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The
EPEC-O
TM
Education in Palliative and End-of-life Care - Oncology
Project
The EPEC-O Curriculum is produced by the EPECTM Project with major funding
provided by NCI, with supplemental funding provided by the Lance Armstrong
Foundation.
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EPEC - Oncology
Education in Palliative and End-of-life Care - Oncology
O
Module 5
Survivorship
Objectives

Define cancer survivor

Identify challenges and barriers for
survivors

Utilize practical interventions to
support survivors

Employ strategies for self care
Video
Importance of cancer
survivorship

 numbers

Cancer as chronic disease

Public knowledge/involvement
Definition of
cancer survivor

‘Any person living with cancer
anytime’
- National Coalition for
Cancer Survivorship
Specific concerns of
cancer survivors . . .

Health insurance

Job loss

Non-medical costs

Lack of mental health providers
. . . Specific concerns

Emotional concerns

Fear of abandonment

Physical symptoms
Quality of survivor

Symptom control

Respectful care

Maintenance of social role

Contributing to society
Physicians and the
emotional environment

Emotional connectedness

‘Cheerleader’ role

Guilt

Reimbursement issues
Survivor goals – diagnosis

Acute disequilibrium

Find ‘best’ care

MD role – focus on clear plan
Survivor goals –
treatment

Complete treatment

Maintain independence

MD role
Prevent/treat side effects
Provide information
Survivor goals –
remission

Redefine ‘normal’

Psychosocial rehabilitation

Re-invest in life

MD role – management fear of
recurrence
Survivor goals –
recurrence/advancing
cancer

Maximize sense of control

Realignment of relationships

Palliative care/hospice

MD role
Clarify plan
Honest communication
Recurrent / advancing
disease . . .

Physician communication

Listen

Tell patients and families what they
want to know

‘There’s always something to do’

No abandonment
. . . Recurrent / advancing
disease

Physician communication

Truth

Symptom management

Involve patient/family in decision
process

Present new advances

Refer as appropriate
Survivor goals –
end-of-life

Dignity

Community contribution

Control emotions

Find meaning

Best care
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Summary