title: Cancer follow-up care in New Brunswick: cancer surveillance, support issues and fear of recurrence.
abstract: The purpose of this study was to find out, from the patient's perspective and using qualitative methodology, how cancer follow-up care is managed in a New Brunswick health region. From focus group discussions with 23 participants 1-year post-cancer diagnosis, 3 prominent themes emerged: fear of recurrence, cancer surveillance/testing and support issues. The fear of recurrence permeates day-to-day life for many patients. To allay these fears, some patients feel a need to be subjected to extensive cancer surveillance. Emotional support, which is important for survivors, is complex. The majority of the participants in this study received cancer follow-up care from specialists. More rural than urban participants received their follow-up care from their family physicians (FPs). Participants had high expectations for follow-up care, regardless of which type of physician--specialist or FP--provided it. If physicians did not provide the level and intensity of care expected by their patients, they were considered uncaring. We advocate a "transition of care" or "shared care" protocol between the acute cancer treatment provider and the FP, particularly in rural areas. This would ensure that cancer patients have a clear understanding of where to turn for ongoing surveillance, when they fear cancer recurrence or need support. For optimized cancer follow-up care, physicians must be cognizant that careful emotional and clinical management over an indefinite period of time is required, and they must recognize the individual needs of each patient.
authors.affiliation: Dalhousie University Family Medicine Teaching Unit, Dr. Everett Chalmers Regional Hopital, Fredericton, NB.
authors.forename: Baukje
authors.initials: B
authors.lastname: Maiedema
authors.forename: Sue
authors.initials: S
authors.lastname: Tatemichi
authors.forename: Ian
authors.initials: I
authors.lastname: MacDonald
mesh_terms: D000328:Adult; D000359:Aftercare; D000368:Aged; D005239:Fear; D005260:Female; D017144:Focus Groups; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000523:psychology; D009369:Neoplasms / Q000523:psychology / Q000628:therapy*; D009509:New Brunswick; D010817:Physician-Patient Relations; D010821:Physicians, Family; D012424:Rural Population; D012944:Social Support; D012959:Socioeconomic Factors; D013997:Time Factors; D014505:Urban Population