Breast cancer survivors show interest in survivorship clinics
ASCO 2011 Breast Cancer Symposium
SAN FRANCISCO - Lower quality of life was associated with younger age, chemotherapy usage, hormonal therapy and distress among survivors of breast cancer, according to a study on the needs and preferences of breast cancer survivors presented here at the 2011 ASCO Breast Cancer Symposium.
According to Daniela L. Stan, MD, of the Mayo Clinic in Rochester, Minn., the aim of the study was to assess satisfaction with follow-up care, needs and preferences for survivorship care and physical and psychological health concerns.
"There are 2 million breast cancer survivors in the United States, and that number is expected to grow significantly," Stan said. "The cancer survivorship phase of care has been largely neglected. The Institute of Medicine recommends development of models of survivorship care that are patient-centered."
Stan and colleagues randomly selected 600 women who were treated at the Mayo Clinic for breast cancer to complete a mailed survey that included 71 questions. Most of the questions were to measure distress and quality of life, but other questions were related to the needs of breast cancer survivors, preferences for follow-up care and health concerns. They received 329 surveys, for a response rate of 55%.
The median age of the patients was 55 years, and the women were an average of 3.3 years after diagnosis. Among the patients, 15% were stage 0, 35% were stage I, 30% were stage II and 15% were stage III. As for treatment, 57% had a mastectomy, 43% had a lumpectomy, 62% had radiation therapy, 55% had chemotherapy and 50% had hormonal therapy.
Most patients (73%) strongly agreed that their physical and medical needs were met, whereas only 49% strongly agreed that their psychological and spiritual needs were met, and 67% strongly agreed that they understood their follow-up plans.
The researchers measured the patients' interest in attending special breast cancer survivorship clinics: 60% were interested, 17% were not interested and 23% did not know. A face-to-face clinic was preferred by 77% of the patients, and 86% of the patients preferred a short 1- to 3-day stay compared with multiple trips to complete tests and consultations. In a subgroup analysis, patients who had chemotherapy, younger patients, patients with more distress, and patients with stage 0 or stage III disease were more interested in the clinics.
Older patients rated the importance of mammography higher than younger patients. Younger patients were more interested in attending clinics, more accepting of an Internet-based model of clinics and wanted to attend clinics earlier, within 6 months. Younger patients were also more interested in complementary and alternative medicine, support groups, social work, exercise and diet counseling and educational materials.
"Understanding the needs and preferences of breast cancer survivorship is imperative in the development of patient-centered survivorship health care programs," Stan said. "A significant portion of patients did not understand the follow-up care plan or have their medical, psychological or spiritual needs addressed. Distress is prevalent in breast cancer survivors, particularly in younger patients, and is associated with a lower quality of life."
For more information:
- Stan D. #147. Presented at: 2011 Breast Cancer Symposium; Sept. 8-10; San Francisco.
Disclosure: Dr. Stan reports no relevant financial disclosures.
Earn CME this spring at the HemOnc Today Breast Cancer Review & Perspective meeting to be held March 23-24, 2012 at the Hilton San Diego Bayfront. See details at HemOncTodayBreastCancer.com.
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