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Cancer Care Plans Help Survivors Make Lifestyle Changes

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Medical researchers at University of Pennsylvania in Philadelphia found online care plans encourage cancer survivors to make needed lifestyle changes to help them cope with their treatments. This finding and other results appear online this month in the journal Cancer (paid subscription required).

The Institute of Medicine recommended in a 2005 report that cancer patients receive a personalized survivorship care plan to provide a road map describing their new lives as cancer survivors. The plans would include medical information, such as tips for follow-up screenings, as well as cover non-medical but still important factors such as insurance and lifestyle adjustments, including changes in diet and exercise.

These plans are taking on a more important role in cancer patient care. In fact, the Commission on Cancer of the American College of Surgeons will require, beginning in 2015, that cancer centers seeking accreditation provide care plans to their patients once they complete their treatment. National Cancer Institute last year estimated that the number of cancer survivors would increase to nearly 18 million by 2022, but evidence at that time on the usefulness of these care plans was anecdotal, not systematic.

The study’s lead and corresponding author, radiation oncologist Christine Hill-Kayser says, “a  survivorship care plan enables the survivor to take more control of his or her care, and to participate in minimizing the ‘slip through the cracks’ phenomenon.” University of Pennsylvania’s medical school developed one such plan in 2007, an online service called the Livestrong Care Plan, branding the service with cyclist Lance Armstrong’s cancer philanthropy and survivor support community.

The Livestrong plan, says the university, enrolled more than 29,000 patients and health care providers, and is designed to serve adult survivors. The Livestrong service asks patients — with their physicians, if needed — a series of questions on their cancers, treatments, and demographic data, which generates an individualized care plan.

In the study, Hill-Kayser and colleagues surveyed some 300 cancer survivors taking part in the Livestrong plans, from the nearly 8,700 participants registered between May 2010 and January 2013, who were sent the survey about a month after generating their plans. Nearly half (45%) of the respondents were breast cancer survivors, with about one in 10 each diagnosed with hematologic (12%) or gastrointestinal (11%) cancers. The median age of respondents was 51.

The researchers found most participants made changes in the their behaviors as a result of the plans. More than half (54%) reported making or planning to make lifestyle changes, either in diet or increased exercise. An even larger percentage (63%) said the plans changed the way they participate in their health care, and eight in 10 respondents said the plans help improve communications with their health care providers.

The participants overall rated highly the plans they received. Nearly all (93%) considered the information provided in their plans “excellent” or “good,” while about the same percentage (94%) would recommend the service to others.

“Our results show that care plans are empowering patients to become more active participants in their own health care,” says Hill-Kayser. “This is an important tool that provides patients with greater education and prompts them to be more proactive about their care and more likely to discuss concerns with their providers.”

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