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Kevin C. Oeffinger, MD: Perspectives on Survivor Care & Risk Reduction in the Adolescent & Young Adult (AYA) Population

Feb 21, 2013

In the following interview, Dr. Kevin Oeffinger, of Memorial Sloan-Kettering Cancer Center and Chair-Elect of ASCO’s Cancer Survivorship Committee, discusses the Cancer Survivor Care and Cancer Risk Reduction self-assessment courses from ASCO University.

AC: The ABIM exams for oncology fellows and Maintenance of Certification (MOC) both cover survivorship and prevention. Do you think the self-assessment format for these ASCO University courses is effective in emphasizing important factors relating to survivorship and risk reduction, as well as helping individuals prepare for exams?

Dr. Oeffinger:
The ASCO University courses are highly effective in preparing fellows for their board exams and in educating clinicians about new areas. One of the components of the ABIM-MOC process is a comprehensive examination covering the major topics in oncology. Consequently, oncology Fellows and those enrolled in MOC seek additional opportunities to self-assess and identify knowledge gaps prior to taking the respective ABIM examination. Topics identified by the ABIM Examination Blueprint for both of these exams include:

--Effects of disease and of treatment on the patient, including psychosocial and physical issues
--The biology, etiology, and epidemiology of neoplastic disease, including screening and prevention

In addition, survivorship is specifically identified on the Blueprint under the category of Supportive Care and Ethics, with 12% of the examination questions dedicated to this category.

AC: What specific areas are covered in these courses?

Dr. Oeffinger: The Cancer Survivor Care and Risk Reduction courses within the ASCO Focus Under Forty series emphasize the potential health risks associated with anti-cancer treatment, the need for continued follow up care, and the importance of lifestyle interventions aimed at risk reduction of second malignancies. Some of the specific topics covered include organ toxicity, second malignancies, neuropathy, fertility, psychosocial problems, legal and economic issues, preventive interventions, and screening.

The expected learning outcomes from each of these courses are to increase healthcare providers’ awareness of Adolescent/Young Adult (AYA) cancer survivor care issues and enhance their confidence and ability to address medical and supportive care needs of this growing population.

AC: Why should cancer care providers participate in this ASCO-SEP Companion Series?

Dr. Oeffinger: Survivorship is now considered an integral part of the care of a cancer patient. Cure of the cancer is the primary goal but needs to be balanced with optimizing the level of functioning and health of the patient post therapy. Thus, it is essential that cancer care providers understand the key physical and psychosocial late effects that are associated with various cancer therapies or the general cancer experience. Simply put, to cure a cancer only to have the survivor die eight years later from a preventable heart attack is a tragedy. Much is known about the long-term and late effects following childhood, adolescent, and young adult cancer leading to evidence-informed consensus based recommendations for follow-up.

Are these courses useful for advanced practice providers as well as oncologists?

Dr. Oeffinger:
Advanced practice providers, such as nurse practitioners and physician assistants, are critically important in the care of the cancer survivor—both in the cancer care setting as well as in the community primary care physician’s office. Advanced practice providers often have a special expertise in educating and counseling patients regarding prevention and healthy lifestyles. This is highly important in the care of the cancer survivors. Because of this expertise and the broad clinical training they received, advanced practice providers have become a central component to most survivorship programs.
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