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Effects of a Cancer Survivorship Clinic—preliminary results

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Abstract

Purpose

Initial investigation of the impact of a Cancer Survivorship Clinic following its introduction in February 2017.

Methods

A systematic chart review of 176 patients enrolled in the Cancer Survivorship Clinic (CSC) who completed a minimum of one follow-up visit after the initial baseline visit. This was assessed using three screening tools: distress thermometer (DT), Canadian Problem Checklist (CPC), and Edmonton Symptom Assessment Scale (ESAS). Descriptive statistics and t tests were utilized to assess the impact of the CSC.

Results

Distress thermometer: Statistically significant decline in scores from the baseline visit to the follow-up visit among the study population (p < 0.05). There was a significant decline in score among high-risk patients with an initial DT≥4 (p < 0.0001). Canadian Problem Checklist: Based on the initial baseline visit, the top five reported causes of distress among the study population include pain, anxiety, fatigue, tingling in hands and feet, sleep. Edmonton Symptom Assessment Scale: Statistically significant decline in reported pain, tiredness, nausea, depression, anxiety, drowsiness, and shortness of breath scores (p < 0.05).

Conclusions

Overall, patients had a significant reduction in distress from the baseline visit to the follow-up visit. High-risk patients experienced a more significant reduction in distress. Reduction in patient distress was independent of the number of visits to the clinic. Reported symptom severity for pain, tiredness, depression, anxiety, drowsiness, and shortness of breath also declined significantly following clinic intervention. Further qualitative studies required to establish the clinical significance of study findings.

Implications for cancer survivors

Continued active clinical support and education for cancer survivors should be considered a potentially essential element in the cancer treatment trajectory to address patient well-being and distress.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. Ganz PA (2011) The “three Ps” of cancer survivorship care. BMC Med 9. https://doi.org/10.1186/1741-7015-9-14

  2. Suija K, Kordemets T, Annuk K, Kalda R (2016) The role of general practitioners in cancer care: a mixed method design. J Cancer Educ 31:136–141

    Article  Google Scholar 

  3. Hoekstra RA, Heins MJ, Korevaar JC (2014) Health care needs of cancer survivors in general practice: a systematic review. BMC Fam Pract 15:94

    Article  Google Scholar 

  4. Hewitt M, Greenfield S, Stovall E (2006) From cancer patient to cancer survivor: lost in transition. Washington, DC

  5. Cheng KKF, Wong WH, Koh C (2016) Unmet needs mediate the relationship between symptoms and quality of life in breast cancer survivors. Support Care Cancer 24:2025–2033

    Article  CAS  Google Scholar 

  6. Faller H, Koch U, Brahler E et al (2016) Satisfaction with information and unmet information needs in men and women with cancer. J Cancer Surviv 10:62–70

    Article  Google Scholar 

  7. National Comprehensive Cancer Network (NCCN) (2010) Clinical practice guidelines in oncology: distress management. Fort Washington, Maryland

  8. Bultz BD, Groff SL, Fitch M, Blais MC, Howes J, Levy K, Mayer C (2011) Implementing screening for distress, the 6th vital sign: a Canadian strategy for changing practice. Psychooncology 20:463–469

    Article  Google Scholar 

  9. Holland JC, Anderson B, Breitbart WS et al (2010) Distress management. J Natl Compr Cancer Netw 5:66–98

    Google Scholar 

  10. Kennard BD, Stewart SM, Olvera R, Bawdon RE, Hailin AO, Lewis CP, Winick NJ (2004) Nonadherence in adolescent oncology: preliminary data on psychological risk factors and relationships to outcome. J Clin Psychol Med Settings 11:30–39

    Article  Google Scholar 

  11. Von Essen L, Larsson G, Oberg K, Sjödén PO (2002) ‘Satisfaction with care’: associations with health related quality of life and psychosocial function among Swedish patients with endocrine gastrointestinal tumors. Eur J Cancer Care (Engl) 11:91–99

    Article  Google Scholar 

  12. Steel JL, Geller DA, Gamblin TC, Olek MC, Carr BI (2007) Depression, immunity, and survival in patients with hepatobiliary carcinoma. J Clin Oncol 25:2397–2405

    Article  Google Scholar 

  13. Hui D, Bruera E (2017) The Edmonton Symptom Assessment System 25 years later: past, present and future developments. J Pain Symptom Manag 53:630–643

    Article  Google Scholar 

  14. Cancer Journey Action Group (2009) Guide to implementing screening for distress, the 6th vital sign: moving towards person-centred care (part a). Toronto, Ontario

  15. Howell D, Keller-Olaman S, Oliver TK, Hack TF, Broadfield L, Biggs K, Chung J, Gravelle D, Green E, Hamel M, Harth T, Johnston P, McLeod D, Swinton N, Syme A, Olson K (2013) A pan-Canadian practice guideline and algorithm: screening, assessment, and supportive care of adults with cancer-related fatigue. Curr Oncol 20:233–246

