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Survivorship Champions

Clinicians and Researchers Improving Care for Cancer Survivors

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Survivorship Champions

What is Survivorship Champions?

  • NCCS’ program for clinicians and researchers who are interested in improving care for cancer survivors.
  • A community, with a multi-directional information exchange about best practices, lessons learned, and effective models of survivorship care.

The Need

Lost in TransitionAs treatments for cancer improve, more people are living with a history of cancer, and the long-term effects of cancer treatment. With more than 17 million cancer survivors in the U.S., the current oncology workforce is not sufficient to handle the acute needs of cancer patients who are in treatment, or who have completed treatment. Thus, it is imperative that some of the responsibility for providing survivorship care shifts from oncologists to primary care physicians.  Even survivors who require continued follow-up by their oncology team need primary care physicians who understand their cancer experience and their health needs in post-treatment survivorship.

The Institute of Medicine of the National Academies issued a report in 2005, “From Cancer Patient to Cancer Survivor: Lost in Transition,” that included several recommendations for improving the quality of care for survivors as they transition from active treatment to long-term survivorship. In response, NCCS and other patient and provider organizations worked to implement key recommendations of the report. Despite these efforts, cancer survivors in 2021 too often describe their movement from active treatment as a time of being “lost in transition,” exactly the experience and emotion captured by the Institute of Medicine in 2005.

Survivorship Champions Webinar - Beyond the Checkbox: Delivering Meaningful Cancer Survivorship Care in a Community Setting - Wednesday May 18, 2022, 12pm EDTBeyond the Checkbox: Delivering Meaningful Cancer Survivorship Care in a Community Setting

Wednesday, May 18, 2022
12:00 PM EDT

As we approach the 17th year since the Institute of Medicine released their landmark report, “From Cancer Patient to Cancer Survivor: Lost in Transition”, oncology programs continue to encounter challenges in implementing survivorship care in a way which provides meaning and long-term value to cancer survivors and their families.

Updates to the American College of Surgeons’ Commission on Cancer (CoC) survivorship standard in 2020 attempt to address this challenge by encouraging cancer programs to move beyond providing a survivorship care plan document to patients and into engaged action that represents the intended outcome of quality survivorship care delivery that includes prevention and surveillance of treated or potential cancers, surveillance and management of physical and psychosocial effects and promotion of health.

Dr. Crystal Labbato will present the current model for survivorship care delivery utilized within the Baptist Health Louisville community cancer center, and how they were able to tailor services to best meet the needs of cancer survivors in their community.

About Crystal Labbato DNP, APRN, AGCNS-BC, AOCNS, NCTTP (they/them or she/her)

Crystal Labbato DNP, APRN, AGCNS-BC, AOCNS, NCTTP, is a board-certified adult-gerontology clinical nurse specialist, advanced oncology clinical nurse specialist, and certified tobacco treatment specialist. Dr. Labbato currently serves as the Survivorship Program Coordinator for Baptist Health Louisville and LaGrange hospitals in Kentucky. Dr. Labbato provides trauma informed, physical and psychosocial supportive care and referrals to people and families living through a cancer experience throughout the full cancer care continuum (prevention, screening, diagnosis, treatment, recovery and palliation). In 2019, Dr. Labbato completed a pilot project incorporating comprehensive geriatric assessments into the care of patients with a thoracic cancer diagnosis that is in the process of being expanded to all medical oncology patients. In addition, Dr. Labbato regularly coordinates and co-facilitates community education events on advance care planning, smoking and tobacco cessation, late and long term effects of cancer and cancer treatments, and other cancer survivorship issues.

Dr. Labbato received a Bachelor of Fine Art in Painting from the Art Academy of Cincinnati, and subsequently completed an accelerated Bachelor of Science in Nursing at Northern Kentucky University. Dr. Labbato’s early clinical practice was spent in acute care, phase one oncology clinical trials, and hospice nursing in the home and inpatient settings before ultimately earning a Doctor of Nursing Practice at the University of Kentucky and assuming their present role. Dr. Labbato has completed additional training in trauma-informed sensitive practice, assessment and supportive care of the older adult with a cancer diagnosis (Memorial Sloan Kettering Cancer Center), primary palliative care for oncology APRNs (End of Life Nursing Education Consortium), and competent care of LGBTQIA+ persons (University of Louisville).

Dr Labbato’s work also includes a photography practice and they have had works selected for inclusion in exhibitions at the Columbus Museum of Art in Ohio and the Museum Angewandte Kunst, in Frankfurt Germany.

Join Survivorship Champions

Survivorship Champions is for all clinicians and researchers, both oncology and primary care, who are interested in improving survivorship care and primary care’s role in caring for cancer survivors.

It’s free to join NCCS Survivorship Champions, and as a member you’ll receive information and resources from NCCS, invitations to webinars, and access to training materials about improving care for cancer survivors.
Learn more and sign up to join Survivorship Champions.

