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From Cancer Patient to Cancer Survivor: Lost in Transition
Some specialty texts were found that were directly related to survivorship care. The text Cancer Patient Follow-Up (Johnson and Virgo, 1997) provides a comprehensive review of follow-up practices. The major focus is on surveillance testing, but treatment complications and their management are also covered. This text provides an excellent source for clinicians interested in the scientific rationale for many survivor issues. Another resource is Principles and Practice of Palliative Care and Supportive Oncology (Berger et al., 2002). This text has two relevant chapters, “Long-term survivorship: Late effects” (Aziz, 2002), and “Psychosocial aspects of cancer survivorship” (Leigh and Clark, 2002). In addition, many of the chapters about specific supportive care issues, such as sexuality and reproduction or depression and anxiety, are pertinent to survivorship. Integrated discussions of these palliative and supportive care topics provide an excellent orientation for the clinician wanting to become grounded in survivorship.
A new certification program of the ABMS may provide opportunities for continuing education regarding survivorship care (ABMS, 2004b). Until recently, Board recertification testing occurred every 6, 7, or 10 years. A new program, called “Maintenance of Certification” (MOC), changed the specialty recertification process for physicians from periodic testing to a more continuous process. The new MOC program will require the assessment and improvement of practice performance by physician specialists. Examples of practice assessment and improvement approaches for MOC include, for internal medicine, Practice Improvement Modules in clinical preventive services and preventive cardiology, and, for pediatrics, web-based education improvement programs in pediatric asthma and attention deficit hyperactivity disorder. A module related to cancer survivorship could be developed to enhance specialists’ knowledge of survivorship-related care.
Continuing Medical Education
For practicing clinicians, continuing medical education provides opportunities to gain skills in this relatively new area. There appears to be a demand for such education, at least among oncologists. According to a recent survey, more than 75 percent of medical oncologists reported that they provide some follow-up care for cancer survivors, but a significant proportion wanted additional training (ASCO, 2004).
Continuing medical education (CME) credits—attained through onsite meeting attendance, virtual meeting participation, or online CME venues—provide significant opportunities for clinicians to be exposed to issues related to survivorship. The Accreditation Council of Continuing Medical Education has accredited the major national societies to offer CME credit for certain sessions at their meetings. Examples of some recent CME opportunities at professional meetings are shown in Box 5-3.