My talk today is going to be on identifying unmet needs in cancer survivors and how this is really becoming a growing and integral part of cancer care delivery. Currently there are approximately 16 million cancer survivors living in the United States; that number is set to grow to over 20 million in the next 5-10 years. So we have a lot of people living both with cancer and who live cured or through cancer. But obviously cancer has a lot of side effects, not only does it increase the risks for things like bone health issues or cardiotoxicity but also there are psychological and financial toxicities of cancer. So survivorship really encompasses a person from the time they’re diagnosed, through their lifespan, and it looks at those with cancer and through cancer and all of the issues that may impact that patient and their family.
What types of programme are you doing with these patients?
When you think about cancer survivorship programmes there are a lot of different facets to that. You may think about the physical consequences, so fertility preservation, cardiac, collaborators in cardiology and cardiotoxicity. You may think about psychology or social work and dealing with a lot of the existential or psychological impacts of cancer. So when you think about a programme some programmes are very comprehensive and have lots of subspecialties and partners, others are more isolated and they need to refer out for a lot of those services. So you’re really talking about a large variability in whether it’s a programme that gives a patient a plan, and may or may not have the next steps of the plan, or it may be more of a hospital or a hospital system based programme where you’re able to provide those services to the patient all encompassing.
How can drugs help survival issues?
There are a lot of opportunities for managing survivorship issues both during treatment and post treatment. If you think of a lot of the new targeted therapies some of them we don’t really know what’s going to happen to a patient six months, two years or ten years down the road, especially when you give drugs in certain combinations. Other drugs we’re leaving patients on for five years, ten years or some, they’ll be on therapy for the rest of their life. So, as you can imagine, you may have patients who have maybe one or two issues today but they’re going to be at risk for things over the next five, ten or the rest of their lifespan versus other patients who may have a significant amount of issues both during and post treatment. Then because we’re leaving patients on these very specific therapies for longer periods of time we’re going to have a lot more need to assess patients, educate patients and manage patients and we need a way to do that. Survivorship care provides a mechanism for really managing both current issues and future issues for our patients and their families.
How can technology be used to help this process?
Technology has to be embraced because it’s part of all of our lives, both from the healthcare delivery perspective as well as from patients accessing information. We know that a majority of patients access information through electronic tools and over 60% of that is from a handheld device. So we have to get patients engaged in reporting symptoms; we have to be better as providers at documenting and using a health record and then how do we merge all that information so that a patient doesn’t report something and it gets lost in cyberspace. We actually can address those issues more real time.
So at our institution we have integrated a lot of assessment, a lot of the care planning pieces into the health record so it’s a lot more seamless and it’s real time versus having to extract information from lots of different places. That’s hard for a lot of places to have access to efficient technology so that’s no longer an option, it’s a must do that we utilise technology to the fullest.