Self-management support a crucial component of follow-up care for cancer survivors
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Encouraging and supporting self-management among cancer survivors is an essential component of successful follow-up care, according to a session during the virtual Cancer Center Survivorship Research Forum.
“Self-management is such an important skill to educate and nourish our cancer survivors, and in my role as a pediatric oncologist, I see this at so many points in a child’s cancer journey,” Karim Sadak, MD, MPH, MSE, assistant professor in the department of pediatrics at University of Minnesota, said in introducing the session. “I see it most notably as a child becomes a teenager and transitions into young adulthood, but this type of transition happens in all cancer survivors’ journeys. There are so many transitions that happen, and self-management skills are critical.”
In her presentation, Doris Howell, RN, PhD, FAAN, emeritus scientist at Princess Margaret Cancer Research Centre, discussed the importance of survivorship self-management in achieving favorable outcomes.
“There is truly an imperative here in terms of the rising numbers, in all age categories, of cancer survivors,” Howell said. “There is a great deal of documentation from multiple studies on the poor physical and mental health, which is becoming a significant concern for survivors.”
Self-management support in survivorship should not be treated as an afterthought, according to Howell, because it can impact a cancer survivor’s long-term outcome. She said survivors who lack this support appear to have poorer outcomes.
“Survivors’ capability in self-management of long-term and late effects influences health far more than medical interventions,” Howell said. “Failing to provide self-management support has negative consequences for well-being and survival.”
Howell defined self-management support as “systematic provision of education and supportive interventions by health care staff to increase patients’ skills and confidence in managing their health problems, including regular assessment of progress and problems, goal-setting, and problem-solving support.”
Survivor self-management strategies may be implemented based on a risk assessment. According to Howell, a self-management support component within personalized follow-up care for patients at low risk for recurrence is now being facilitated in England, Ireland and Australia.
“Low-risk follow-up survivors, who make up 85% of the survivorship population, could handle long-term management effectively with self-management support,” she said. “Decades of research in chronic diseases shows [self-management support] to be an effective means of reaching Triple Aim health care goals of better health and patient experience at lower costs.”
Cancer survivor Patty Spears, of the Patient Advocate Alliance, spoke of the overwhelming challenges and distractions involved in living with cancer and the potential feeling of abandonment when regular support systems recede during survivorship.
“I love this term that came from Doris Howell: person-centered care,” Spears said. “Survivorship is a term, it’s not a label, and it includes all patients from diagnosis to the balance of their lives. This is a very inclusive statement, and it is essential so that we value every patient who has ever had a cancer diagnosis, and we support and care for them as part of the self-management program.”
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Alfano C, et al. Engaging the cancer survivor in self-management. Presented at: Cancer Center Survivorship Research Forum (virtual meeting); April 15-16, 2021.
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