Transcript No Slide Title

FACET - European Journal of Cancer Care
July 2004
After treatment – who cares?
Van der Molen, B.1, Griffiths, P.2 & Lansdown, J.3
After treatment
Who is responsible for providing
Slide One
follow up care and support?
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FACET - European Journal of Cancer Care
July 2004
After treatment – who cares?
(continued)
‘I just wanted everything to get back
to how it had been before the cancer.
Going back to work restored a sense
Slide Two
of “normality”, but I didn’t give myself
the chance to rest, recuperate and
psychologically adjust to the shock
and the trauma. I ended up getting
anxious and depressed, and I’m sure it
delayed my full recovery.’
Lucy (in Van der Molen, 2003, pg 102)
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FACET - European Journal of Cancer Care
July 2004
After treatment – who cares?
(continued)
After treatment – a
patient’s perspective
‘I felt guilty about taking time to
Slide Three
recover, not being able to manage
domestic life, work or a daily routine.
I felt the financial pressures of being
out of work, of having to get back to
normal as soon as possible, before I
felt ready.’
Jill, breast cancer
(The Cancer Resource Centre)
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FACET - European Journal of Cancer Care
July 2004
After treatment – who cares?
(continued)
‘After radiotherapy I felt bereft of
support and didn’t know who could
answer questions.’
Slide Four
John, prostate cancer
‘I felt reluctant to take up the time of
my hard-pressed GP and hospital
consultant but I needed a different
kind of support structure for two
years after my treatment had
finished.’
Sarah, leukaemia
(The Cancer Resource Centre)
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FACET - European Journal of Cancer Care
July 2004
After treatment – who cares?
(continued)
Slide Five
A mapping exercise
looking at the needs of
patients after treatment,
highlighted three key
areas:
These are:
• The role of the general
practitioner and primary
care
• Information and support
• Social and psychological care
issues
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FACET - European Journal of Cancer Care
July 2004
After treatment – who cares?
(continued)
Concerns for patients
when they finish
treatment
Slide Six
• Follow-up appointments
• Long-term side effects and when
after cancer treatment they may
develop
• What symptoms to look out for
that might indicate the cancer
has returned?
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FACET - European Journal of Cancer Care
July 2004
After treatment – who cares?
(continued)
Concerns for patients
when they finish
treatment (cont.)
Slide Seven
• Financial and work issues
• Can measures like exercise and
diet decrease cancer risk?
• Contact details if there are any
worries
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FACET - European Journal of Cancer Care
July 2004
After treatment – who cares?
(continued)
Follow up clinics
• What purpose do they serve?
Slide Eight
• Clinician or nurse led?
• Hospital or telephone?
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FACET - European Journal of Cancer Care
July 2004
After treatment – who cares?
(continued)
Slide Nine
Who provides follow-up
care and support for
patients at the end of
treatment?
Should it be:
• The hospital (where treatment
was provided)
• Primary care (the community)
• Non-statutory organisations
(e.g. cancer support centres)
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FACET - European Journal of Cancer Care
July 2004
After treatment – who cares?
(continued)
The role of the
hospital
Slide Ten
• Should hospitals provide more
than just follow-up care?
• If so, what kind of care/support
should be offered?
• For how long should support be
offered?
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FACET - European Journal of Cancer Care
July 2004
After treatment – who cares?
(continued)
Slide Eleven
The role of primary
care
‘Having a supportive GP and access to a
local cancer resource centre have been
very important in my cancer journey.
Once active treatment has ended,
tiredness can make the thought of
returning to work and living with the
results of cancer feel quite challenging.
Encouraged by my GP to use counselling
and complementary therapies, these
challenges were less daunting.’
Karen, breast cancer
(The Cancer Resource Centre)
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FACET - European Journal of Cancer Care
July 2004
After treatment – who cares?
(continued)
Slide Twelve
The role of nonstatutory
organisations
‘Being able to access advice and
information from the local cancer
resource centre, the hospital, and from
national cancer helplines has been
extremely valuable. I often wonder how
I would have coped without this help.’
Karen, breast cancer
(The Cancer Resource Centre)
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FACET - European Journal of Cancer Care
July 2004
After treatment – who cares?
