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U Penn Abramson Cancer Center Living Well After Cancer Survivorship Center
Philadelphia, PA
Clinical Setting:
• Survivorship care is part of the continuum of care within the Oncology Clinic
• Breast cancer patients are given their Survivorship Care Plan and Treatment summary by their oncologists
• Generally breast cancer patients are internally referred on the recommendation of their oncologist to the
survivorship program around 5 years from diagnosis, but that’s not the mandate
• Visit is like any other oncology follow-up appointment but longer
• Survivorship Clinic held on Fridays (one day a week)
• Patient returns to same clinic, same waiting area, same labs, and same location of their oncologist
• The only change is that they are seen by the nurse practitioner who manages the survivorship clinic
o Covers more survivorship issues
o Patient reported outcomes
o What patients might be experiencing
o Surveillances are kept up to date
o Referrals to appropriate specialists (i.e. rehab, nutritional counseling, weight gain, acupuncture)
• Patients come yearly as part of their oncology follow-up
• Some patients see their oncologist one year and the survivorship nurse the other year in attempt to transition
patients away from oncologist
Staffing:
• Nurse practitioner who is only dedicated to the survivorship clinic one day a week
Patient Population:
• 200 Patient visits a year that are identified specifically for survivorship program
• Urban setting, white urban educated, higher socio-economic status
• Located in West Philadelphia
• 15%-20% African American
• Reflective of population in the area
Funding:
• Initially funded by a seed grant from the Livestrong Foundation
• Research funding
• All nurse practitioner appointments are fully reimbursable
• Integrative Services (i.e. reiki, massage, acupuncture) are not reimbursable, unless patient qualifies for a
research study
• Rehab is reimbursable post treatment to an extent, but co-pays are high
Integrative Medicine Programs (Cancer Supportive Services)
• Integrative supportive services are designed to help patients cope with the cancer experience
o Acupuncture
o Diet and Nutrition
o Mindfulness- Based Stress Reduction Therapy
o Massage
o Reiki
o Yoga
o Exercise/Rehabilitation
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Challenges:
• Longer term cancer patients who have been seeing their oncologists longer than the survivorship clinic has
operated, may refuse to be transitioned to the survivorship clinic
Lessons Learned:
• Working within an existing system rather than trying to create something new, is less difficult to monitor and
set-up
• Working within the system allows for a seamless transition for patients
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