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Survivorship Program ing in the Survivorship MDC complete a validated, self-report measure of physical and psychosocial quality of life. In summary, the chief concerns among our survivors are fear of recurrence, general anxiety, fatigue and sleep changes, and pain.
Fear of recurrence can persist unabated for many years after treatment has concluded. Achieving better understanding of and ways of treating fear of recurrence is one of our future goals.
our Survivorship MDC), and complete a treatment summary and care plan. It is also our hope that instead of relying on survivors to seek out our services, as we have in the past, our new navigator will be better able to reach out to underserved populations and reduce the disparities we reported. Second, we hope to concentrate further on survivors’ fear of recurrence. We
chose to make this a priority because fear of recurrence is the most frequently cited top concern of our survivors, fear of recurrence does not tend to improve over time,3 and currently there is no evidence-based treatment for fear of recurrence. Therefore, as a first step we have decided to develop an independent line of translational research to better understand fear of recurrence. In the
longer term, after we have had the opportunity to further refine our program, our goal is to evaluate the effectiveness of our Survivorship MDC in a randomized, controlled trial. Looking forward at the national level, cancer survivorship is in many ways a frontier. With the ongoing development of different models of survivorContinued on page 32
NNew ew PPerspectives erspectives in in Oncology Practice
At the follow-up Survivorship MDC appointment, survivors repeat the same quality-of-life assessment. From the start, we acknowledge that our survivorship program is not a randomized, controlled trial and that we cannot conclude that any observed changes in quality of life are a result of participating in the Survivorship MDC. That said, we have found statistically significant improvements in overall quality of life, fatigue, sleep, general anxiety, and depression. These changes may be the result of the passage of time and general recovery, participating in the Survivorship MDC, other factors, or some combination. We do not, however, find any statistically significant improvement in reported fear of recurrence. This is particularly noteworthy because fear of recurrence represents our survivors’ top concern, and neither the passage of time nor participating in our Survivorship MDC appears to help alleviate this concern. This finding is also consistent with reports in the literature, which document that fear of recurrence can persist unabated for many years after treatment has concluded. Achieving better understanding of and ways of treating fear of recurrence is one of our future goals. Future directions Looking ahead within our program, we have chosen to focus on two areas for the immediate future. First, we were recently awarded grant support from the NCCCP to fund a new full-time survivorship nurse navigator. Our new navigator will focus on building relationships with our survivors as they are completing treatment and providing education about the possible challenges associated with making the transition to life after treatment. The navigator will follow up with survivors after treatment has concluded to screen for unmet medical and psychosocial needs, making the appropriate referrals as indicated (including to
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