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(Left to right) Amy Logue, NP; Colleen DeBoer, NP; Nancy Houlihan, CNS; Kate Keenan, NP; Mary Schoen, NP; Robin Rawlins-Duell, NP; Beth Whittam, NP; Zana Correa, NP; Meghan Newcomer, Program Coordinator; and Mary McCabe, Director |
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There were approximately three million cancer survivors in the US in 1971. Today, that figure has grown to nearly 12 million, according to the National Cancer Institute. While most cancer survivors will lead healthy, active lives, some may develop problems related to their cancer and its treatment. To help address these issues in the pediatric population, Memorial Sloan-Kettering Cancer Center has had a pediatric long-term follow-up clinic for nearly two decades. In 2005, a new care model for survivors of adult-onset cancers was developed in which specially trained nurse practitioners provide follow-up care with a focus on both the medical and psychosocial issues related to an individual's cancer and its treatment.
Survivor Care Model
The clinical care model for adult-onset cancer survivors, which uses a nurse practitioner (NP) as care provider, was first developed at Memorial Sloan-Kettering for prostate cancer survivors treated with surgery. An NP is a registered nurse with an advanced degree who is licensed to diagnose, manage, and treat acute and chronic illnesses. The model was subsequently expanded to include breast, colorectal, lung, esophageal, and kidney cancers, as well as prostate survivors treated with radiation therapy.
"It is very rewarding for the NPs to work with patients who have successfully completed their cancer treatment and are getting on with their lives but have lingering problems that need the attention of a knowledgeable clinician," says Nancy Houlihan, RN, AOCN, Clinical Nurse Specialist in the Cancer Survivorship Program at Memorial Sloan-Kettering.
Survivorship Care Services
A visit with a survivorship NP starts with a review of the patient's recent medical history and a medical examination, which is focused on the unique needs that may follow a particular diagnosis and treatment. The visit includes surveillance testing to detect cancer recurrence, as well as identification and management of any aftereffects of the cancer and its treatment. Screening referrals for other cancers are made, and counseling about health behaviors, such as diet, exercise, and smoking cessation, is provided. Since the incidence of depression in cancer survivors can be significant, a psychosocial assessment is also done at every session and, when necessary, referrals for support services are made.
