The Divide and Conquer of Advanced Colorectal Cancer - Episode 13

Survivorship Care Plans in Colorectal Cancer

Transcript:John Marshall, MD: I want to do one last switch for you guys, before I let you go back to the meeting, and learn even more and teach even more is this concept of survivorship. I am very pleased to have this problem. This is a good problem. I want to talk a little bit, Johanna, about survivorship and how you think of it. Who’s a survivor?

Johanna Bendell, MD: Anybody who’s living with colon cancer, in my opinion, are survivors. Everybody has a different definition. I feel like I’m on the stand going through the Secretary of Education, but to me what survivorship means is that you’re living with cancer and there are ways that I can maximize quality of life for all my patients no matter where they are in their therapy. We’ve worked very hard, at least in my practice, and Alan said that they have somebody like this, too, on symptom management. So, we actually have experts in symptom management that are palliative care nurse practitioners. But the way that we describe them to the patients is that they are symptom management nurse practitioners who go hand-in-hand with us to really delve down into a lot of these issues that sometimes we hear as physicians, sometimes we don’t hear as physicians—issues with depression, nausea, vomiting. How can we make their quality of life better? Because, we’ve also seen that the people who feel better live longer.

John Marshall, MD: And so, we have a lot more pressure for delivering survivorship care plans, rehab, and follow-up. Is everybody picking up on this and starting to provide information for patients?

Tanios Bekaii-Saab, MD: Absolutely. That’s key to our practice, from day 1 actually, when a patient shows up through the door. We want to treat them as survivors on chemotherapy.

Alan P. Venook, MD: Our program, we started just about a year ago. We have 170 patients already on our survivorship program for colon cancer. I believe this is THE most common diagnosis other than early breast cancer in terms of survivorship groups. So, yes, of course, it’s a mandate that we have a plan and we do that. And the other thing, we’re looking very hard at the surveillance, what strategies we should be using to do surveillance. When have we done enough surveillance? I think that’s another important aspect of it as well.

John Marshall, MD: I’m really proud of an effort that our group has been making to pull together the various support groups that are out there and patient advocacy groups under one umbrella. We actually met this morning and the topic was, how do we build a unified modular survivorship care plan for GI cancer patients? Because if you’re a pancreas cancer patient, there aren’t that many that meet the CMS definition. But it meets our definition of you’re alive and dealing with your cancer. Stay tuned in this space. We know it’s a Medicare requirement, a meaningful use requirement. But we really need to do a good job of this.

Transcript Edited for Clarity