Female patient sitting with doctor holding clipboard

According to the National Cancer Institute, there are over 16.9 million cancer survivors living in the United States. Unfortunately, many of them do not receive the full support that they need during and after treatment.

Cancer survivorship can be divided into three phases, each accompanied by its own unique physical, psychosocial, practical and spiritual challenges:

  • Acute Survivorship: Begins at diagnosis and lasts until the end of treatment. Focus is on enduring active treatment and living with cancer.
  • Extended Survivorship: Through the months after treatment ends. Focus is on recovering from treatments and monitoring for cancer recurrence.
  • Permanent Survivorship: Through the years after treatment has ended. Focus is on managing the long-term effects of cancer and treatment.

As the number of cancer survivors grows, many cancer centers have begun shifting focus to supporting survivor needs from the moment of diagnosis and onward.

The Commission on Cancer (CoC) accreditation standards provide one of the best criteria for delivering patient-centered care to survivors. This accreditation is difficult to achieve, but the centers that earn the accreditation have invested substantially in providing essential resources for cancer survivors across the full continuum of care.

All University of Maryland Cancer Network hospitals are CoC accredited, with some cancer centers offering robust survivorship programs that are designed help patients navigate life after diagnosis using a wide variety of methods.

Delivering Survivorship Care Plans

One of the most important requirements of the CoC accreditation standards is the delivery of a Survivorship Care Plan (SCP). SCPs offer a comprehensive summary of the treatments administered, as well as follow-up recommendations and screening guidelines that are specific to the patient's condition.

"Patients have that SCP to take to any future physician. They can see what condition the patient has had, what treatments they've received, and who to contact if they have any questions," says Pat Wallace, CTR, Cancer Registry Supervisor at UM Upper Chesapeake Health's Kaufman Cancer Center.

After finishing treatment, there is often more work to be done to support the patient's physical and mental health. SCPs bridge the gap between the patient's cancer care team and primary care providers, helping patients continue their survivorship journey and receive the care that they need once treatment is complete.

The relationship between the cancer care team and patient's primary care provider doesn't end with the SCP.

"If the patient's primary care provider feels that something is missing or has questions, our physicians are happy to have those conversations to ensure that everyone knows the next steps for the patient," says Diane Fitzgerald, MBA, MSW, Executive Director of Oncology at UM UCH's Kaufman Cancer Center.

Measuring Patient Distress

The CoC accreditation standards also require cancer centers to have a variety of other survivorship programs and resources in place. One of these requirements is measuring patient distress.

Using a tool to manage patient distress is incredibly important for helping patients maintain quality of life during survivorship. According to the National Comprehensive Cancer Network (NCCN), a third of cancer patients experience significant distress, but only five percent of patients receive any kind of psychological care.

"Identifying a way to evaluate the patients' level of distress allows providers to properly address their patients' mental health needs and maintain quality of life," says Monica Fulton, RN, MBA, and Director of Operations at the UM St. Joseph Medical Center Cancer Institute.

The UM Cancer Network has established a multi-hospital committee dedicated to defining the best times to measure patient distress and which tools to use. At the Cancer Institute, they utilize a NCCN-issued "distress thermometer."

"It's literally a piece of paper with a thermometer on it. It may be simple, but it allows patients to identify their stress levels in different categories on a scale of one to ten," says Fulton. The categories cover a wide variety of areas, including physical and physiological symptoms, as well as spiritual and financial concerns.

The distress thermometer opens up a dialogue between the health care team and their patients who exhibit high levels of distress in certain areas. "It gives patients an opportunity to address the issues they are experiencing, whether it's physical symptoms, emotional problems, returning to work and more," says Fulton.

Improving Quality of Life

Many robust survivorship programs also take a more holistic approach to addressing survivorship concerns on-site.

Many cancer centers within the UM Cancer Network focuses on providing promising treatments and classes that have been shown to help patients during their survivorship journey.

The UM SJMC Cancer Institute's Wellness and Support Center, opening July 2019, offers a number of unique integrative services aimed at improving patient quality of life.

"We offer state-of-the-art, integrative services on-site, all under one roof. It's convenient for patients, because they can go straight from their providers' office to a dietician, financial counselor, or even yoga or healing touch classes," says Virginia Jump, CRNP, Nurse Practitioner at the Wellness and Support Center.

Regardless of exact offerings, the overall focus of all survivorship programs within the UM Cancer Network is ensuring that the patient can continue their care with their primary care provider after cancer treatment and providing patients with the tools they need to find their "new normal."

"Incorporating the services and wellness interventions that have an impact on patients while they're undergoing treatment is essential for maintaining their wellbeing," says Fulton.

Help your patients receive high-quality care that takes all stages of survivorship into account. Refer a patient today.

About the UM Cancer Network

With the NCI-designated UM Marlene and Stewart Greenebaum Comprehensive Cancer Center as its hub, the UM Cancer Network offers patients access to nationally-renowned experts, cutting edge treatments and technologies, and the latest clinical trials. Learn more about the UM Cancer Network.