New Efforts to Improve Care of Cancer Survivors

Jun 25, 2013

In 2011, ASCO convened a new committee to oversee the Society’s survivorship activities and provide leadership in joint efforts with other societies. Cancer Survivorship Committee member and survivorship expert Patricia A. Ganz, MD, of the University of California, Los Angeles (UCLA), discusses ongoing initiatives in this important arena.

AC: What is the most pressing issue in cancer survivorship care?
Dr. Ganz: One of the big challenges is the fragmentation of post-treatment care. Right now, patients do not know who should follow them and what intensity of follow-up should be done. Even in uncomplicated cases, what frequently happens is that there isn’t one member of the oncology care team seeing that patient every three or four months; it’s every member—the radiotherapist, the medical oncologist, and the surgeon. For each one of those physicians seeing that patient, there’s a chance of unnecessary tests or procedures being ordered.

A related problem is that many patients don’t get followed by their primary care doctor. Engaging the primary care doctor and letting him or her take over the coordination of care, particularly when a patient has high blood pressure or heart disease, often leads to better care for the patient; whereas an oncologist may send the patient to five or six different specialists for symptom management.
These issues dovetail with ASCO’s focus on oncology workforce issues—better coordinated follow-up care could reduce unnecessary patient visits without reducing quality of care in a limited oncology workforce.

AC: What is the biggest accomplishment of the Cancer Survivorship Committee since it was convened in 2011?

Dr. Ganz: Publishing the policy statement was an important step. It lays out a blueprint for what the committee feels is its purview and how it needs to interact across ASCO. There are many different areas in which survivorship is an important component—research, policy, quality.

AC: What are the committee’s goals?
Dr. Ganz: The most important area of activity right now is working with the Clinical Practice Guidelines Committee to develop and adapt survivor-specific clinical guidance. The priority areas are depression and anxiety, fatigue, and neuropathy, which relate to very troubling and persistent problems for survivors. There is a lot of interest in developing and demonstrating different models of care delivery for survivors. The committee is working to create an online compendium of tools and resources for providers (whether a physician, a nurse, or another member of the care team) to deliver care and offer educational materials to patients. There’s also a lot of interest in developing a curriculum and an educational strategy on cancer survivorship for all graduate medical trainees. Physicians in every specialty will be seeing cancer survivors and would benefit from some core competencies and increased awareness of late effects.

Dr. Ganz is Director of Cancer Prevention and Control Research at the Jonsson Comprehensive Cancer Center and a faculty member at the UCLA Schools of Medicine and Public Health. Since joining ASCO in 1980, she has served in numerous volunteer capacities, including on the Board of Directors, the Cancer Prevention Committee, and the Scientific Program Committee, among others. She became a Fellow of ASCO in 2008 and received the Conquer Cancer Foundation’s Comparative Effectiveness Research Professorship in 2011.


Marc Holman

Feb, 02 2016 8:44 PM

I have been reading the recent research in cancer survivors and fall risk due to chemo related neuropathy. I am a strength and conditioning coach with a background in Neurokinetic therapy. I currently only work with one breast cancer survivor. She has made some incredible progress, with focuses mainly in re-training her breathing and movement qualities. The neuropathy in her feet was treated by starting each session with 5-10 minutes of walking across a bed of round river stones. This significantly improves blood flow and develops intrinsic stabilizers in the foot when performed slowly. Additionally working on integrity of breathing and Allignment in many positions from the ground up, this comprehensive approach to movement has significantly improve proprioception. Wanted to share my experiences.

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