Health after cancer: Early patient experience in a pilot survivorship clinic embedded in primary care.

Authors

Lidia Schapira

Lidia Schapira

Stanford Cancer Center, Palo Alto, CA

Lidia Schapira, Marcy Winget, Siqi WU, Jennifer Kim, Cati Brown-Johnson

Organizations

Stanford Cancer Center, Palo Alto, CA, Stanford Cancer Institute, Stanford, CA, Stanford School of Medicine, Stanford, CA, Stanford Medicine, Stanford, CA, Stanford University School of Medicine, Stanford, CA

Research Funding

Other

Background: Prior research has identified barriers to provision of quality survivorship care in primary care settings such as lack of expert knowledge and training, primary care burden and insufficient communication with oncologists. We implemented a survivorship clinic at an academic medical center in the primary care division with the goal of defining the elements required for a seamless transition and co-management. Methods: The primary care physician received training in cancer survivorship based on the ASCO Curriculum, shadowing of 3 breast medical oncologists and 1 gynecologic oncologist, attendance at the 2018 Cancer Survivorship Symposium and NCCN’s Cancer Survivorship Advocacy Meeting. Patients with breast and gynecologic cancers were referred by their oncologists or APP (PA or NP) at various points in their cancer trajectory. Clinical characteristics of patients were abstracted from the electronic medical record and in-depth interviews were conducted with 2 patients. Results: 41 patients attended the survivorship clinic. The majority (88%) were breast (63%) or gynecologic (24%) cancer survivors. Patient age was evenly distributed with 8 age < 46, 11 age 46-59, and 7 age > = 60. 23 (56%) patients had stage < 3 at diagnosis. 21 (51%) had been cancer-free for five years + and 4 were referred by their oncologist to help with patient co-management during cancer treatment. Of the 8 breast cancer patients < 46 years old, 6 had a genetic mutation and 7 were interested in fertility. 15/26 breast cancer patients are currently on endocrine therapy. Interviewed patients expressed appreciation for receiving whole-person care and knowing there is bidirectional communication between clinicians. Conclusions: Cancer survivors are open to and interested in a survivorship visit based in a primary care clinic; this includes both patients who have been cancer-free > 5 years as well as those recently treated with curative intent. Greater efforts are needed to train primary care physicians to deliver survivorship visits that are customized to meet the needs of cancer survivors.

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Abstract Details

Meeting

2018 Palliative and Supportive Care in Oncology Symposium

Session Type

Poster Session

Session Title

Poster Session B: Advance Care Planning; Caregiver Support; Coordination and Continuity of Care; End-of-Life Care; Models of Care; Survivorship; and Symptom Biology, Assessment and Management

Track

Advance Care Planning,End-of-Life Care,Survivorship,Coordination and Continuity of Care,Symptom Biology, Assessment, and Management,Models of Care,Caregiver Support

Sub Track

Survivorship

Citation

J Clin Oncol 36, 2018 (suppl 34; abstr 180)

DOI

10.1200/JCO.2018.36.34_suppl.180

Abstract #

180

Poster Bd #

E1

Abstract Disclosures

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