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Survivorship: More than just a care plan

January 20, 2017

    There will be more than 18 million cancer survivors in the United States by 2022. Unfortunately, the needs of cancer survivors are not being met, resulting in poor outcomes and disease surveillance. While most cancer programs today are working towards providing patients with survivorship care plans, a nationally representative survey of cancer patients reveals that the quality of survivorship discussions is still falling short.

    Less than a quarter of patients have comprehensive, high-quality survivorship discussions

    The study authors used the national Medical Expenditure Panel Survey (MEPS) of cancer patients to assess how well providers were engaging patients in discussions across four key areas of survivorship: emotional/social needs, lifestyle recommendations, late or long-term effects, and follow-up care.

    Degree physicians discussed survivorship with patients

    survivorship discussion graph

    Discussions were deemed "high-quality" if providers "discussed in detail" at least three of the four areas. Based on this analysis, only 24% of patients had detailed conversations across all four categories, suggesting that most survivorship conversations are not comprehensive.

    Emotional needs and long-term effects are high-impact areas

    Although the study demonstrates that survivorship discussions fall short across all four areas, emotional needs and long-term effects in particular represent high-impact areas. As shown in the bar graph above, providers spent the least amount of time discussing emotional and social needs, with only 29% of patients reporting that their providers discussed this topic in great detail. This is particularly troubling because research has shown that depressed cancer survivors are twice as likely to die prematurely compared with non-depressed cancer survivors.

    Another area critical to successful survivorship planning is patient education on the long-term effects of treatment. As we all know, cancer treatment comes with serious and far-reaching consequences, including infertility, secondary cancers, and cognitive challenges. This makes patient education critical to their emotional and physical well-being. Unfortunately, less than half of the patients (43%) in this survey reported detailed conversations on long-term effects. One major contributing factor is the lack of oncologist training. For example, in one nationwide survey, only 36% of oncologists reported extensive training on the long-term impacts of cancer treatment.

    To determine the scope of survivorship services your organization should provide and how to provide them, visit the Oncology Roundtable's top resources on survivorship.


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