrounding which healthcare provider is responsible what aspect of patient care after the acute phase of treatment is completed.
“Cancer Survivorship” according to Cancer.net has 2 common meanings; 1) having no signs of cancer after finishing treatment and 2) living with, through, and beyond cancer. According to this definition, cancer survivorship begins at diagnosis and includes people who continue to have treatment over the long term, to either reduce the risk of recurrence or to manage chronic disease.2
Survivorship programs for breast cancer vary from institution to institution resulting in a wide definition of the level of assessment, education and care patients receive. Some survivorship programs provide ongoing care through quarterly appointments depending on the assessment done at the 4-5 year mark. Other programs are less specific, handing the patient a piece of paper with their clinical care to date, resources and phone numbers – expecting the patient to navigate the next steps in their own care. In the best programs, survivorship is embedded into each specialty within an institution or healthcare system, and at each visit — for any reason — the patient is evaluated for emotional, nutritional, other existing or potential health concerns and is monitored for breast cancer recurrence.4,8
Your treatment team. As you know from the early days around the time of your diagnosis, your treatment team is a large, diverse group of people and medical specialists. The surgeon, pathologist, radiation oncologist, medical oncologist, primary care physician, physician assistant, nurse practitioner, oncology nurse, nurse navigator, and others all play important roles in your care. The question of who you believe is best suited to provide specific care as you enter your chronic disease management phase was the primary focus of a recent article.
In a study published recently in an important oncology journal, 2,000 newly diagnosed, early stage breast cancer survivors provided responses to questions about who they want to see for which healthcare issue both related and unrelated to the breast cancer diagnosis as a part of the Individualized Cancer Care Study. See the graphic below. The goal of the research was to understand patient preference and identify opportunities for patient education around the goals and coordination of survivorship care.
Survey says… On average, the women had been diagnosed about eight months before the survey, so this may have impacted their responses. Around 80% of women preferred their primary care provider (PCP) handle general preventative and on-going medical conditions. Over 90% of women preferred their oncologist handle mammography and second cancer screenings. More Asian, Latina and Black women preferred the oncologist administer all care. Other differences in preferences were seen based on age, education and type of insurance.
Authors of the study concluded that women being treated for a breast cancer diagnosis may benefit from better education regarding the roles of the different physicians involved in their on-going care. Special emphasis should be given to the Primary Care Physician who may provide additional cancer screening and surveillance, as well as preventative and comorbidity (other health ailments) care related and unrelated to a breast cancer diagnosis.
Survivorship is not one size fits all. Breast cancer survivors are also not one size fits all. Women living with a previous diagnosis of breast cancer may have different questions and concerns ranging from lingering side effects of either chemotherapy or anti-estrogen therapy, to what’s the next phase of treatment based on the newest data and available tests, or when treatment will be concluding based on their personal situation.
Ask for information. As you’ve likely figured out by now, depending on the level of survivorship care offered by your program; it is important that you be your own advocate. Ask the right questions and seek the resources needed for successful adaptation to your “new normal.”
For more information on survivorship, see these previous blogs and visit reputable websites:
- Wallner, et al, Patient Preferences for Primary Care Provider Roles in Breast Cancer Survivorship Care; J Clin Oncol, July 7, 2017 (online)
NOTE: This material was created by or on behalf of Biotheranostics, Inc. The content, products and services discussed in this material are offered to educate healthcare providers and/or consumers on molecular diagnostic testing performed by Biotheranostics, and should not be considered or used as a substitute for medical advice, diagnosis or treatment of specific medical conditions. To see BCI Intended Use & Limitations, please visit www.BreastCancerIndex.com