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| Cancer Survivorship 2011: The Patient and Nursing Challenges |
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| Audience |
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Gerontology:
Geriatric Assessment
Oncology
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| Authors |
Jennifer Guy, BS, RN, OCNŽ
Jennifer L. Guy, BS, RN, OCNŽ |
| Hours |
3.00 contact hours |
| Expires |
February 2014 |
| Level |
Advanced |
| Passing Grade |
70% |
| Test Retries |
Unlimited
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After completion of this course the participant should be able to:
- Define the demographics of cancer survivors in the U.S.
- Recognize the limitations of the current ?science? of survivorship.
- Understand the potential physical problems occurring in survivors.
- Delineate the psychological impact of cancer survivorship
- Define social problems impacting cancer survivors.
- Describe the primary elements of ?survivorship? care plans.
- Define the mechanisms to ensure appropriate long term follow-up health care.
- Identify resources available to cancer survivors.
- Identify the challenges for nurses of caring for this population.
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To take just this course, test, and evaluation and get your certificate online, the cost is only $ 45.00!
| Hours |
Price |
p/Hour |
% FREE |
| 10 |
$ 142 |
$ 14.20 |
5% FREE! |
| 15 |
$ 203 |
$ 13.53 |
10% FREE! |
| 20 |
$ 257 |
$ 12.85 |
14% FREE! |
| 25 |
$ 302 |
$ 12.08 |
19% FREE! |
| 30 |
$ 339 |
$ 11.30 |
25% FREE! |
| 35 |
$ 367 |
$ 10.49 |
30% FREE! |
| 40 |
$ 386 |
$ 9.65 |
36% FREE! |
| 45 |
$ 405 |
$ 9.00 |
40% FREE! |
Hours purchased are good for an unlimited time, but only within the discipline they were purchased in.
(If located in Ohio state taxes will be applied before purchase)
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No Commercial Support or Sponsorship is accepted by CEU4U, Inc.
Products, drugs, and/or therapies discussed within this educational offering do NOT imply endorsement by CEU4U, Inc. or American Nurses Credentialing Center.
No off label use of product(s) are discussed in this educational offering.
The author(s) and planning committee of this content declare that they have no real or perceived conflict of interest related to this presentation.
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Course Sample:
OVERVIEW
The National Coalition for Cancer Survivorship defines a cancer survivor as anyone who has been diagnosed with cancer as well as the people who are affected by the diagnosis, such a family members, friends and caregivers 1. Historically, a cancer survivor was defined as only the person diagnosed with a malignancy beginning with the day of diagnosis and continuing for the duration of the patient?s lifetime. This definition is problematic because it includes a wide variety of patients from those receiving active cancer treatment to those who are cancer-free and not being actively treated. The needs of the former group are definitively different than those of the latter group. This course is restricted to the challenges of those who have been declared disease-free, are off treatment, and face potentially long-term cancer-free survival that will be impacted by their prior cancer experience physically, psychologically, socially and economically.
Heretofore, little attention was paid to survivorship issues because little effective treatment was available for most malignancies, few people survived more than a few years, and cancer was considered an acute, rather than chronic illness. The combination of improved screening, early detection, and efficacious therapeutic interventions has resulted in an ever-increasing population of cancer-free people requiring routine health care and management of the acute and chronic complications of cancer and its treatment. Compared to cancer biology and cancer treatment, there is a paucity of research about the long-term problems that occur in the successfully treated. The majority of information comes from the pediatric population, predominately from children cured of acute lymphoblastic leukemia. Currently research is underway to better document and understand the problems of the long-term cancer survivor. Recent efforts are aimed at improving the ongoing health care of the cancer survivor and incorporating what is known about the chronic and late effects of cancer therapy. This course will provide an overview of the challenges facing this population and the implications for nursing care.
MAGNITUDE OF THE PROBLEM
Definition of a ?Survivor?
A number of different definitions of a ?cancer survivor? have been promulgated over the years. With the establishment of the National Coalition for Cancer Survivorship (NCCS) in 1986, ?survivor? was used in place of the then-popular term ?cancer victim? to convey the more hopeful aspects of improving cancer therapies and that the disease was in fact treatable and not a mandatory death sentence. Because of the increasing recognition of the impact of malignancy on not only the patient but also on their significant others, NCCS expanded their definition to include family, friends and lay caregivers. The National Cancer Institute?s (NCI) Office of Cancer Survivorship also uses this definition in its public communications, but limits it to only those individuals diagnosed with cancer when generating statistics and analyzing data about survivorship issues2. Other groups have struggled with the appropriate terminology. Some say ?survivor? is too optimistic for the state-of-the art, others say it implies a cancer-free status, while yet others suggest that the person diagnosed with cancer be designated the ?primary? survivor and the family, friends and caregivers be called ?secondary? survivors. Memorial Sloan-Kettering Cancer Center defines a survivor as those in "a particular period in a cancer patient?s life, which is post-treatment, separate from diagnosis and treatment and end-of-life care". This is the definition that is the focus of this course. Nurses must identify the definition being used when consulting the literature to appropriately interpret reports related to cancer survivor issues.
Demographics of Cancer Survivors
In 1971 there were approximately three million people living in the United States whom had ever had a diagnosis of cancer (excluding in situ cancers and basal cell cancers of the skin). Only 50 % of patients diagnosed with cancer from 1974-1976 could expect to live five years. For those diagnosed between 1995 and 2000, 64% of adults were anticipated to live at least five years. For children the five year survival rates were 56% (1974-1976) and 79% (1991-2000) and 75 % ten year survivals for childhood cancer diagnoses made during the latter period3. Today there are more than ten million individuals alive in the Unites States who have had a diagnosis of cancer representing about 3.0% of the population3, 4. With the aging of Americans, progress in cancer detection and management and decreasing mortality from other causes, this number is expected to double by the year 20505. Tables 1 - 5 delineate the characteristics of the survivors. Because the incidence of cancer increases with advancing age, the relative number of survivors reflects this. Females represent the highest number of survivors (5.5 million) because they experience more tumors for which early detection and curative therapies exist as opposed to men who have a higher incidence of tumors with suboptimal detection and treatment. The per cent of total survivors is highest in those tumors for which the best early detection and treatment exists, such as breast cancer in women and prostate cancer in men. As improvements in detection and treatment occur in various malignancies, the distribution of survivors by primary site is expected to change. With improved treatment, cancer has become a chronic illness and an ever-increasing number of people are expected to be alive more years after diagnosis.
Table 1: Age Distribution of U.S. Cancer Survivors, 20046
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Age (yrs) |
% of Survivors |
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< 20 |
1 |
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20-39 |
5 |
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40-64 |
34 |
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≥ 65 |
60 |
Table 2: U.S. Survivors (millions) by Gender and Years Post Diagnosis, 20046
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Yrs Post Diagnosis |
Male |
Female |
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0-4 |
1.9 |
1.8 |
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5-9 |
1.2 |
1.2 |
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10-14 |
0.6 |
0.9 |
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15-19 |
0.3 |
0.6 |
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20-24 |
0.2 |
0.35 |
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≥ 25 |
0.2 |
0.7 |
Table 3: Proportion of U.S. Cancer Survivors by Type of Cancer, 20046
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Type
of Cancer* |
% of
Survivors |
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Female
breast |
22 |
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Prostate |
19 |
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Colorectal |
10 |
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Gynecologic |
9 |
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Hematologic** |
7 |
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Bladder
& Testis |
7 |
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Melanoma |
7 |
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Lung |
3 |
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All
other sites |
16 |
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