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Survivorship Care

"An individual is considered a cancer survivor from the time of diagnosis, through the balance of his or her life. Family members, friends, and caregivers are also impacted by the survivorship experience and are therefore included in this definition."

 -National Cancer Institute (NCI) Office of Cancer Survivorship   (adapted from the National Coalition for Cancer Survivorship)

In 2006 the Institute of Medicine (IOM) influential report From Cancer Patient to Cancer Survivor: Lost in Transition focused attention on unmet needs of the nation's growing population of cancer survivors. Included in the report's call to action was the recommendation "that each cancer patient receive a 'survivorship care plan.' "
Since the report's publication, the population of cancer survivors in the U.S. has grown from 10 million to nearly 16 million. This number is expected to grow by 31 percent to 20.3 million by 2026.1

The Commission on Cancer (CoC) Cancer Programs Standards 2016 addresses the requirement for survivorship care plans in Standard 3.3.

For cancer programs and practices, integration of survivorship care plans into the care continuum process is ongoing challenge.  

The Commission on Cancer (CoC) recently issued the following announcement regarding Standard 3.3:

Effective December 11, 2017, the percentage of delivered survivorship care plans to eligible patients required for CoC-compliance with Standard 3.3 has been lowered to 50% for 2018. All CoC-accredited programs will be expected to meet or exceed the delivery of survivorship care plans to 50% of eligible patients by the end of 2018. 
Additional revisions to CoC Standard 3.3 will be announced in the first quarter of 2018, but will not go into effect until January 1, 2019. Submit any CoC-related questions to the CAnswer Forum.2

As the population of cancer survivors continues to grow, survivorship care remains an important area of ongoing discussion. In 2018, the National Academies of Sciences, Engineering, and Medicine (formerly the IOM) published proceedings from its workshop on Long-Term Survivorship Care After Cancer Treatment

Sources:
1. National Cancer Institute. Division of Population Control & Cancer Sciences. Cancer Statistics. Office of Cancer Survivorship. Number of Cancer Survivors. Last accessed January 28, 2018.

2. American College of Surgeons. Commission on Cancer. Important information regarding CoC Survivorship Care Plan Standard. Online
 December 13, 2017. Last accessed January 28, 2018.

 

Featured Programs

Elevating Survivorship
ACCC has partnered with the National Coalition for Cancer Survivorship (NCCS) on the Elevating Survivorship project. ACCC has launched a web-based survey to learn about gaps in survivorship care delivery, technical support needed to improve survivorship care, and unmet and evolving survivorship care needs of patients who have been treated with immunotherapy.
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Let’s Be Clear: Communicating to Improve the Patient Experience
With this education initiative ACCC seeks to help cancer programs across the country to improve survivorship programming through the application of the health literacy principles.
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ACCC Metastatic Breast Cancer Project
While breast cancer is a high-profile disease, receiving significant private and public research funding and focused awareness and prevention initiatives, patients with metastatic breast cancer face unique challenges. ACCC has identified these 6 effective principles for patient suppor
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Venous Thromboembolism: Identifying Patients at Risk
ACCC captured several of the barriers to identifying cancer patients at risk of VTE and approaches to facilitate the identification of at-risk patients, as well as tools and resources to help ensure evaluations and identification occur.
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ACCCBuzz Blog Posts

