The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD
Elissa Thorner Bantug, Catherine Saiki, Jane Zorzi, Vered Stearns, Antonio C. Wolff
Background: Emotional distress and poor symptom management are highly prevalent among patients with metastatic breast cancer (MBC). A high disease burden can further negatively impact these patients’ quality of life. To address the evolving survivorship needs in their trajectory from initial diagnosis of advanced disease to end-of-life care, patients with MBC require prompt assessment, reevaluation, and specialized support services. Limited survivorship resources are devoted to this patient population and greater attention to their needs is warranted. Methods: To address the survivorship needs of patients with MBC Johns Hopkins, we developed a new initiative designated a “Living with Breast Cancer” appointment. During this dedicated clinic encounter, a palliative care nurse practitioner works with the patient and her caregiver to develop an individualized “survivorship care plan” that describes medical and psychosocial care, symptom management, nutrition counseling, goal setting, mind/body techniques, palliative care, legacy work, pain management, health screening recommendations, family support, community referrals, and care coordination with oncology providers, among others. Patients with stable MBC are referred to this service by our medical oncology team. Patients are then asked to complete an evaluation survey (either by email or over the phone) 4-6 weeks after the appointment. Results: Since the initiation of program in March 2016, we evaluated 8 patients (3 African-Americans; 3 Caucasian; 2 Asians); mean age is 54.1 years (range, 38-75). Most patients were approximately 1-year post diagnosis of MBC (range, 1-10 years). We are currently collecting and analyzing evaluation survey results. At the time of the meeting, further demographics and evaluation results through August 2016 will be reported. Conclusions: If successful, the Living with Breast Cancer initiative may allow for more patient-centered care of individuals with MBC and their families at Johns Hopkins. The creation of an infrastructure for care coordination, survivorship support services and education aims to promote individualized services within the metastatic setting and improve the quality of life for this population.
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