Mapping Out Success

Survivorship plans are a critical tool for patient care, yet they are not always implemented.


Imagine that you've just landed in a foreign country. Problematically, you don't speak the language, you don't know how to get to your hotel, and you don't know any of the social customs. Dead ends seem to hit you everywhere, and you don't know whom to call for help.


Cancer patients often find themselves in a similar state following treatment. They are elated to find that they are well, but soon realize that life as a cancer survivor is entirely different than it was before. They have a host of unfamiliar issues, including dealing with the side effects of their treatment.

One way to ease the patent's transition is for radiation oncologists to arm them with survivorship plans, semi-comprehensive reports that summarize what occurred during treatment, explain what is expected in terms of side effects and follow-up care, and provide resources for further information. "A survivorship plan is like a roadmap," says Ann H. Partridge, MD, MPH, head of the survivorship program at the Dana-Farber Cancer Institute in Boston. "Patients don't know what to do or expect after cancer, and a survivorship plan is a good way to guide them."

Survivorship plans can do a lot to quell anxiety and help patients transition to a healthy lifestyle. After cancer treatments, patients have a whole different host of needs, says Partridge. Radiation oncologists are already a step ahead of most oncologists because the summary — a detailed overview that radiation oncologists give at the end of treatment — is like a partial survivorship plan.

One roadblock to implementing survivorship plans, however, is the debate as to who should write them. "Some say that oncology nurses are perfectly capable while others say it's the doctors' responsibility. Still others feel that multiple members of the care team should contribute," says Abram Recht, MD, deputy chief of the department of radiation oncology at Beth Israel Deaconess Medical Center in Boston. Both Recht and Partridge suggest making survivorship planning a team effort, whether it involves your staff or the patient's entire care team. By communicating with other physicians, you are not only sharing some of the work, but you are also making sure that you avoid miscommunication, says Partridge.

Radiation oncologists should be involved in the team effort to create survivorship plans because they are radiation experts and have the best, most current understanding of the side effects of treatments. Partridge notes, "Radiation oncologists are at the forefront of studying the side effects of radiation; they're the first ones to learn about new problems the patient may encounter." Recht adds, "There's a great deal of mystery around what radiation oncologists do. Other specialists may not understand as well as we do the potential side effects to radiation therapy."

No matter the misgivings, says Partridge, survivorship plans can be a critical tool in patient care. "We often land patients in the foreign world of survivorship without any kind of map. And that contributes to a lot of anxiety and excess visits and tests," she says. "Survivorship plans can help mitigate some of that."

 By Meghan Edwards,ACR Bulletin copywriter


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