Dealing with cancer can be difficult enough, but often the aftermath can be just as troubling. Survivors not only have to deal with the disease, but also may struggle with lasting physical and emotional effects of treatment. Patients who felt they had a great deal of support throughout treatment often find it hard to adjust to a new way of life and the challenges they may face in the recovery phase.
Dayton Physicians Network offers a survivorship program to help patients navigate these difficulties and continue supporting them after treatment. Elizabeth Delaney, DNP, APN, FNP-BC, is a nurse practitioner with the program.
“We have had the opportunity to witness people experiencing the long-term effects of therapy, as well as impacts to their quality of life from their treatments,” Delaney said. “Cancer survivorship is about addressing the impact of cancer and treatment for the individual, particularly after those initial therapies are completed.”
Rotating through four Dayton Physicians Network locations, Delaney sees patients who are in stages 0 through 3 with curative therapy at the Survivorship Clinic. Right now, that includes only patients of breast and colon cancer, but DPN hopes to expand to include lung and prostate cancer patients in the near future.
Once curative therapy is completed, patients have the opportunity to complete a National Comprehensive Cancer Network (NCCN) survivorship assessment to determine what issues may need to be addressed post-treatment. Dayton Physicians screens for a variety of issues including anxiety, depression, distress, changes in cognitive and memory, hormonal or sexual problems, even financial concerns.
For example, some treatments have delayed impacts to the heart and lungs, so patients may need to be aware of the potential for shortness of breath or swelling in the arms. And breast cancer patients might experience lymphedema, a swelling in one of the legs or arms. The patient may not even be aware of these conditions, but they all affect long-term recovery.
The next part of the visit is to create a tailored Survivorship Care Plan, a summary document about everything regarding the patient’s cancer diagnosis and treatment. A copy is given to the patient and all of their care providers, such as the surgeon or other specialists.
Finally, staffers review the current national recommendations for healthy lifestyle choices and ways to reduce the potential for recurrence of the patient’s original cancer or development of other types. For example, helping them to stop smoking, integration of a healthier diet and exercise, mental health counseling, and regular spirituality practice. Research has shown that all of these practices improve quality of life, reduce anxiety and depression, and in some cases, reduce recurrence of cancer.
Delaney says that patient response to the Survivorship Clinic has been overwhelmingly positive, and they are grateful to have the plan review. “I articulate common concerns for cancer patients, like emotional and mental health, weight gain, smoking cessation, fertility issues, and so on,” she explained. “We go through all of those and, often, just showing people that these are common concerns can help reduce the ‘suffering in silence.’ It feels good to them to know they’re not uncommon.”
“Being able to articulate their story and have someone listen to them can make a big difference,” Delaney said. “Sex, for example, is a big topic that comes up. Women who have had mastectomy may suffer with body image changes, and the effects of chemotherapy and hormonal drugs can lead to other related complications.”
The most common concerns and questions from patients tend to depend on the stage of cancer and the age of the patients. Understanding the common concerns, however, is helpful across the board. Many are interested in the impact of healthy lifestyle and want input from the providers on those choices.
The greatest barrier to helping survivors through the challenging time following treatment is that they often do not schedule the visit. Patients have expressed the value of the service, from the information provided and the overall support offered, to keeping office visits to a minimum. When a provider says you may be eligible for a survivorship visit, take advantage of it.
For more information about the Dayton Physicians Network Cancer Survivorship Clinic, call 937-293-1622.More Perspectives