Introduction

Shelley Fuld Nasso, MPP

CEO, NCCS

NCCS has an incredible network of advocates, cancer survivors and caregivers, who are passionate about sharing their experiences and advocating for better, more holistic care for cancer survivors. Please enjoy these videos, in which long-term survivors describe their post-treatment needs and challenges in receiving survivorship care.

Ana María López, MD, MPH

Sidney Kimmel Medical College

As a medical oncologist, I see my job as taking care of the whole person with cancer, from diagnosis through post-treatment survivorship. In my career, I have seen the gaps in care that cancer patients face, during treatment and as they transition to post-treatment care. As Past President of the American College of Physicians, I know the challenges that primary care physicians face in practice and the desire of primary care physicians to learn more about the needs of cancer survivors. Through Survivorship Champions, we hope to provide support, resources, best practices, and community to clinicians and researchers who are interested in improving survivorship care.

Take Our Concerns Seriously

People talk about a “new normal” after cancer, but many cancer survivors say that there is no such thing as a new normal. After a cancer diagnosis, their lives have been changed forever. Fear of recurrence is a significant and often debilitating concern for many cancer survivors. And the effects of cancer treatment are long-lasting. Cancer survivors tell us that they need their care team to take their concerns seriously.

Understand the Collateral Damage of Cancer Treatment

Cancer treatment has long-lasting effects on cancer survivors’ physical health, mental health, and quality of life. Some use the term “collateral damage” to describe the effects of cancer treatment. Some treatments cause infertility, heart damage, neuropathy, and other significant health effects. Cancer survivors tell us that they are not always prepared for the long-term effects, and they wish their primary care team better understood the long-term effects of cancer treatment.

Communication Is Critical

Cancer patients and survivors see multiple different doctors as part of their ongoing medical care, and often the task of coordinating among different clinicians falls on the patient. Many cancer survivors become strong advocates for themselves and share information among their providers, but it can be a huge burden. Communication between the oncology team and primary care physician is critical to ensuring continuity and coordination of care.

Mental Health Is a Top Concern

A cancer diagnosis takes a huge toll on mental health. Cancer turns one’s world upside down and forces survivors to face their mortality. In NCCS’ 2020 State of Cancer Survivorship Survey, fatigue and mental health issues are among the most common side effects reported by cancer patients and survivors, yet few reported that their health care teams were very helpful in addressing these concerns during treatment, and most reported their doctors did not bring up mental health during post-treatment care.

Cancer Survivors are Unique Patients

Cancer survivors are unique patients. They have been through a life-changing experience and cancer treatment not only impacts their health, but also their finances, their family, their careers and their mental health. Cancer survivors often take on the responsibility of managing their treatments and coordinating among multiple providers. As a result, they often know an incredible amount of information about their own health and the health care system. Meeting cancer patients where they are, and listening to their concerns, is critical.

NCCS’s Cancer Survivorship Checklist: A Guide for Clinicians

The Cancer Survivorship Checklist: A Guide for Clinicians provides health care professionals with a step-by-step process to implement survivorship care with their patients.  The guide highlights the need for a survivorship care plan and treatment summary, and the coordination of health care during active treatment and post-treatment.

This tool helps ensure that patients are receiving the right care at the right time, the care is coordinated, and resources are used effectively. Cancer survivors should be provided with information to guide them through the different stages of treatment and resources for psychosocial support, rehabilitation, and wellness as part of cancer risk reduction. The guide concludes with having a conversation about when to transition care from oncology team to primary care providers and having the survivorship care plan to support the transition.

Cancer Survivorship Checklist: A Guide for Clinicians

Survivorship Champions Webinars

Rural Survivorship Care Webinar

Nurse-led care model survivorship webinar flyerPam DeGuzman, PhD, RN, joined NCCS to discuss the development and evaluation of Comprehensive Assistance: Rural Interventions, Nursing and Guidance (CARING), a nurse-led intervention aimed at reducing disparities in quality of life for rural cancer survivors.

During active treatment, rural survivors may forgo supportive care interventions to prioritize and consolidate medical visits into one day, with the goal of minimizing travel (called “appointment stacking”). CARING connects rural survivors with an oncology-specialized registered nurse several weeks after the completion of active treatment, to exclusively focus on lingering supportive care needs.

After Dr. DeGuzman’s presentation, NCCS CEO Shelley Fuld Nasso moderated a discussion featuring questions from the audience.

Watch the full video below or watch on YouTube.

Note: Due to a technical glitch, the Q&A portion of the webinar is audio only.

Webinar Slides and Links Discussed

Dr. Pamela DeGuzman is an Associate Professor of Nursing at the University of Virginia School of Nursing. She has worked with individuals with cancer since 1996, beginning her career as a bedside nurse at Georgetown Medical Center in Washington, DC. She obtained her PhD in 2012 and joined the faculty of the UVa School of Nursing. In addition to developing innovative nurse-led care models, she is currently studying the implementation of telemedicine video visits in rural public libraries and has written the foundational research agenda aimed at studying this practice. She has published more than 40 peer-reviewed articles.

Survivorship Champions is supported by an educational grant from Bristol-Myers Squibb.