Fuentes Alejandra C, Lambird Jonathan E, George Thomas J, Markham Merry Jennifer
From the Department of Medicine and the Division of Hematology & Oncology, University of Florida College of Medicine, Gainesville.
South Med J. 2017 Jan;110(1):37-44. doi: 10.14423/SMJ.0000000000000585.
The number of cancer survivors is estimated by 2022 to increase to almost 18 million, in part because of improvements in earlier detection and cancer therapies, leading to longer-term survival of cancer patients. This growing number of survivors has presented challenges to the healthcare community, one of which is the need to provide to the survivor a seamless transition from the oncologist to the primary care provider (PCP). A major national initiative is under way for oncologists to provide survivorship care plans to their patients and PCPs, with the aim of communicating a complete record of cancer treatment and guiding the PCP in the future care of these cancer survivors. In caring for cancer survivors, PCPs must be familiar with the long-term and late effects, both medical and psychosocial, that are associated with common cancer treatments as well as the oncologic diagnosis itself. This article provides a unique approach to the traditional history and physical of easing the transition to primary care after completing cancer therapy for the cancer survivor. The cancer survivor-focused history and physical provide the PCP with a familiar and efficient method to clinically evaluate cancer survivors that closes the gap in this important transition of care.
据估计,到2022年癌症幸存者的数量将增至近1800万,部分原因是早期检测和癌症治疗有所改善,使癌症患者能够获得更长的生存期。越来越多的幸存者给医疗界带来了挑战,其中之一是需要为幸存者提供从肿瘤学家到初级保健提供者(PCP)的无缝过渡。目前正在开展一项重大的全国性倡议,让肿瘤学家为患者和初级保健提供者提供癌症生存护理计划,目的是传达完整的癌症治疗记录,并指导初级保健提供者对这些癌症幸存者进行后续护理。在护理癌症幸存者时,初级保健提供者必须熟悉与常见癌症治疗以及肿瘤诊断本身相关的长期和晚期影响,包括医学和心理社会方面的影响。本文提供了一种独特的方法,用于传统的病史采集和体格检查,以帮助癌症幸存者在完成癌症治疗后顺利过渡到初级保健。以癌症幸存者为重点的病史采集和体格检查为初级保健提供者提供了一种熟悉且有效的方法,用于对癌症幸存者进行临床评估,弥合这一重要护理过渡中的差距。