1. The KU Wichita Center for Breast Cancer Survivorship Judy Johnston, MS, RD/LD Research Instructor Department of Preventive Medicine and Public Health, KUSM-W Program Director, KU Wichita Center for Breast Cancer Survivorship

2. Utilizing the CDC definition of “Cancer Survivor” Those diagnosed with cancer and Those affected by the diagnosis: –family members –friends –caregivers Cancer Survivorship: Survive Cancer and Live. Centers for Disease Control and Prevention, Department of Health and Human Services. Division of Cancer Prevention and Control. APR04

3. Addressing Multiple Categories of Survivorship Challenges Physical Emotional Social Spiritual Financial Hudson et al. Identifying Key Questions to Advance Research and Practice in Cancer Survivorship Follow-Up Care: A Report From the ASPO Survivorship Interest Group Cancer Epidemiology July 2009

4. Models of Survivorship Care Currently Being Tested Community-based shared care model –The PCP refers the patient to the oncologist for cancer therapy and periodic follow-up consultation –PCP provides ongoing maintenance of co-morbid diseases and health- maintenance care –Cancer survivorship care plan is provided to the PCP by the oncologist Disease-specific cancer survivorship programs at academic institutions Comprehensive survivorship programs at academic institution –consultative option –advanced practitioner clinician-led survivor clinic –specialized multidisciplinary survivorship program Oeffinger KC, McCabe MS. Models for delivering survivorship care. J Clin Oncol 2006;24:5117–24.

5. KU-Wichita Center for Breast Cancer Survivorship Cypress Medical Park, Wichita Comprehensive survivorship program Tailored care plans Research-supported health promoting behavioral options Patient navigation Rural access Education & Research Community partnerships Funded in part through generous grants from Susan G. Komen for the Cure Mid-Kansas Affiliate

6. Coordination of Survivorship Care Communication among all members of the care team –Survivor –Oncologist –Breast Surgeon –Radiation oncologist –Primary Care Physician –Survivorship Center Staff Non-duplication of services Connecting survivors to existing community support services

7. Activated Patients Tailored care plans –ASCO Survivorship Forms –Additional assessment and follow-up of potential late side effects of treatment Patient communication Hewitt ME, Greenfield S, Stovall E; National Cancer Policy Board (U.S.). Committee on Cancer Survivorship: Improving Care and Quality of Life. From cancer patient to cancer survivor: lost in transition. Washington (DC): National Academies Press; 2006.

8. Major Research Questions about Survivorship What are the most common late effects? Who is at risk for late effects? Can treatment-related injury to normal tissue be prevented/reversed? What % of survivors will have recurrent or second malignancies? Who should be following these survivors to detect disease recurrence? What constitutes ‘optimal surveillance” and what is the cost of such follow-up care? Do medical, psychosocial or behavioral interventions reduce morbidity in these populations?