When asked about the importance of coordination of care for this patient population, Dr Cohen said that it is “in a word, paramount.”
“This is a situation where a single skill set is simply inadequate,” he said. “That is exactly why we targeted primary care providers with these guidelines. We felt they would be in the best position to coordinate the care and communicate with the patient and their caregivers.”
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Regarding health education, he said that convincing patients of the importance of maintaining their health is “always challenging.”
“I think in the head and neck survivorship situation, though, it might be a little different,” he said. “First, patients understand that some of the guidelines are provided to prevent recurrence or detect them early. Second, for many patients the consequences of poor survivorship care are readily apparent and relevant…so there is a desire to avoid them.”
Nonetheless, it can definitely be difficult to get patients to perform tasks or exercises especially after completing therapy for head and neck cancer. “I think therein lies a large benefit of the guidelines. Now providers can point to a highly visible document to back up their recommendations,” he said.
Dr Cohen stressed the fact that human papillomavirus-related oropharyngeal cancer incidence is rapidly increasing the incidence of HNC in the United States.
“These cancers are also more likely to be cured,” he said. “Therefore, the number of survivors is already starting to increase dramatically in the United States. It is now not unusual for physicians to see these patients in their practices.”
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The ACS intends to continue to update these guidelines based on formal reviews of literature, with new updates at least every 5 years.
Reference
- Cohen, EEW, LaMonte, SJ, Erb, NL, Beckman, KL, et al. American Cancer Society Head and Neck Cancer Survivorship Care Guideline [published online ahead of print March 22, 2016]. CA Cancer J Clin. doi: 10.3322/caac.21343.
