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Let's Discuss: Cancer Survivorship and Cancer Control: Working Towards a Coordinated Approach

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We were so very delighted today to welcome Sarah Birken and Julia Thorsness to today's cyber-seminar.  
 
Each offered a unique perspective on the opportunities, challenges and directions for how researchers and practitioners can collaborate with one another survivors, cancer care providers, and follow-up care providers improve outcomes for cancer survivors through shared resources, approaches and interventions.
 
And now we turn the discussion over to you...
  • What has been your experience in implementing (and supporting the implementation of) cancer survivorship care plans?
  • What is your comprehensive cancer control program doing to support cancer survivors in your communities?
  • Have you leveraged the work of partners and others to further your survivorship efforts?
  • What did you take away from today's session?
We welcome your questions, thoughts and perspectives.

Posts/Comments

We had a robust

We had a robust back-and-forth with the presenters and are most appreciative of all your participation.  Unfortunately, there was a question that was raised at the end that we were unable to get to so will ask our speakers to follow up:

Have there been disparities related to race/ethnicity and survivorship care plans?

The question about

The question about disparaties is an excellent one. I am not aware of any research that has specifically assessed racial/ethnic disparaties in cancer survivors' receipt of survivorship care plans. This is clearly an area that deserves more attention. However, it should be noted that survivorship care plan use is very limited in the US - across the board; as rates of SCP use increase, it may be easier to detect disparaties in receipt of survivorship care plans.

Despite lack of research related to racial/ethnic disparaties in cancer survivors' receipt of survivorship care plans, there are several studies that assess the preferences of racial and ethnic minorities (e.g., Ashing-Giwa, 2013; Burg, et al. 2009; Kantsiper, 2009) related to survivorship care plans.

 

Ashing-Giwa K, Tapp C, Brown S, Fulcher G, Smith J, Mitchell E, et al. Are survivorship care plans responsive to african-american breast cancer survivors?: Voices of survivors and advocates. J Cancer Surviv. 2013 Mar 8.

Burg MA, Lopez ED, Dailey A, Keller ME, Prendergast B. The potential of survivorship care plans in primary care follow-up of minority breast cancer patients. J Gen Intern Med. 2009 Nov;24 Suppl 2:S467-71.

Kantsiper M, McDonald EL, Geller G, Shockney L, Snyder C, Wolff AC. Transitioning to breast cancer survivorship: Perspectives of patients, cancer specialists, and primary care providers. J Gen Intern Med. 2009 Nov;24 Suppl 2:S459-66.

This is such a great topic! I

This is such a great topic! I wanted to let folks know about a few things we have going on at the George Washington University (GW) Cancer Institute:

  • Technical Assistance for Comprehensive Cancer Control Programs - In September 2013 we received funding from the Centers for Disease Control and Prevention to provide technical assistance to enahnce cancer control efforts. As part of this project we are adapting our popular in-person Executive Training on Navigation and Survivorship to an online format that will be available at no charge to participants. It's a nuts and bolts program on how to create and sustain patient navigation and clinical surivorship programs, including tools, resources and case studies. We expect to launch it this fall. To sign up for updates on this project, send an email to cancercontrol@gwu.edu with a note in the body to add you to the cancer control listserv. If you are looking for some specific technical assistance related to survivorship, please email us and let us know what you need.
  • Cancer Survivorship E-Llearning Series for Primary Care Providers - As part of the National Cancer Survivorship Resource Center, collaboration between the American Cancer Society and the GW Cancer Institute funded by a 5-year cooperative agreement from the Centers for Disease Control and Prevention, we developed a free continuing education program on caring for cancer survivors. Although it was develoepd for primary care providers, many onccology providers have completed the program and found the information useful.
  • Evaluating Cancer Survivorship Care Models - Funded by the Patient-Centered Outcomes Research Institute, this project seeks to compare the effectiveness of models of survivorship care on outcomes identified as most important by cancer survivors. Visit our website for more information on the project and to sign up to receive updates about our project.
  • Center for the Advancement of Cancer Survivorship, Navigation & Policy (caSNP) - Through caSNP we provide monthly webinars on navigation and survivorship issues as well as a monthly enewsletter with relevant news and resources. To sign up for our enewsletter, send an email to casnp@gwu.edu with a note in the body to add you to the caSNP listserv.

Feel free to contact me at annewillis@gwu.edu if you have any questions.

Great program! We may have

Great program!

We may have some data on potential different delivers of SCPs to diverse groups from larger surveys: NHIS and our SEER-based FOCUS study. As I recall in the latter, African American patients were more lilkely than other groups to report receiving followup care instructions. I have left on travel (to our bienni on Atlanta)and do not have ready access to my reference files.  I will make sure to follow up.
 
 
Finally, on measuring the impact of care plans/planning: what do we know? That is exactly what our Program Announcement is designed to answer! Reference for these is: PA-12-274 and PA-12-275
 

 

Julia, thanks for your post!

Julia, thanks for your post! I’d be interested in seeing more about the FOCUS study. I just finished reading the Ashing-Giwa et al. article: Are survivorship care plans responsive to African-American breast cancer survivors?: voices of survivors and advocates that Sarah recommended and as it focused on African-American breast cancer survivors understandings of survivorship care plans (SCP) it would be valuable to see in what ways the data overlaps and where there are gaps.

In brief, the study used a community-based participatory framework to structure three facilitated consensus meetings with African-American (AA) breast cancer survivors and advocates. They identified content domains of SCPs that are culturally responsive this population. Participants raised the idea of including patient-centered information within the purpose and implementation of an SCP. Concerns were raised that higher mortality in AA populations could be due to greater comorbidities and inadequate surveillance and follow-up care.

It is interesting to hear that AA patients were more likely than others to report receiving follow up care instructions as, at least in the case of the Ashing-Giwa research, standard SCP templates lacked adequate content in several areas including: health history, comorbidity, health promotion, and functioning, which they felt exacerbated health risks for poor disease outcomes. Since SCPs are intended to educate patients and engage them with their medical care team, it seems logical and imperative to develop plans in ways that heighten survivor engagement by making plans more culturally responsive. 

I'm looking forward to hearing more!