The interface between primary and oncology specialty care: treatment through survivorship.
The period after completing primary and adjuvant cancer treatment until recurrence or death is now recognized as a unique phase in the cancer control continuum. The term "survivorship" has been adopted to connote this phase. Survivorship is a time of transition: Issues related to diagnosis and treatment diminish in importance, and concerns related to long-term follow-up care, management of late effects, rehabilitation, and health promotion predominate. In this article, we explore the unique challenges of care and health service delivery in terms of the interface between primary care and specialist care during the survivorship period. The research literature points to problems of communication between primary and specialist providers, as well as lack of clarity about the respective roles of different members of the health-care team. Survivorship care plans are recommended as an important tool to facilitate communication and allocation of responsibility during the transition from active treatment to survivorship. Research questions that remain to be answered with respect to survivorship care plans and other aspects of survivorship care are discussed.
Grunfeld
Eva
E
Institute for Clinical Evaluative Sciences, 2075 Bayview Ave, G Wing Rm 106, Toronto, ON, Canada.
Earle
Craig C
CC
D000293:Adolescent; D000328:Adult; D000359:Aftercare; D000368:Aged; D003695:Delivery of Health Care; D005260:Female; D005544:Forecasting; D006301:Health Services Needs and Demand; D006302:Health Services Research; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D008495:Medical Oncology; D008875:Middle Aged; D008962:Models, Theoretical; D009369:Neoplasms / Q000401:mortality / Q000523:psychology / Q000534:rehabilitation / Q000628:therapy*; D010347:Patient Care Planning; D011320:Primary Health Care; D016032:Randomized Controlled Trials as Topic; D017741:Survivors
Can Fam Physician. 1996 May;42:899-904; 907-10
8688693
J Clin Oncol. 2008 Mar 1;26(7):1073-9
18309941
Eur J Cancer. 2008 Jan;44(2):195-204
18035534
Can Fam Physician. 1996 Feb;42:263-8
9222575
Fam Pract. 1995 Mar;12(1):60-5
7665044
Br J Gen Pract. 2005 Oct;55(519):741-2
16212847
Ann Oncol. 1995;6 Suppl 2:47-52
8547197
Br J Cancer. 2006 Apr 24;94(8):1116-21
16622437
CMAJ. 2005 May 10;172(10):1319-20
15883407
Can J Oncol. 1994 Jul;4(3):285-90
7529630
J Natl Cancer Inst Monogr. 2010;2010(40):81-9
20386056
J Clin Oncol. 2008 May 10;26(14):2246-7
18467713
BMJ. 1996 Sep 14;313(7058):665-9
8811760
Br J Cancer. 1999 Mar;79(7-8):1227-33
10098764
J Clin Oncol. 2006 Nov 1;24(31):5091-7
17033037
J Clin Oncol. 2008 Feb 10;26(5):759-67
18258984
Cancer. 2004 Oct 15;101(8):1712-9
15386307
J Clin Oncol. 2006 Feb 20;24(6):848-55
16418496
BMJ. 1995 Jul 1;311(6996):54
7613333
Med J Aust. 2002 Nov 4;177(9):516-20
12405897
J Clin Oncol. 2009 May 20;27(15):2489-95
19332716
J Clin Oncol. 2000 Jun;18(11):2345-8
10829057
N Engl J Med. 2008 Mar 6;358(10):1064-71
18322289
Can Fam Physician. 2003 Jul;49:890-5
12901486
Br J Gen Pract. 1999 Sep;49(446):705-10
10756611
J Clin Oncol. 2005 Aug 20;23(24):5458-60
16043826
J Clin Oncol. 1996 Sep;14(9):2612-21
8823341
JAMA. 2005 Nov 23;294(20):2587-93
16304072
J Clin Oncol. 2003 Apr 15;21(8):1447-51
12697865
J Oncol Pract. 2007 Mar;3(2):79-86
20859376
Ann Thorac Surg. 1995 Dec;60(6):1563-70; discussion 1570-2
8787445
J Natl Cancer Inst. 2004 Sep 1;96(17):1311-21
15339969
J Clin Oncol. 2006 Nov 10;24(32):5117-24
17093273