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From Cancer Patient to Cancer Survivor: Lost in Transition
TABLE 4-5 Adult Cancer Survivorship Clinics
Clinic Name and Location
University of Texas
M.D. Anderson Cancer Center: Life After Cancer Care
Year founded: 2001.
Patient population: Accepts survivors with all cancer diagnoses, although most are breast cancer survivors who are cancer free and are no longer seen by their oncologist.
Staff: Endocrinologist and nurse practitioner.
Clinical focus: General evaluation and check-ups of survivors with recommendations for follow-up and screening provided to primary care physicians. Late effects identification and management, especially premature menopause and endocrine dysfunction.
Research: An online survey has been completed by nearly 11,000 survivors and is used for studies of survivor needs and late effects.
Barriers: Fewer patients from outside M.D. Anderson than expected, possibly because patients do not expect or look for survivorship care.
University of Michigan: Breast Cancer Survivor Clinic
Year founded: 2000.
Patient population: Breast cancer survivors who have been followed at the cancer center and are 5 years post-diagnosis.
Staff: Medical oncologist and five nurse practitioners.
Clinical focus: Management of menopause, osteoporosis, lymphedema, and cancer screening and prevention. Screening exams and mammography are performed. Referrals to support groups and genetic counseling are available. The clinic does not serve as a primary care clinic, but rather refers survivors back to primary care physicians with appropriate recommendations for follow-up care.
Research: Clinical trials conducted in the past, but no currently active clinical trials.
Barriers: Some insurance companies will not reimburse for nurse practitioner visits.
University of Pennsylvania: Living Well After Cancer Program
Year founded: 2001.
Patient population: Survivors of testicular cancer and lymphoma, and adult survivors of childhood cancers who have completed primary treatment and are at least 2 years post-diagnosis. Also provides a consultative service for breast cancer survivors, but does not actually see them in the clinic.