Patients Prioritize Recurrence Assessment, Psychological Support at Post-Treatment Appointments

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(ChemotherapyAdvisor) – Most patients prioritize tumor recurrence assessments and psychological support during breast cancer post-treatment follow-up appointments, according to a single-institution, cross-sectional study reported by Duke University researchers at the 2013 Breast Cancer Symposium held in San Francisco, CA.

However, details of patients' experiences and preferences after treatment vary, and more research is therefore needed to determine how best to design survivorship care programs at cancer centers, noted Kelly Westbrook Mitchell, MD, and coauthors, from the Duke University Medical Center and Duke Cancer Institute, in Durham, NC.

“Patients' experiences and preferences regarding long-term management of breast cancer are varied,” the team reported. “Many patients desire ongoing follow-up with their primary oncology team.”

The “optimal method for delivery of care to over 2 million breast cancer survivors in the U.S. remains unclear, with multiple models currently in practice,” the coauthors reported. In order to explore patient preferences and experiences in post-treatment care, the authors conducted a cross-sectional, self-administered survey that asked patients about their “needs, experiences and interests” following initial breast cancer treatment. All patients treated were provided the survey at appointment check-in during a 4-week period. A total of 66.8% of 612 patients completed the survey. Just over half (55%) of patients had a college degree.

More than 90% of patients indicated that the priority for follow-up appointments should be assessment of disease recurrence, the coauthors noted. “A majority were interested in emotional and psychological support (52%). Nearly 40% of patients felt that assistance with non-cancer related health issues was very important in oncology clinic follow-up, but only 25% wanted a cancer specialist to provide general medical care.”

Only 42% of participants reported that they had received a summary of their cancer treatment, and 37% reported receiving written recommendations or post-treatment survivorship plans; patient ethnicity but not education or age correlated with whether or not such materials were provided. White patients were less likely than other patients to receive either (P<0.02 and <0.005, respectively), the coauthors reported.

“Regarding ongoing care, 63% preferred to see a cancer specialist at least annually, and 30% wanted access to a cancer specialist as needed,” the coauthors reported. “Less than 15% preferred referral to a local practice, and less than 15% favored follow-up care from a specialized cancer survivorship clinic.”

Given patients' varied responses, further work is needed to identify how best to tailor post-treatment follow-up for survivors, the researchers concluded. “Further evaluation of patients' goals, needs and an evidence-based approach to follow-up care are needed to guide optimal program design,” they reported.

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