From Oncology Issues

  • A More Personalized Approach to Survivorship Care?
    Jennie R. Crews, MD, MMM, FACP
    Since the 2005 publication of From Cancer Patient to Cancer Survivor: Lost in Transition by the Institute of Medicine (now the National Academy of Medicine), the healthcare community has become more aware of the needs of cancer survivors and responded by developing survivorship services and programs.
  •  Providing Psycho-Education to Combat Fatigue
    By Shannon Morton, LMSW, MA; Alison Snow, PhD; Anthony H. Bui, MS3; and Manjeet Chadha, MD
    Exercise has been demonstrated to alleviate the effects of cancer-related fatigue, but patients with cancer may not understand the true scope of its benefits. Mount Sinai Downtown Cancer Centers created a quality improvement (QI) initiative to provide psycho-education on exercise during initial radiation treatments and throughout treatments.
  •  Supportive Oncodermatology
    Stephanie Kao, BA, and Adam Friedman, MD
    Dermatologic adverse events can have a profound impact on the physical, emotional, financial, and psychosocial health of cancer patients. Discover how the emerging collaborative subspecialty of supportive oncodermatology aims to address cancer-related dermatologic events.
  •  The SCOOP Program
    Christopher Koprowski, MD, MBA; Edith J. Johnson, PhD, MBA; Karen Sites, BSN, RN, OCN; and Nicholas Petrelli, MD
    The Helen F. Graham Cancer Center and Research Institute implemented the Supportive Care of Oncology Patients (SCOOP) Program, which developed and implemented a clinical pathway that improved the patient experience and reduced the cost of care in selective curative cases.
  •  Development of Care Pathways to Standardize and Optimally Integrate Multidisciplinary Care for Head and Neck Cancer
    Assuntina G. Sacco, Charles S. Coffey, Parag Sanghvi, Gloria P. Rubio, et al.
    The complexity of head and neck cancer management demands greater attention in order to provide high-quality care. UC San Diego Moores Cancer Center developed a well-defined care pathway to enable predictability and consistency in both care delivery and cost.
  •  Development of an Outpatient Cardio-oncology Program
    By Laurie Walton Fitzgerald, MSN, RN, and Peyton Neilson, MSN, RN, OCN
    At University of Maryland Upper Chesapeake Health, the Heart and Vascular Institute and the Kaufman Cancer Center have come together to create a cardio-oncology program that provides a patient-centered, multidisciplinary clinic for cancer patients during diagnosis, treatment, and survivorship.
  •  Life with Cancer at Inova Schar Cancer Institute
    By Sage Bolte, PhD, MSW, OSW-C
    Learn how Inova Schar Cancer Institute’s Life with Cancer program, with more than 40 multidisciplinary staff members, comes together to offer psychosocial support and survivorship care.
  •  New Horizons in Oncology Rehabilitation
    Christopher M. Wilson, PT, DPT, DScPT; Reyna Colombo, PT, MA; and Basil Hakmeh, MPH
    Beaumont Health in metropolitan Detroit is actively preparing its physical therapists (PTs) and occupational therapists (OTs) to provide patient-centered, diagnosis-specific, compassionate care to cancer patients through advanced training by development of an accredited clinical residency program in cancer rehabilitation.
  •  A History of Cancer Survivorship Plans
    Sigrun Hallmeyer, MD, and Naveed Cheema, DO
    A generation ago cancer care consisted of diagnosis, active treatment, and resigned palliation. Today, advances in cancer care have increased the number of people surviving a cancer diagnosis leading to a new dimension of care—cancer survivorship.
  •  An EMR-Driven Approach to Survivorship Care Plans
    Sigrun Hallmeyer, MD, and Naveed Cheema, DO
    In order to minimize the challenges of time and resource allocation, Oncology Specialists, SC, set out to create a survivorship care plan (SCP) using its electronic medical record (EMR) as a tool to ease the clinician’s workload and time commitment, while still delivering patient-centered care at the end of treatment.

In 2007-2008 ACCC conducted an educational initiative to raise awareness about the importance of comprehensive survivorship programs. ACCC President (2007-2008) Richard B. Reiling, MD, FACS, selected survivorship as his president's theme, and ACCC developed Comprehensive Survivorship Services: A practical guide for community cancer centers

Publication and distribution of ACCC's Comprehensive Survivorship Services: A Practical Guide for Community Cancer Centers was made possible through a sponsorship funded by AstraZeneca and Abraxis Oncology.