Challenges & Success in Patient Survivorship
Indicators of Survivorship How ready are we for cancer? o Government: Policies, cancer control, resources invested, whole of society approach o Environment: culture, perceived attitudes to cancer, stigma Cancer Diagnosis o Type, stage, availability of therapies, financial resources
Cancer incidence and mortality 2012 Data from GOBOCAN 2012 Region No of new cases Incidence (Per 100 000) No of deaths Mortality (per 100 000) Cumulative risk WORLD 14 067 894 182.0 8 201 575 102.4 1 in 5.4 More developed countries 6 053 621 267.2 2 878 462 108.5 1 in 3.7 Less developed countries 8 014 273 147.7 5 323 113 98.4 1 in 6.7 MALAYSIA 37 426 143.6 21 678 85.8 1 in 6.7
Stage of Diagnosis: selected cancers NCR 2007
How ready is Malaysia?
The Economist (EIU): NCCP Report Card
EIU Breast Cancer in Asia Report
ACTION Study Asean Costs in Oncology
Challenges in the community Multicultural barriers o Diversity within a country (ethnicity/cultural, language, religion) o Urban/rural divide An uninvolved civil society: prevention, diagnosis, survivorship o Stigma (social, employment, status) o Fatalism o Low health literacy : most vulnerable population Competing Therapies o Distrust of western medicine : myths on treatment lack of positive outcomes o Holistic Therapies Alternative (western, eastern), Traditional (Chinese, Aryuveda) Natural : perceived less toxic
Professional support: beyond treatment Lack of definitive best practice guidelines Lost in Transition : newly diagnosed, during treatment, post treatment Oncology setting to primary health care setting Delays in Rx, compliance to Rx, follow up Cancer care plans: facilitates communication Patient Centric: Survivor s values and preference of care Dialogue on medical, functional & psychosocial consequences of cancer & its treatment Collaboration with CSO/ Community organisations
Community Community Awareness Primary Healthcare Suspicious finding Helpline Survivor/ Volunteer Outreach Current Services Support networks Complementary /Wellness therapies CSOs providing services Equipment Therapies Support Empowerment Diagnosis Treatment Rehabilitation Palliative care home services Long term/ Palliative Hospital Hospital Resource Centres Patient Navigation Cancer Care Plans Support networks (R2R) Integrative therapies Diet, physio Follow ups Referrals Palliative care
Patient Navigation Programme Navigating patients, improving survival Prof Teo: info@cancerresearch.my 100 80 60 40 20 0 5 year Survival 92 90 56 49 Previously 250 women per year 150 breast cancers 55% late stage 30% incomplete treatment 15% default With Patient Navigation 250 women per year 150 breast cancers 55% late stage 10% incomplete treatment 3% default Statewide programme National programme All cancers
Community Support Cancer Information Service Information as well as emotional support phone, email or live chat providing clear and credible information about cancer. Helpdesk Peer support and navigation for newly diagnosed Extending services into hospital resource centres Medical Support Medical counselling (navigating a diagnosis, psychosocial, sexuality) Nutrition
Rehabilitation Services Post mastetectomy Physiotherapy Complementary Therapies Promote physical, emotional and mental well being Help in stress and pain management. (e.g. Reiki, Yoga, Qigong, Laughter therapy) Wellness Classes & Activities Chinese Ink Painting, Cooking, Feel Good workshops
Pink Unity Support Network Focus group established in 2008 under NCSM Run by women cancer survivors as a peer support group Support women with ALL types of cancer and not only limited to breast cancer Their mission is to unite women cancer survivors in the fight against cancer Their roles include: Support for those newly diagnosed with cancer and assist them on their journey through visits, phone calls and helpdesk Personal Networks built between members by participating in our various activities. We have fun because laughter is so important for long term healing. Empowerment via numerous talks and workshops carried out for survivors for improvement of quality of life. 15
16
Complementary Therapies Chinese Ink Painting Yoga Qi Gong Reiki Laughter Therapy
Lifestyle Dance Aerobics: walking Dragon boat
THANK YOU