Health - Cancer Survivorship

Question 1

Cancer is….

Five year survival is now…

Up until the last 20-30 years the main focus was on cancer patients who were undergoing….

But now there is a strong focus on….

Survivorship is a….

Understanding in the community mainly focused on…

Also a shift from quantity of life to…

Answer 1

…common (by age 85… 1 in 2 men and 1 out of 3 women)

…66% (up from 46%)

active treatment

…survivorship

…distinct phase of the cancer trajectory

…active treatment, but also now moving towards experience of survivors

..quality

Question 2

For many survivors, life is good after cancer. However, some can have:

• poorer ______ overall
• are more likely to die from ____-______ diseases
• have ________ problems

During cancer, they are actively involved in treatment, but after they have to fend for themselves. Life can be more difficult. there is lots of process psychologically.

Answer 2

health
non-cancer
psychological

Question 3

Qualitative research => Cancer Survivorship State/Liminality

What is Liminality?

= an enduring and dynamic existential process of accommodation and adaption that the patient experiences during the illness trajectory

Answer 3

FRAMEWORK for understanding survival (fluctuation of changes, integrating past experiences and new experiences into a new life)

The Cancer Survival State (CaSS)

This is the “in between state”
- between what you were before, but not yet in a new steady state.

Very unique experiences

Question 4

Qualitative research => Cancer Survivorship State/Liminality

What are the 3 main components of Liminality?

Answer 4

1. Cancer patientiness
2. Communicative alienation
3. Boundedness

Question 5

Qualitative research => Cancer Survivorship State/Liminality

Cancer Patientness describes an ongoing __________ of recognition of oneself as a cancer patient, regardless of the time since _______ and of the presence/absence of disease

It is express in many ways:

• _________ on how life has changed
• regular reminders via check-ups, ________, medication, ______
• body is a house of suspicion (lose trust in body)
• _______ - can’t concentrate, changes in cognition, etc (Self-report measures)

Some are ________ or threatened, others ______ the identity (pride, contribute to others).

Answer 5

identification
treatment

dwelling
side effects
media
chemobrain

overwhelmed
embrace

Question 6

Qualitative research => Cancer Survivorship State/Liminality

Communicative alienation is a state of alienation brought about my an inability to __________ the nature of the ________ of the illness, it’s diagnosis and treatment.

There is:

• recognition that others can’t share the trauma of the experience - better communication with those who have had _____ experience
• __________ tension - compulsory philosophers
• distancing and _______ from friends/family because of these changes
• ______ on relationships

Answer 6

communicate
experience
similar
Existential
isolation
strain

Question 7

Qualitative research => Cancer Survivorship State/Liminality

Boundedness is a persistent and heightened awareness of:

• _________ of future time
• ______ on social/working roles
• ________ in the freedom to use space

–> restricted lives made them part of community of disadvantaged people.

Answer 7

uncertainty
constraints
limitation

Question 8

Identity disruption

In general, extreme experiences such as cancer produces discontinuity in the sense of ________

• discontinuity of memory
• discontinuity of embodiment
• existential disruption
• disruption of the memory of others.

Often become a new “_____”. Need to acknowledge the “_____” as well and validate the new process.

Answer 8

identity

self
losses

Question 9

Unmet needs

Continuity of care is crucial. And unmet needs must be addressed.

What do Quantitative studies tell us about what LATE EFFECTS patients have in common?

Answer 9

TOP 3

• fatigue
• pain
• depression

poverty - huge financial burden of patients
memory
learning
fear of recurrence
fertility
sexual functioning
relationship changes
medical costs
re-evaluating life/life-values

Question 10

Unmet needs

Continuity of care is crucial. And unmet needs must be addressed.

What is the largest unmet need of cancer survivors?

Answer 10

Psychosocial - mental, existential issues

Resilience is there for most people - especially with age.

Question 11

Unmet needs

Continuity of care is crucial. And unmet needs must be addressed.

Fear of cancer recurrence is huge. However, it can often be higher in the ______ rather than the survivors.

Answer 11

caregivers

Question 12

Essential elements of survivorship care delivery

Survivorship - or the post-treatment phase is now recognised as a _______ phase requiring increased attention. Especially _______ needs of survivors and caregivers. There is generally poor _______ of care.

the essential elements are:
_______-centred
_______-oriented
_______ care

People need to get support for _______ symptoms and focus on _______ and maintaining ______ and satisfaction in their lives. A _______-based approach is always good.

Answer 12

distinct
psychosocial
coordination

survivor
recovery
integrated

ongoing
building
meaning

strengths

Question 13

Survivorship Care Plans

These have been established to address poorly ______ follow-up care. It is tailored to the person’s situation and needs, with a focus on ______ rather than illness. It is often provided towards the _____ of curative treatment.

Helps when you move between health professionals.

Answer 13

coordinated
health
end

Question 14

Australian Cancer Survivorship centres - great for…

Answer 14

resources