cancersurvivorshipinprimarycarepsychooncology…癌症幸存者在初级保健心理肿瘤学….pptxVIP

1971-3 million 2012-13.7 million 2020-18 million Approximately 15% of the 13.7 million estimated cancer survivors were diagnosed 20 or more years ago 67% of patients treated now will be alive in 5 years 75% of childhood cancer survivors will be alive in 10 years Most common cancer sites-female breast-22%, prostate-20%, colorectal-9%, gynecologic-8%;History of the Development of Cancer Survivorship;Definitions;Definitions;DefinitionIOM Recommendation ;“Seasons of Survival”;Acute Survival;Extended Survival:Transitional Fallow up ;Permanent Survival:Extended follow up;Goals of Survivorship care;Goals of Survivorship Care;Focus of Survivorship Care;Surveillance;Prevention;Interventions;Coordination;Quality of life:Physical well being;Quality of Life:Psychosocial;Quality of Life:Social well being;Quality of Life:Spiritual well being;Treatment related Toxicities:Long term and Late effects;Late effects;Tumor Related Factors;Treatment Related Factors;Host Related Factors;Surgery;Chemotherapy;Chemotherapy: Cardiac Toxicity;Chemotherapy:Cardiotoxicity;Chemotherapy: Cardiotoxicity;Pulmonary Toxicity;Neuropathy;Neuropathy;Bone Loss;Radiation Therapy;Cancer Survivors have a 14% higher risk of secondary malignancies;Secondary Malignancies;Psychosocial Impact:Risk factors;Interventions to decrease Psychosocial distress;Demands of Cancer Survivorship;Oncologists Challenges;Supply and Demand;Supply and Demand;Challenges of the Primary Care Provider; Co-morbidities/Chronic illness 60% of cancer survivors have at least 1 co-morbid condition vs 45% without cancer Worse oncologic outcomes with poorly managed co-morbidities 1PCP per 10,000 decreases mortality rate in a community by 5.3% 85% o f cancer care is provided in community settings Higher rate of screening and vaccinations in cancer survivors with PCP care More Primary Care Providers =Better cancer Survivor care ;Shared care Risk based follow up Disease specific clinics Institution based progra