Comprehensive long-term care of patients with lung cancer: Development of a novel thoracic survivorship program Journal Article

Authors: Huang, J.; Logue, A. E.; Ostroff, J. S.; Park, B. J.; McCabe, M.; Jones, D. R.; Bains, M. S.; Rizk, N. P.; Kris, M. G.; Rusch, V. W.
Article 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. © 2014 by The Society of Thoracic Surgeons.
Keywords: adult; aged; aged, 80 and over; middle aged; survival rate; prospective studies; lung neoplasms; models, theoretical; primary health care; long-term care; humans; male; female
Journal Title: Annals of Thoracic Surgery
Volume: 98
Issue: 3
ISSN: 0003-4975
Publisher: Elsevier Science, Inc.  
Date Published: 2014-09-01
Start Page: 955
End Page: 961
Language: English
DOI: 10.1016/j.athoracsur.2014.05.020
PUBMED: 25087931
PROVIDER: scopus
PMCID: PMC4713027
Notes: Export Date: 1 December 2014 -- Source: Scopus
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MSK Authors
  1. Jamie S Ostroff
    208 Ostroff
  2. Valerie W Rusch
    651 Rusch
  3. Nabil Rizk
    134 Rizk
  4. James Huang
    119 Huang
  5. Bernard J Park
    155 Park
  6. Amy E Logue
    7 Logue
  7. Manjit S Bains
    227 Bains
  8. Mark Kris
    597 Kris
  9. Mary McCabe
    93 McCabe
  10. David Randolph Jones
    152 Jones