    Article  Google Scholar 

  16. Linden W, Yi D, Barroetavena MC, MacKenzie R, Doll R (2005) Development and validation of a psychosocial screening instrument for cancer. Health Qual Life Outcomes 3:54

    Article  Google Scholar 

  17. Nekolaishuk C, Watanbe S, Beaumont C (2008) The Edmonton Symptom Assessment System: a 15-year retrospective review of validation studies (1991-2006). Palliat Med 22:111–122

    Article  Google Scholar 

  18. Cancer Care Ontario (2004) Telephone nursing practice and symptom management guidelines. Toronto, Ontario

  19. Cancer Care Ontario (2005) Palliative care collaborative care plan: fatigue (cancer patients). Toronto, Ontario

  20. Oldenmenger WH, de Raaf PJ, de Klerk C, van der Rijt CC (2013) Cut points on 0-10 numeric rating scales for symptoms included in the Edmonton Sympton Assessment Scale in cancer patients: a systematic review. J Pain Symptom Manag 45:1083–1093

    Article  Google Scholar 

  21. Feldstain A, Tomei C, Bélanger M, Lebel S (2014) Screening for distress in patients with cancer: methodologic considerations. Curr Oncol 21:330–333

    Article  Google Scholar 

  22. Howell D, Hack TF, Oliver TK et al (2011) Survivorship services for adult cancer populations: a pan-Canadian guideline. Curr Oncol 18:e265–e281

    CAS  PubMed  PubMed Central  Google Scholar 

  23. Fitch MI (2000) Supportive care for cancer patients. Hosp Q 3:39–46

    CAS  PubMed  Google Scholar 

  24. About Wellspring. Wellspring. https://wellspring.ca/the-wellspring-approach/. Accessed 27 Oct 2018

  25. O’Donnell E (2013) The distress thermometer: a rapid and effective tool for the oncology social worker. Int J Health Care Qual Assur 26:353–359

    Article  Google Scholar 

  26. VanHoose L, Black LL, Doty K, Sabata D, Twumasi-Ankrah P, Taylor S, Johnson R (2015) An analysis of the distress thermometer problem list and distress in patients with cancer. Support Care Cancer 23:1225–1232

    Article  Google Scholar 

  27. Olesen ML, Hansen MK, Hansson H, Ottesen B, Andersen KK, Zoffmann V (2018) The distress thermometer in survivors of gynaecological cancer: accuracy in screening and association with the need for person-centred support. Support Care Cancer 26:1143–1150

    Article  Google Scholar 

  28. Jacobsen PB, Donovan KA, Trask PC, Fleishman SB, Zabora J, Baker F, Holland JC (2005) Screening for psychologic distress in ambulatory cancer patients. Cancer 103:1494–1502

    Article  Google Scholar 

  29. Roth AJ, Kornblith AB, Batel-Copel L, Peabody E, Scher HI, Holland JC (1998) Rapid screening for psychologic distress in men with prostrate carcinoma. Cancer 82:1904–1908

    Article  CAS  Google Scholar 

  30. Ma X, Zhang J, Zhong W, Shu C, Wang F, Wen J, Zhou M, Sang Y, Jiang Y, Liu L (2014) The diagnostic role of a short screening tool – the distress thermometer: a meta-analysis. Support Care Cancer 22:1741–1755

    Article  Google Scholar 

  31. Donovan KA, Grassi L, McGinty HL, Jacobsen PB (2013) Validation for the distress thermometer worldwide: state of the science. Psychooncology 23:241–250

    Article  Google Scholar 

  32. Howell D, Olsen K (2011) Distress – the 6th vital sign. Curr Oncol 18:208–210

    CAS  PubMed  PubMed Central  Google Scholar 

  33. Sanson-Fisher R, Girgis A, Boyes A, Bonevski B, Burton L, Cook P (2000) The unmet supportive care needs of patients with cancer. Cancer 88:226–237

    Article  CAS  Google Scholar 

  34. Cancer Journey Portfolio (2012) Screening for distress, the 6th vital sign: a guide to implementing best practices in person-centred care. Toronto, Ontario

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Correspondence to Martin Chasen.

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The authors declare that they have no conflict of interest.

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This study received approval through the William Osler Health System Research Ethics Board. This article does not contain any studies with human participants or animals performed by any of the authors. This is a systematic review that does not involve any contact with human participants. No informed consent is needed.

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Jammu, A., Chasen, M., van Heest, R. et al. Effects of a Cancer Survivorship Clinic—preliminary results. Support Care Cancer 28, 2381–2388 (2020). https://doi.org/10.1007/s00520-019-05067-7

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