Survivorship Care Plan

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Battistina Vittoria Mariotti
5 anni fa
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1 Management/Prevention of Symptoms and Treatment Toxicities Survivorship Care Plan Francesco Atzori Oncologia Medica AOU-Cagliari Bologna 30 marzo 2017

2 Agenda Epidemiology of cancer in Italy Definition of Survivorship Care Plan Survivorship Care Plan in action How to build an effective Survivorship Care Plan Conclusion

3 Agenda Epidemiology of cancer in Italy Definition of Survivorship Care Plan Survivorship Care Plan in action How to build an effective Survivorship Care Plan Conclusion

4 Quanti sono gli italiani che vivono dopo una diagnosi di tumore? Nel 2015, (il 4,9%) Nel 2016, (stime) Nel 2006,

5 Agenda Epidemiology of cancer in Italy Definition of Survivorship Care Plan Survivorship Care Plan in action How to build an effective Survivorship Care Plan Conclusion

6 Who is a cancer survivor? Any person who... has had a diagnosis of cancer has completed treatment for cancer has lived cancer-free 5 years beyond a cancer diagnosis has a history of cancer... who eventually dies from something else

7 Who is a cancer survivor? Any person who... has had a diagnosis of cancer In parole più semplici: il paziente cui è stato eradicato un tumore maligno che abbia terminato le cancer eventuali diagnosis cure adiuvanti has completed treatment for cancer has lived cancer-free 5 years beyond a has a history of cancer... who eventually dies from something else

8 What is a Survivorship Care Plan? "In 2006 the Institute of Medicine issued a report recommending that every cancer patient receive an individualized survivorship care plan that includes guidelines for monitoring and maintaining their health. In response to that report, many groups have now developed various types of "care plans" to help improve the quality of care of survivors as they move beyond their cancer treatment. Institute of Medicine Report and National Research Council 2006 Report - From Cancer Patient to Cancer Survivor: Lost in Transition -

basato su linee guida generali condivise e validate scientificamente, ma personalizzato. individualized survivorship care plan that includes guidelines for monitoring and maintaining their health.

9 What is a Survivorship Care Plan? "In 2006 the Institute of Medicine issued a report recommending that every cancer patient receive an Strumento essenziale è la realizzazione di un programma di follow up, consistente in un piano basato su linee guida generali condivise e validate scientificamente, ma personalizzato. individualized survivorship care plan that includes guidelines for monitoring and maintaining their health. In response to that report, many groups have now developed various types of "care plans" to help improve the quality of care of survivors as they move beyond their cancer treatment. AIOM-Consensus Conference Dalla pratica del follow up alla cultura di survivorship care. Roma, settembre 2015 Institute of Medicine Report and National Research Council 2006 Report - From Cancer Patient to Cancer Survivor: Lost in Transition -

10 Bridging the gap... Active Treatment Post Treatment Survival Cancer Survivor Care Plan

11 Agenda Epidemiology of cancer in Italy Definition of Survivorship Care Plan Survivorship Care Plan in action How to build an effective Survivorship Care Plan Conclusion

12 Survivorship Care Plan In action Psychologist Nutrition Specialist Surgeon/RT Others Survivor Oncologist Primary Care Physician (MMG)

From a Survivor s point of view Fear of recurrence One of the most common concerns survivors have is worrying the cancer will come back. The fear of recurrence is very real and entirely normal.

14 From a Survivor s point of view Fear of recurrence One of the most common concerns survivors have is worrying the cancer will come back. The fear of recurrence is very real and entirely normal. Anxious thoughts like Has the cancer come back? and What will happen if it does? may be triggered by the appearance of a headache, cough, or joint stiffness, or it may precede events like your diagnosis anniversary or follow-up appointments and tests. For some survivors, these worries and feelings of uncertainty lead to struggles with depression and anxiety. However, it is important to remember that although you cannot directly control whether the cancer returns, you can control how much the fear of recurrence affects your life.

15 From a Survivor s point of view La paura della recidiva può comportare: distress moderato o severo con ansia e depressione attenzione ossessiva per possibili segni e sintomi di malattia eccessivo utilizzo di servizi sanitari a scopo di rassicurazione interferenza con la capacità di pianificazione per il futuro I risultati di un ampia indagine su 1275 survivors al cancro della mammella, colon retto e prostata evidenziano come il più frequente bisogno non corrisposto sia l aiuto a gestire la preoccupazione sulla recidiva del cancro. Foster et al 2009, Koch L. 2013, Harrison 2011 Cortesia di Anna Costantini

16 From the oncologist s point of view Perdita di tempo Perdita di tempo Perdita di tempo Ho un sacco di lavoro da finire Che pesantezza.mi parlano di tutt altro (cataratta, dieta, artrosi del ginocchio ) Atzori F. et tanti altri, 2017

17 From the oncologist s point of view Potential Benefits of a Survivor Care Plan Cancer recurrences can be caught early Preventable conditions may be avoided Potentially lethal late affects may be averted Psychosocial distress can be addressed Quality of life may be improved

18 The importance of communication The way a doctor or other health or social care professional delivers news places an indelible mark on the doctor/professionalpatient relationship

19 Agenda Epidemiology of cancer in Italy Definition of Survivorship Care Plan Survivorship Care Plan in action How to build an effective Survivorship Care Plan Conclusion

20 Setting up a Survivorship Care Plan Prepare yourself

21 The importance of knowledge

22 Early Breast Cancer Surveillance Program Basato su linee guida e non sulle proprie convinzioni (si è sempre fatto così qua perché cambiare?) Personalizzato per ogni paziente (età, comorbidità, trattamenti adiuvanti) Evitare quanto più possibile la medicina difensiva e la ridondanza degli esami (non dimentichiamoci che deve sempre essere la clinica a guidarci)

23 An example of Cancer Survivor Care Plane

24 Dalla pratica del follow up alla cultura di survivorship care DOCUMENTO DI CONSENSO Roma, settembre 2015

25 Giving the KNOWLEDGE Share the information

26 Agenda Epidemiology of cancer in Italy Definition of Survivorship Care Plan Survivorship Care Plan in action How to build an effective Survivorship Care Plan Conclusion

27 STRATEGY & SUMMARY

28 Conclusion I sopravviventi da cancro in Italia sono in progressivo aumento E indispensabile un programma di sorveglianza (Survivorship Care Plan) Un efficace Survivorship Care Plan si deve basare su: Linee guida nazionali Personalizzazione, autonomia e flessibilità (sono fondamentali per migliorare la QOL del paziente e dei medici che seguono a vario titolo il paziente) Il risparmio che deriverebbe da un efficace SCP in termini di tempo e denaro sarebbe rilevante per la comunità

29 Grazie per l attenzione

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