(continued)
Improving Supportive
and Palliative Care for
Adults with Cancer
Slide Thirteen
Addresses:
• Co-ordination of care
• User involvement in planning,
delivering and evaluating services
• Face-to-face communication
• Information
• Psychological support services
• Social support services
• Rehabilitation services
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FACET - European Journal of Cancer Care
July 2004
After treatment – who cares?
(continued)
There needs to be
Slide Fourteen
better co-ordination
between the providers
of cancer care
(statutory and nonstatutory) in hospitals
and the community.
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FACET - European Journal of Cancer Care
July 2004
After treatment – who cares?
(continued)
Slide Fifteen
Resources – what is
available?
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FACET - European Journal of Cancer Care
July 2004
After treatment – who cares?
(continued)
We must prepare our
Slide Fifteen
patients to adjust to
a new kind of
‘normal’ life after
treatment for
primary cancer.
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FACET - European Journal of Cancer Care
July 2004
After treatment – who cares?
(continued)
References
Slide Fifteen
• Adewuyi-Dalton, R., Ziebland, S., Grunfield, E. & Hall, A.
(1998) Patients’ views of routine hospital follow-up: A
qualitative study of women with breast cancer in
remission. Psycho-oncology. 7: 436-439.
• Bristol Oncology Centre., Dept. of Sociology,
University of Warwick & Bristol Cancer Help Centre.
(1999) Meeting the needs of people with cancer for
support and self management. Bristol Cancer Help
Centre, Bristol.
• Colice, G.L., Rubins, J., & Unger, M. (2003) Follow-up
and surveillance of the lung cancer patient following
curative-intent therapy. Chest. 123: 272S-283S.
• Cox, K. & Wilson, E. (2003) Follow-up for people with
cancer: nurse-led services and telephone
interventions. Journal of Advanced Nursing. 43(1): 51-61.
*Click on “View”; “Notes Page” for explanatory notes
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FACET - European Journal of Cancer Care
July 2004
After treatment – who cares?
(continued)
References (continued)
Slide Fifteen
• Moore, S., Corner, J., Haviland, J., Wells, M., Salmon, E.,
Normand, C., Brada, M., O’Brien, M. & Smith, I. (2002)
Nurse led follow up and conventional medical follow
up in management of patients with lung cancer:
randomised trial. BMJ. 325: 1145-1151.
• National Institute for Clinical Excellence (2002)
Improving Outcomes in Breast Cancer – Information for
the public. National Institute for Clinical Excellence.
London.
• National Institute for Clinical Excellence (2004)
Improving Supportive and Palliative Care for Adults with
Cancer. National Institute for Clinical Excellence.
London.
• Oldervoll, L.M., Kaasa, S., Hjermstad, M.J., Lund, J.A. &
Loge, J.H. (2004) Physical exercise results in the
improved subjective well-being of a few or is effective
rehabilitation for all cancer patients? European Journal
of Cancer. 40: 951-962.
*Click on “View”; “Notes Page” for explanatory notes
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FACET - European Journal of Cancer Care
July 2004
After treatment – who cares?
(continued)
References (continued)
Slide Fifteen
• Schultz, P.N., Stava, C., Beck, M.L. & Vassilopoulou-Sellin
, R. (2003) Internet message board use by patients and
their families. Clinical Journal of Oncology Nursing. 7(6):
663-667.
• Van der Molen, B. (2003) Taking control of cancer. Class
Publishing. London.
• Van der Molen, B. & Hutchison, G. (1999) Learning to
live with cancer: the U. K. experience of a European
patient education and support programme. European
Journal of Cancer Care. 8: 170-173.
• White, C.A. & Macleod, U. (2002) ABC of
psychological medicine: Cancer. BMJ. 325: 377-380.
• Ziebland, S., Chapple, A.., Dumelow, C., Evans, J.,
Prinjha, S. & Rozmovits, L. (2004) How the internet
affects patients’ experience of cancer: a qualitative
study. BMJ. 328: 564-570.
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FACET - European Journal of Cancer Care
July 2004
After treatment – who cares?
(continued)
References (continued)
Web based resources
Slide Fifteen
• After Treatment can be found on The Royal Marsden
NHS Foundation Trust’s website at
http://www.royalmarsden.org
• What now? Adjusting to life after cancer can be found on
CancerBACUP’s website at
http://www.cancerbacup.org.uk
• Life after cancer treatment can be found on the
National Cancer Institute’s website at
http://www.cancer.gov/cancerinfo/life-aftertreatment
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