Health After Cancer
Stanford Primary Care Doctor Establishes Clinic for Cancer Survivors
Special Training Helps Dr. Kim Understand the Needs of Cancer Patients When They Transition from the Oncology Team to Primary Care
Collaboration is Key
Quality survivorship care requires a strong collaboration between the oncology health team and primary care clinicians. Cancer survivors have described the anxiety caused by not knowing who to call when a new problem arises after finishing cancer treatment, and by not having a clearly defined roadmap for future check-ups and tests. Some have vividly described feeling they are ‘in limbo’ and this contributes to feeling anxious and unsettled.
A Survivorship Clinic Embedded in Primary Care Practice
Responding to the need to improve the transition from oncology to primary care, Stanford is piloting a cancer survivorship clinic that is embedded in a primary care practice. Dr. Jennifer Kim, a Clinical Assistant Professor of Medicine, devotes a day a week of her primary care clinic to the care of cancer survivors. Her practice has focused on women treated for breast and gynecologic cancers, although not restricted to these groups alone.
Some of the patients who see Dr. Kim finished their treatment several years ago, while others consult with her as their cancer treatment is about to finish or finished a few weeks earlier. The issues that are handled during these visits vary considerably and depend on what is most important to the individual patient – from worries about future fertility to recovery of a sense of physical and emotional control after chemotherapy.
As of August 2019, Dr. Kim has seen over 100 patients and the feedback from patients has been glowing and speaks to the collaboration that exists between oncology clinicians and Dr. Kim. Patients describe feeling safer knowing there is open communication between the clinicians involved in their care and are grateful that care feels seamless rather than fragmented. In order to prepare for this role, Dr. Kim shadowed some of her colleagues at the Women’s Cancer Center and this contributed to her understanding of how oncology visits are conducted. It also allowed Dr. Kim to get to know her colleagues in oncology and for them to know her, an important element that has enabled her to communicate with her colleagues in real time to solve problems as they arise.
Sharing Findings and Planning for the Future
Dr. Kim and the Stanford team (Dr. Schapira in Medical Oncology and Dr. Winget in Population Sciences) shared their findings with colleagues at a national research meeting in November 2018 (ASCO’s Palliative Care Symposium held November 16-17 in San Diego, CA). Dr. Kim is enthusiastic about discussing her findings with colleagues and has started teaching medical students and junior doctors about the special needs of cancer survivors.
For their part, cancer survivors are open to and interested in attending a survivorship clinic that is embedded in a primary care program and eager to collaborate with researchers to identify the elements required for success. Working together, researchers and clinicians hope to learn with and from every patient and use this knowledge to improve the experience and health outcomes for cancer survivors.