younger women were the most likely to vividly describe feeling somewhat “abandoned” after active care, and they even described the difference in using the word “plan.” They said that during active treatment, they felt that there was a plan in place, and they knew what to do and what to expect. Once active care was over, however, they did not know what to do or what to expect, and some felt that they were not being cared for. One woman, for example, said that she felt, during active care, that she was in the front seat of the car. Somebody was driving, they were going along, and she could see where they were going. As soon as she finished her active care, she had to get into the backseat, and then she did not know and could not see what was going on. Some men also agreed and said that they felt their follow-up care was “sporadic.”

At least some participants in all three groups complained that they found their specialist (oncologists, urologists) “uncommunicative” and even “uncompassionate” or “uncaring” during follow-up. Younger women were not only the most vocal about this, but also they were much more likely to report switching oncologists because of the problem. Men were more reticent about complaining about any aspect of their care, but they said very directly that their physicians had not done a good job of meeting their psychological needs. They agreed that counseling should be part of follow-up care. One also pointed out that physicians need to be more active in this area with men, precisely because men are so reluctant to seek out psychological help. Men particularly said that physicians had not even warned them about the possible sexual consequences of their treatment. One man said, “I think they treated everything that was physical, but if I wanted any support—mental health, anything like that—I would have to seek it out. It was available, but it wasn’t like I was offered it or it was talked about at all.” One woman pointed out in a similar way that she had not even considered that she might need spiritual counseling, but if a plan had suggested it, she might have understood her need better. Relatively few participants seemed to have been directed to support groups, but those who had used such groups seemed to have benefited tremendously. One of the participants said, “I don’t feel cared for. The treatment ended, and then you are out the door of the hospital, and you don’t know what happens next. I don’t have any information about what the effect might be on the rest of my life.” Another group member said, “Posttreatment is really important for your peace of mind, if nothing else. I was terribly fearful. I woke up in the middle of the night. I felt like I was just dropped.”

Reactions to Survivorship Care Plans

Participants in all three groups expressed a great desire for a written follow-up plan. Only one or two members in the three groups had received



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