title: Comprehensive long-term care of patients with lung cancer: development of a novel thoracic survivorship program.
abstract: BACKGROUND
  Recent advances have improved the likelihood of long-term survival for patients with lung cancer. However, little attention has been given to the growing need for dedicated survivorship care for these patients. To address this unmet need, we developed a unique follow-up care model.
  
  
  METHODS
  In 2006, we convened a multidisciplinary working group to design a thoracic survivorship program (TSP) that provides follow-up by a nurse practitioner (NP) trained in survivorship care. Patients with early-stage lung cancer who were disease free for at least 1 year after resection were eligible for the program, which incorporates a standardized approach to cancer surveillance. Data on symptoms and outcomes were prospectively collected. Real-time electronic medical documentation was developed to optimize communication with primary physicians.
  
  
  RESULTS
  Data were analyzed for the initial phase of the program, which comprised 655 patients. Ninety-two percent of eligible survivors who remained disease free chose to continue their care in the TSP, rather than receive follow-up with their thoracic surgeon. Clinically significant posttreatment symptoms were common, including fatigue (46%), anxiety (32%), chronic pain (25%), dyspnea (14%), and depression (12%). The majority of recurrences (72%) and second primary cancers (91%) in this cohort were identified by scheduled chest computed tomography at TSP visits.
  
  
  CONCLUSIONS
  Survivorship care for patients with lung cancer, delivered in our NP-led TSP, is feasible, effective, and well accepted by patients. Through the implementation of a uniform self-sustaining patient-centered system, the TSP model improves on the variation of physician-led follow-up care.
authors.affiliation: Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York. Electronic address: huangj@mskcc.org.
authors.forename: James
authors.initials: J
authors.lastname: Huang
authors.affiliation: Memorial Sloan Kettering Survivorship Program, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Amy E
authors.initials: AE
authors.lastname: Logue
authors.affiliation: Behavioral Sciences Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Jamie S
authors.initials: JS
authors.lastname: Ostroff
authors.affiliation: Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Bernard J
authors.initials: BJ
authors.lastname: Park
authors.affiliation: Memorial Sloan Kettering Survivorship Program, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Mary
authors.initials: M
authors.lastname: McCabe
authors.affiliation: Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: David R
authors.initials: DR
authors.lastname: Jones
authors.affiliation: Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Manjit S
authors.initials: MS
authors.lastname: Bains
authors.affiliation: Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Nabil P
authors.initials: NP
authors.lastname: Rizk
authors.affiliation: Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Mark G
authors.initials: MG
authors.lastname: Kris
authors.affiliation: Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Valerie W
authors.initials: VW
authors.lastname: Rusch
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008134:Long-Term Care / Q000379:methods; D008175:Lung Neoplasms / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D011320:Primary Health Care; D011446:Prospective Studies; D015996:Survival Rate
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