Survivorship

New cancer program standards require survivorship care plans

A patient-centered approach is at the forefront of new accreditation standards for hospital cancer programs released last year by the Commission on Cancer (CoC) of the American College of Surgeons.

The new CoC standards ensure that key elements of quality cancer care are provided to every person with cancer treated in a CoC-accredited facility (like the Seattle Cancer Care Alliance, the Hutchinson Center’s clinical arm) throughout their diagnosis and treatment process. One key area of patient-centered treatment is a survivorship care plan that summarizes care received and provides a roadmap for future care needs. The overall goal of the care plan is to improve cancer survivors’ quality of life.

"These new guidelines mandate that every cancer patient will now receive a summary of their treatment when they complete their active phase of treatment. This is a tremendous advancement for survivorship care," said Dr. Scott Baker, director of the Hutchinson Center’s Survivorship Program. "We have been doing this in the Survivorship Clinic since it opened, but the total number of patients that we see is quite small compared to the total number that this new guideline will impact. The new standards will help to further incorporate survivorship care into the cancer continuum so it becomes an integrated part of the overall care of every cancer patient."

National cancer patient support/advocacy organizations, including the American Cancer Society, the Cancer Support Community, the National Coalition for Cancer Survivorship, and LIVESTRONG worked closely with the CoC to develop the new patient-centered standards to better enable cancer patients to work with their interdisciplinary cancer treatment team and become partners in their own care.

The CoC revises its standards every five to seven years. While the new patient-centered approach is now a required part of the standards, the commission knows that cancer programs may not immediately have all elements in place, and are allowing them to be phased in.

Baker said the delay for many cancer programs in providing survivorship care plans stems from difficulty in compiling the treatment information. "It is not easily available even with electronic medical records, so it will take a lot of time in every clinic for this document to get prepared," he said. "We have created an automated database system that will help to streamline the process of creating the treatment summary as much as possible, and at the SCCA this will be available to clinics besides the Survivorship Clinic."

The standards are welcome news to Dr. Patricia Read-Williams, clinic chief at the University of Washington Issaquah Clinic. "I wish that everybody who’s had cancer came with a plan so that we can make sure we do the best job of taking care of them," she said, estimating that currently only 1 percent to 2 percent of her patients who’ve had cancer have such plans.

Read-Williams said the plans aid her visits with cancer survivors. "They help give us a guideline as to what things to look for, like potential secondary cancers and tests we should be doing to monitor the patient after they finish their care with their oncologist," she said. "Especially when people come in for their annual physicals, we can go back to the checklist and make sure we get these things done.

"It also helps reassure the patient that we’re really watching out for them specifically. It helps decrease their fears of recurrence.

"I’m grateful that awareness of the need for survivorship care plans is increasing," Read-Williams said. "They really do help."

The CoC is a consortium of 47 professional organizations that establish cancer care standards and monitor quality at hospitals that it accredits. More than 1,500 hospitals in the United States and Puerto Rico are CoC accredited, representing only 30 percent of all institutions but more than 70 percent of all new cancer patients diagnosed annually.

Fred Hutchinson Cancer Research Center is a world leader in research to prevent, detect and treat cancer and other life-threatening diseases.