New plans help define life after cancer

By suzanne ovelJanuary 22, 2015

New plans help define life after cancer
(Photo Credit: U.S. Army) VIEW ORIGINAL

Cancer patients can now expect to receive an even clearer understanding of their follow-up care plan at Madigan Army Medical Center, thanks to a new cancer survivorship program started here in January.

Madigan's Cancer Committee is creating standardized follow-up care plans for types of cancers treated here to help patients remain in the best possible health after they complete their cancer treatment.

"Cancer is a chronic disease, and it's something that patients live with, either the active disease or a history of it, so I think that their survivorship plan defines for them what they need to do in their continuum of care," said Genevieve Fuller, the clinical coordinator for Madigan's Breast Pathway Clinic. "It really defines for them what they need to do next."

The survivorship plans are simple plans of action with healthcare recommendations for the next several years after patients complete their primary cancer treatments, and are geared around patients' specific cancer diagnoses. Follow-up plans can differ amongst cancer types -- breast cancer survivors, for example, are encouraged to schedule breast MRIs annually after treatment, while testicular cancer survivors are encouraged to get blood tests for tumor markers every four months.

Prior to these survivorship plans, which are now required to maintain cancer care accreditation, some patients received informal follow-up plans while others did not. For instance, cancer patients who only underwent surgery without chemotherapy or radiation as well would often be viewed as having completed their treatment.

"Some end with surgery and you're done. Still, if it's a colon cancer and you've had your surgery and that's the end of it, you still need to know when to come back for your colonoscopies, etc.," said Helen McGregor, a nurse practitioner consultant with the Breast Pathway Clinic and a lead for the survivorship plan program.

For some patients this old way of business led to an uncertainty of who would track their follow-up care; in some cases, specialists focused on solely the primary treatment of the cancer, while primary care providers may have felt out of their lane in following their cancer survivor patients.

With the new Army Medical Home concept, though, primary care providers are encouraged to be aware of all aspects of their patients' care, said Fuller. This includes being familiar with follow-up care recommendations from specialty care and encouraging patients to follow these plans.

The new survivorship plans are completed by staff members in each cancer specialty area, and then uploaded and clearly identified in patients' electronic health records to ensure they are easily accessible by primary care providers, said McGregor. Prior to this method, recommendations for follow-up care were less formal and may have been buried in other providers' notes.

In addition, patients will receive hard copies of their plans, which ties into the new focus of encouraging patients to take the lead in their own healthcare, said McGregor. This is particularly important for patients who switch primary care providers, especially if they move to providers outside of the military network.

The Cancer Committee has already developed survivorship plans for the cancers more commonly treated here (breast, lung, prostate and testicular cancers) and will continue to develop further cancer survivorship templates this year. In addition to the follow-up screening recommendations, these plans also note who will follow patients long-term to include who to contact with any questions.

Outside of attending regular follow-up screenings to ensure any cancer reoccurrences are detected early, McGregor encourages cancer survivors to also continue focusing on being healthy overall, since it can be easy to neglect other areas of one's health when faced with a big health scare.

"You tend to get wrapped up into this major diagnosis, whatever it might be, and some things like your cholesterol and other screening recommendations may get lost," she said. "It's important people understand to ensure their continued good health, there are certain things that need to be checked periodically --you're not just always done when you have that last treatment."