Cancer Survivors Send Distress Call
Cancer Survivors Send Distress Call
Medscape: Let's talk a little about potential barriers to use of PCSGs. Is lack of insurance coverage an issue for many of those who don't participate in PCSGs?
Dr. Forsythe: In our study, very few survivors reported that financial costs were the reason that they didn't access PCSGs. However, the most commonly reported barrier was lack of awareness of these services or lack of availability of these services, which might have a relationship with insurance coverage. Greater coverage would probably promote greater availability of these services and greater knowledge about the availability of such services. If insurance coverage was known to be available, providers might be more likely to say, "Psychosocial treatment is part of the package that we can offer you."
Because this was a population-based study, we don't know where patients received their cancer care, or whether these services would have been available to them. We only know that they frequently told us that they didn't know these services were available.
Medscape: The number of Web-based cancer support communities is burgeoning. Is anything known about the effectiveness of this mode of psychosocial support for cancer survivors?
Dr. Forsythe: Research has been done comparing modalities of support, and some literature shows that in certain settings, online peer support can work very well. In many cases, however, the most appropriate treatment will depend on the survivor and his or her unique needs. Some of the more serious psychosocial needs might be best addressed in a professional setting, but others can be handled appropriately through peer support. The effectiveness of an intervention also depends on the interest of the patient participating in that intervention. Therefore, having a variety of these approaches available is valuable, taking into account not just preference for participating in a specific modality, but also access to that modality.
Medscape: Does the growing use of survivorship care plans help survivors take advantage of PCSG?
Dr. Forsythe: Cancer survivors have many important medical needs that must to be addressed, particularly as they age, and cancer survivors tend to be an older population. This study doesn't directly answer questions about whether providers are using or sharing survivor care plans, but we know from other recent work that many primary care physicians don't receive cancer survivor care plans for the patients under their care who are cancer survivors. The primary care providers who said they did receive a care plan told us that they felt more confident about understanding and treating their patient's psychosocial needs after cancer.
No studies to date have tested the link between receipt of survivorship care plans and subsequent use of PCSG. That would be a great future study to help us understand whether care planning can enable greater access to psychosocial care. However, recent studies suggest that sharing survivorship care plans, both with the patient and the primary care provider, has the potential to promote more comprehensive care after cancer, including addressing psychosocial needs. [Editor's note: The American Society of Clinical Oncology guidelines recommend that oncologists and primary care physicians maintain survivorship care plans; see the Medscape article Surviving Cancer Is Not Enough: ASCO Survivorship Guidelines Explained.]
Barriers to Psychosocial Support
Medscape: Let's talk a little about potential barriers to use of PCSGs. Is lack of insurance coverage an issue for many of those who don't participate in PCSGs?
Dr. Forsythe: In our study, very few survivors reported that financial costs were the reason that they didn't access PCSGs. However, the most commonly reported barrier was lack of awareness of these services or lack of availability of these services, which might have a relationship with insurance coverage. Greater coverage would probably promote greater availability of these services and greater knowledge about the availability of such services. If insurance coverage was known to be available, providers might be more likely to say, "Psychosocial treatment is part of the package that we can offer you."
Because this was a population-based study, we don't know where patients received their cancer care, or whether these services would have been available to them. We only know that they frequently told us that they didn't know these services were available.
Medscape: The number of Web-based cancer support communities is burgeoning. Is anything known about the effectiveness of this mode of psychosocial support for cancer survivors?
Dr. Forsythe: Research has been done comparing modalities of support, and some literature shows that in certain settings, online peer support can work very well. In many cases, however, the most appropriate treatment will depend on the survivor and his or her unique needs. Some of the more serious psychosocial needs might be best addressed in a professional setting, but others can be handled appropriately through peer support. The effectiveness of an intervention also depends on the interest of the patient participating in that intervention. Therefore, having a variety of these approaches available is valuable, taking into account not just preference for participating in a specific modality, but also access to that modality.
Medscape: Does the growing use of survivorship care plans help survivors take advantage of PCSG?
Dr. Forsythe: Cancer survivors have many important medical needs that must to be addressed, particularly as they age, and cancer survivors tend to be an older population. This study doesn't directly answer questions about whether providers are using or sharing survivor care plans, but we know from other recent work that many primary care physicians don't receive cancer survivor care plans for the patients under their care who are cancer survivors. The primary care providers who said they did receive a care plan told us that they felt more confident about understanding and treating their patient's psychosocial needs after cancer.
No studies to date have tested the link between receipt of survivorship care plans and subsequent use of PCSG. That would be a great future study to help us understand whether care planning can enable greater access to psychosocial care. However, recent studies suggest that sharing survivorship care plans, both with the patient and the primary care provider, has the potential to promote more comprehensive care after cancer, including addressing psychosocial needs. [Editor's note: The American Society of Clinical Oncology guidelines recommend that oncologists and primary care physicians maintain survivorship care plans; see the Medscape article Surviving Cancer Is Not Enough: ASCO Survivorship Guidelines Explained.]
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