2/6/ Allina Health System. Disclosure. Objectives

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1 Survivorship Marketing Care for Update Breast Cancer Patients November February 26, th, 2016 Sarah Jax, MA, APRN, AOCNP Minnesota Oncology Disclosure There are no conflicts of interest or relevant financial interests in making this presentation and have indicated that my presentation does not include discussion of an unlabeled use of a commercial product, or an investigational use not yet approved for any purpose. Objectives 1. Review concept of survivorship care and your role to support a survivorship program. 2. Understand the components of a survivorship care plan, including cancer diagnosis, treatment received, ongoing surveillance and potential late/long-term side effects. 3. Identify the most common concerns of breast cancer survivors and available organizational, community and national survivorship resources for management.

2 Background Survivorship What does it mean? "an individual is considered a cancer survivor from the time of cancer diagnosis through the balance of his or her life -- Institute of Medicine (IOM) Report, From Cancer Patient to Cancer Survivor: Lost in Transition (2006) Survivorship care also includes family members and caregivers. GOAL.to provide comprehensive survivorship care for patients beginning at the time of diagnosis and continuing throughout the cancer trajectory. What is a Survivorship Program? A Survivorship Program s primary goal is to address the potential problems cancer survivors may face during or after therapy, including the physical and emotional effects and general issues related to cancer survivorship including health promotion, cancer surveillance and future cancer risk. At the patient s appointment, an individualized Survivorship Care Plan is discussed in detail and given to the patient, primary care provider and referring providers. All staff have an important role in understanding survivorship, reinforcing the purpose of survivorship visits, and referring patients to the program.

3 Survivorship Program Background A visit with an advanced practice provider (NP, PA, CNS) to review the patient s treatment summary, discuss survivorship issues/concerns, assess the patient s quality of life, and make referrals as needed. It is also an ideal time to engage in discussions around advance care planning, palliative care or hospice as appropriate. As a whole, these visits reinforce Shared Decision Making and conversations about personal values and goals as they relate to treatment options, thus making the care we provide patientcentered. What Are Breast Cancer Survivorship Patient Concerns? Anxiety, depression, coping with a cancer diagnosis, fear of recurrence, finding a new normal Side effect management fertility and sexuality questions, body image issues, lymphedema, hot flashes, bone pain, dealing with chemo brain, nutrition issues, cancer rehab, smoking cessation Financial issues, employment concerns, living wills and advance care planning, marital/family concerns, genetic counseling Follow-up care, regular health maintenance, cancer screening Survivorship Visit Quality of life assessment Example: PROMIS-10 or FACT assessment Late and long-term side effects Signs of cancer recurrence Survivorship care plan

4 Components of a Survivorship Care Plan Survivorship care - outcomes Higher quality of care Increased patient satisfaction Improved access to resources Better communication between patients and medical team Survivorship Care Plan - example

5 Survivorship Program Success: A Team Approach How to Explain a Survivorship Program to Patients To help you tie everything that s happened over the last days/weeks/months together and make the whole experience more understandable To look behind and look ahead. We give you a care plan that outlines what has happened and clarifies what needs to happen in the future To make sure you are connected to all of the resources you may need. Think of it as sewing together the netting before you walk on a tight rope (of survivorship). We want everything to be in place first, so you don t run into trouble along the way To make sure we aren t assuming how you are doing. We have you complete a quality of life questionnaire so that we don t assume that you re doing fine emotionally or physically. This helps us make sure we are addressing the issues that you need addressed and not the issues we think you need addressed Questions?

6 References American Cancer Society. Cancer Treatment and Survivorship Facts & Figures Atlanta: American Cancer Society, 2014 Institute of Medicine. From Cancer Patient to Cancer Survivor: Lost in Transition. Washington, DC: The National Academies Press, doi: /11468 To Contact Me Sarah Jax, MA, APRN, AOCNP Nurse Practitioner & Survivorship Coordinator Minnesota Oncology Plymouth & MPLS clinics (office) 763/ (cell) 701/