Background: Per the American Cancer Society, there will be an estimated 20 million cancer survivors by 2026. Survivors have often voiced concern and fear after completion of treatment: “What now? I don’t want to lose my medical cancer team.” The Cancer Institute at Prisma Health has been known for innovative ideas for advancing the care of cancer survivors. Survivor concerns were considered, and after researching ongoing needs, the “Lifetime Clinic” (LTC) was launched.
Objective: How to best meet cancer survivors’ needs for long-term follow-up care while encouraging and helping them optimize living a healthy long life after cancer.
Method: The Center for Integrative Oncology and Survivorship (CIOS) created a clinic in which survivors receive care according to national guidelines and are monitored for new cancers. The LTC was officially announced on Cancer Survivors Day, June 2014, offering long-term follow-up care by nurse navigators (NNs) and nurse practitioners (NPs). In 2014, the LTC provided care for 205 patients, and in 2019 the clinic has serviced over 1300 patients. Care is according to cancer type, stage, and number of years since diagnosis. The clinic was set up to assess patients for delayed toxicities and long-term effects from treatment. If needed, referrals are made to specialists for issues. On average, 2 referrals are made to other services for each patient, including preventive screenings, genetic testing, and integrative therapy opportunities. CIOS also offers free resources for nutrition, exercise, and coping posttreatment. In each visit, patients are counseled on cancer prevention, reducing risks from environmental factors, and encouraged to maintain healthy lifestyles. Patients are followed per NCCN guidelines, but between visits the care team is available to address any concerns or issues—they become part of the family. With these services, plus counseling provided as needed, CIOS helps to prevent recurrences and addresses needs of survivors.
Results: In 2019, the LTC has about 1020 active patients, including adults and young adults with various cancers, gynecological cancers, and patients at high risk for breast cancer—showing about a 78.2% retention rate. Reasons for inactive patients in the clinic include: deceased, returned to the oncologist with recurrence, patient chose to follow-up elsewhere, or declination of service. The LTC has received an average of 15 referrals a month. The high degree of coordination of care between the NN and the NP has been a significant reason for the success of the clinic, along with the support from the Oncology Medical Director encouraging referrals of patients from their primary oncology teams, patients’ word of mouth, and CIOS’s collaboration with community resource programs.
Conclusion: The LTC has been a successful endeavor in our Cancer Institute to offer seamless continuation of care for cancer survivors. Through the LTC, CIOS has addressed survivorship issues, including fear of recurrence, survivorship stress, and anxiety, and has promoted healthy lifestyle choices to improve quality of life. Patients often remark that this clinic helps them to live a “new” normal life. Because of the proactive cancer screening and management of long-term toxicities, the LTC has offered greater access to preventive services, helping to prevent recurrences, and promoted higher quality of life.
- American Cancer Society. Cancer Treatment & Survivorship Facts & Figures. www.cancer.org/research/cancer-facts-statistics/survivor-facts-figures.html.
- Cancer Center Profile. Center for Integrative Oncology and Survivorship at the Greenville Health System Cancer Institute. The Oncology Nurse. 2016;9(6).
- O’Rourke M, Gluck L. Lifetime Clinic is a great fit for cancer survivors, http://grnol.co/1hStc8g.
- Prisma Health. GHS Launches State’s Only Lifetime Clinic for Cancer Survivors. www.ghs.org/healthcenter/ghsblog/ghs-launches-states-only-lifetime-clinic-for-cancer-survivors.