Congress Abstracts 2006

95

LUNG CANCER SURVIVORSHIP: A NURSE PRACTITIONER MODEL FOR FOLLOW-UP CARE. Amy Logue, MS, APRN, BC, NP-C, Memorial Sloan-Kettering Cancer Center, New York, NY.

In the US, there are 10 million cancer survivors; 64% will be alive 5 years from diagnosis. Lung cancer (LC), the second most common cancer in both sexes, is the leading cause of cancer-related deaths. While the overall 5 year survival rate for those diagnosed with LC is 15% and the risk of disease recurrence is high, approximately 62% of patients (pts) diagnosed with Stage I non-small cell lung cancer (NSCLC) can expect to survive 5 years after treatment. Recent evidence demonstrates that targeted therapies and platinum-based adjuvant chemotherapy in early stage NSCLC improve survival.

Follow-up after lung cancer treatment is an important phase of the cancer continuum. Lung cancer patients are often older with significant comorbid conditions. Late treatment effects of lung cancer therapy include fatigue, pain, decreased pulmonary function, depression, anxiety and diminished QOL. At our institution, a LC survivorship pilot program utilizing a nurse practitioner (NP) care model was developed to meet these specific patient needs as well as serve as a paradigm for other survivorship programs.

Eligible pts are those with history of stages I/II NSCLC, 1 year post surgical resection without evidence of disease. Institutional standards require pts be seen by the NP every 6 months for the second post-operative year and annually thereafter. Our program, implementing cancer survivorship recommendations published in a recent Institute of Medicine report, provides a broad set of services emphasizing health promotion and cancer prevention. Follow-up care includes radiographic and close clinical surveillance for disease recurrence or new primary lung cancers; recommendations for routine cancer screening per national guidelines; assessment and management of treatment-related sequelae; identification and referral for chronic comorbid medical and psychosocial conditions; and smoking cessation.

Evaluation of the LC survivorship pilot program will include pt and provider satisfaction, adherence to follow-up recommendations, percentage of referrals for cancer screening, psychosocial and sub-specialty evaluation and assessment of feasibility.

Oncology advanced practice nurses can effectively provide comprehensive follow-up care for LC survivors. Our program hopes to define the medical and psychosocial needs of LC survivors so that oncology nurses can incorporate this knowledge into daily practice and patient care.