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Cancer Survivorship Care: Exploring the Role of the General Internist

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Abstract

According to the National Cancer Institute (NCI), cancer survivorship encompasses the “physical, psychosocial, and economic issues of cancer from diagnosis until the end of life.” Today, one in 30 Americans are cancer survivors. Almost two-thirds have at least one chronic health condition. As the numbers of cancer survivors increase, cancer itself can be viewed as a chronic medical condition. This paper illustrates some of the challenges faced by cancer survivors. We discuss the limitations of current models of survivorship care, including shared care. In addition, we explore how the American Board of Internal Medicine’s previously proposed credential of Comprehensive Care Internist could serve to define and integrate the complex needs of adult cancer survivors with the skills and talents of general internists.

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Conflict of Interest

None disclosed.

Author information

Authors and Affiliations

  1. Internal Medicine, Section of General Internal Medicine, University of Chicago, 5841 S. Maryland Ave MC 3051, Chicago, IL, USA

    Susan Hong MD, MPH

  2. Harvard Medical School, Boston, MA, USA

    Larissa Nekhlyudov MD, MPH

  3. Harvard Vanguard Medical Associates, Boston, MA, USA

    Larissa Nekhlyudov MD, MPH

  4. Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Aarati Didwania MD, MS

  5. Internal Medicine Section of Hematology & Oncology, University of Chicago, Chicago, IL, USA

    Olufunmilayo Olopade MD

  6. Rush University Medical Center, Chicago, IL, USA

    Pamela Ganschow MD

Authors
  1. Susan Hong MD, MPH
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  2. Larissa Nekhlyudov MD, MPH
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  3. Aarati Didwania MD, MS
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  4. Olufunmilayo Olopade MD
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  5. Pamela Ganschow MD
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Corresponding author

Correspondence to Susan Hong MD, MPH.

Appendices

Appendix A: NCI -designated CCC with at least one Adult Survivorship Follow-up Clinic.** [Information Last Accessed from Websites April 1, 2009]

Center Name

*Abramson Cancer Center-University of Pennsylvania

http://penncancer.org/cancerprograms_detail2.cfm?id=32&w=about

Case Comprehensive Cancer Center

http://www.uhhospitals.org/irelandcancer/tabid/1883/Default.aspx

City of Hope

http://www.cityofhope.org/about/publications/hope-news/2008-vol-3-num-20-june-30/Pages/prostate-cancer-survivorship-clinic-opens-doors.aspx

*Dana Farber Cancer Institute

http://www.dana-farber.org/pat/surviving/default.html

*Fred Hutchinson Cancer Research Center

http://www.fhcrc.org/science/clinical/ltfu/

+MD Anderson

http://www.mdanderson.org/topics/survivorship/display.cfm?id=27f0b87c-175f-441e-91b2dbaa58d6302b&method=displayfull

*Memorial Sloan-Kettering Cancer Center

http://www.mskcc.org/mskcc/html/64918.cfm

Norris Cotton Cancer Center

Dartmouth-Hitchcock Medical Center

http://www.cancer.dartmouth.edu/survivorship/index.shtml

*Ohio State University Comprehensive Cancer Center

http://www.jamesline.com/patientsandvisitors/survivorship/

*UCLA’s Jonsonn Comprehensive Cancer Center

http://www.cancer.ucla.edu/Index.aspx?page=590

*University of Colorado Cancer Center

http://www.uccc.info/conditions/cancer/survivorship-clinics/adult-survivors-clinic/adult-cancer-survivors-clinic.aspx

*University of North Carolina Lineberger Comprehensive Cancer Center

http://cancer.med.unc.edu/patient/support/clinics.asp

Vanderbilt-Ingram Cancer Center

http://www.vicc.org/news/?p=445

Yale Cancer Center

http://www.yalecancercenter.org/surviving/challenge.html

  1. * Receives financial support from Lance Armstrong Foundation
  2. **Since formal published information on adult survivorship clinics for the 2009 NCI-CCCs is lacking, information was obtained from individual center’s website. Centers had to have a description of a follow-up program on their website that provided individualized follow-up care by a health professional (MD or NP) and provide access to a multidisciplinary team for adult survivors of adult cancers.
  3. + General Internal Medicine Involvement Specified at Cancer Center

Appendix B: Types of Cancer Programs in US

NCI-designated

(N=63)

Goals selection process

Comprehensive cancer centers (N=40)

Research*

Application/NCI- approval

 

Provides clinical care outreach and education

 

Cancer centers (N=23)

Research*

Application/NCI- approval

 

+/-Provides clinical care

 

Community cancer centers** (N=16)

Pilot study

Application/NCI approval

American College of Surgeon’s Commission on Cancer^ (N=1433)

Clinical care

Application/approval

Association of Community Cancer Centers » (N=650)

Clinical care

Membership application

  1. * Basic science, population, and clinical
  2. **Purpose is to expand cancer research and increase access to advanced cancer care
  3. ^ http://www.facs.org/cancer
  4. » http://accc-cancer.org/

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Hong, S., Nekhlyudov, L., Didwania, A. et al. Cancer Survivorship Care: Exploring the Role of the General Internist. J GEN INTERN MED 24 (Suppl 2), 495–500 (2009). https://doi.org/10.1007/s11606-009-1019-4

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