At the beginning of their cancer treatment, most patients look forward to celebrating its end. Yet, as they transition from active treatment to managing their health as cancer survivors, that once eagerly anticipated moment often brings with it a new set of concerns.
For starters, patients are no longer seeing the cancer care team to whom they may have become very attached. This can sometimes leave people feeling as though they don’t have the same level of support as they experienced during treatment. “We’ve had many patients tell us that one of their most difficult times is the day they complete treatment,” says Kevin Oeffinger, Director of Memorial Sloan Kettering’s Adult Long-Term Follow-Up Program and inaugural Director of MSK’s new Cancer Survivorship Center. “They’ll say, ‘Cancer therapy was killing the cancer cells. Now what? What happens six months from now, or in a year?’”
Easing the Road to Survivorship
To give patients the tools to manage their health after treatment, MSK is aiming to have every cancer survivor treated here receive a treatment summary and a survivorship care plan — a blueprint to navigating post-treatment life. This includes details of patients’ diagnosis and treatment; information on potential side effects (known as late effects) of the therapies they received that can occur long after their treatment has ended; and screening recommendations.
The summary can be updated — if, for example, a patient should be treated for a second cancer — and all the information can be uploaded to MSK’s online patient portal, MyMSK, accessible to patients whenever they need it. This summary also serves as an important communication tool between MSK clinicians and patients’ primary care physicians as the care of survivors passes from the former to the latter.
“Survivorship care plans are important for two main reasons,” says Mary McCabe, Director of Clinical Programs for the Cancer Survivorship Center. “One is patient empowerment — giving people information about the treatment they received and issues they may face in the future and a guide for screening and surveillance. The other is [it serves] as a vital communication tool between the cancer treatment team and other healthcare providers, such as a primary care physician, cardiologist, or gynecologist.”
In 2013, approximately 10,000 cancer survivors of adult-onset cancers visited one of MSK’s survivorship clinics, and most of them received survivorship care plans. The nurse practitioner survivorship clinics, led by Ms. McCabe, are available for survivors of breast, cervical, colorectal, endometrial, esophageal, head and neck, kidney, lung, ovarian, prostate, and thyroid cancers and melanoma, as well as for those who have undergone blood and marrow stem cell transplantation.
“People want not only to be successfully treated for cancer but also to live well afterward,” says Ms. McCabe. “When you finish treatment, the ‘what’s next’ is a scary time. Having something that sets out the plan for the next phase can be very reassuring for patients transitioning from active treatment to post-treatment and invaluable for any physicians they may see in the future in terms of knowing how to monitor a patient’s general health and how to optimally screen for any cancer recurrence or second cancers.”