title: Is there a role for survivorship care plans in advanced cancer?
abstract: OBJECTIVE
  The Institute of Medicine (2006) has recommended that cancer survivors completing treatment receive a survivorship care plan (SCP). The survivorship needs in advanced cancer have been overlooked and understudied. The potential role of SCPs for survivors with advanced or metastatic cancer is unknown and was explored in this study.
  
  
  METHODS
  We conducted two focus groups of survivors with advanced or metastatic cancer. Participants reviewed a sample JourneyForward™ SCP modified for advanced cancer. Sessions were audiotaped and transcribed; transcripts and field notes were evaluated using inductive content analysis.
  
  
  RESULTS
  Sixteen survivors with metastatic cancer participated: 12 (75 %) were female, 15 (94 %) were white, and median age was 66 (range 55-80); 9 participants had breast cancer, 4 colon, 2 prostate, and 1 ovarian cancer. Participants believed that an SCP would be most helpful after initial diagnosis and treatment, but not as helpful once the cancer progressed. They thought a "cancer care plan" focusing solely on the current management would be better to concisely summarize the treatment plan and time frame for the next segment of care for those with advanced cancer. Most participants endorsed the need to have written information to reinforce verbal information received during medical visits since it was difficult to remember information provided. Participants expected their oncologist to assume primary responsibility for coordination of the care plan, but anticipated an important supportive role for primary care providers. To this end, they emphasized the need for better communication between providers.
  
  
  CONCLUSIONS
  A cancer care plan developed by the oncologist, similar to an SCP but more focused on current management, may be more useful for survivors with advanced cancer. Exploring this topic in larger groups of more diverse survivors with advanced cancer will help to elucidate the details a written plan of care should contain, and how to promote effective coordination between oncology and primary care providers.
  
  
  CONCLUSIONS
  There are many transitions of care along the cancer journey. A written plan of care, similar to an SCP, may be useful for survivors with advanced cancer.
authors.affiliation: School of Nursing, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA, dmayer@unc.edu.
authors.forename: D K
authors.initials: DK
authors.lastname: Mayer
authors.forename: M
authors.initials: M
authors.lastname: Green
authors.forename: D K
authors.initials: DK
authors.lastname: Check
authors.forename: A
authors.initials: A
authors.lastname: Gerstel
authors.forename: R C
authors.initials: RC
authors.lastname: Chen
authors.forename: G
authors.initials: G
authors.lastname: Asher
authors.forename: S B
authors.initials: SB
authors.lastname: Wheeler
authors.forename: L C
authors.initials: LC
authors.lastname: Hanson
authors.forename: D L
authors.initials: DL
authors.lastname: Rosenstein
mesh_terms: D000368:Aged; D003142:Communication; D003266:Continuity of Patient Care; D005260:Female; D017144:Focus Groups; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology / Q000534:rehabilitation / Q000628:therapy*; D010347:Patient Care Planning; D015996:Survival Rate; D017741:Survivors; D014481:United States