It is clear that people who have completed treatment for breast cancer are left with multiple needs. It has been shown that cancer survivors have similar health to people with other long-term conditions and cancer survivorship is increasingly being seen as a chronic illness. However, it is also clear that the burden on oncology services to continue long term follow up is unsustainable. Traditional models of follow up have focussed on early detection of recurrence, but have failed to improve survival rates. A number of reports on cancer survivorship have also shown that many people who have completed treatment for cancer feel that they are abandoned despite many unmet health needs.
The response to this to date has been to attempt to improve communication with the patient and between health care providers. The development of survivorship care plans provides a useful summary of treatment and potential late effects to guide medical care. However, even in the UK where there are clear lines of communication between primary and secondary health care practitioners these are not always utilised, and evidence from Grunfeld et al shows that these may not be beneficial for improving patient reported outcomes.
Work with patients to explore what they feel they need at the end of treatment has identified that they want more help to increase their damaged sense of confidence and ability to self-manage the problems they are left with. There is therefore a growing body of work to explore how this might best be supported. There is an increasing onus on cancer survivors to take up healthy lifestyles and adhere to long-term adjuvant therapies, but if we have failed to address the fundamental disruption to their sense of self and supported them to restore lost confidence then they may be unable to engage with the requirement to effectively self-manage these complex issues. This presentation will share some of the UK experience research and practice in addressing survivorship needs of people with breast cancer.