Posts Tagged ‘cancer screening’

Survivorship Care Plan- Are You Prepared? Take-Aways from Web Chat

Cancer Survivorship SupportRecently, I conducted a chat with Winship Cancer Institute of Emory University on the Effects of Chemo and Radiation on Cancer Survivors. In 1978, as a child, I was diagnosed with Ewing’s Sarcoma. I received radiation and chemotherapy at that time that resulted in my development of significant late side effects in my adult life.

The participants asked some great questions. One particular question we did not have time to answer was,

“Did you find a survivorship care plan an effective tool for you or your parents once you moved from active treatment?”

For me, a cancer treatment summary or a survivorship care plan was extremely helpful after my active treatment. Without the knowledge from my parents and their guidance, I would not have been able to properly prepare a care plan.

I recommend that every cancer survivor become well informed and secure a treatment summary and survivorship care plan.  Consider it the first step in accepting responsibility for your personal health and well-being after cancer treatment.

A Cancer Treatment Summary should include the following information at a minimum:

  • Identifiers for you (name, medical record number and birthdate)
  • A description of your cancer diagnosis including pathology and staging information
  • A list of all treatments you have received (surgery, chemotherapy, biological therapy, hormonal therapy, and/or radiation therapy)
  • All dates and doses of treatment you received  (i.e. cumulative doses of anthracyclines)
  • Any significant side effects you experienced during treatment
  • Contact name and phone number of a member of your family or close friend
  • Names and Contact information of all providers involved in your care

A Survivorship Care Plan should include the following information at a minimum:

  • A Treatment Summary
  • A plan for long term follow-up including appointments and testing you will need and when you should have them
  • A list of any long term side effects that you need to be aware of and ways to handle them (including physical issues as well as emotional and social issues you may experience)

For more information on how to prepare your survivorship plan and the benefits of having one, check out the chat transcript.

About Stephanie Zimmerman

Stephanie’s personal experience as a child diagnosed and treated for Ewing’s Sarcoma in the late 1970’s led her to become a nurse serving the physical and psychosocial needs of children and their families along the cancer trajectory. In April 2008, Stephanie’s heart failed because of the chest radiation and Doxorubicin used to cure her Ewing’s Sarcoma three decades prior. Unable to return to clinical practice following a heart transplant, yet unwilling to abandon her passion for the survivor population, Stephanie partnered with Judy Bode of Grand Rapids, MI in the founding of myHeart, yourHands, Inc. [MHYH]

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Questions on Validity of PSA Test as Prostate Cancer Screening Tool?

Prostate Cancer PSA ScreeningViraj Master, MD Prostate cancer is the second leading cause of cancer death among American men.  Nearly 250,000 men will be diagnosed with prostate cancer this year.  More than 32,000 men will die from prostate cancer this year.  In Georgia, 7,360 men will be diagnosed and 1,080 will die.  With statistics like that, we want every advantage possible in our fight with this disease.

Since the early 1990s, the Prostate Specific Antigen (PSA) test has been the primary screening tool used to detect prostate cancer. The PSA is a simple blood test, non-invasive and easy to administer and process.  The US Preventive Services Task Force has recently recommended, however, that the PSA test no longer be offered to men as a screening tool.

This task force is a federally funded independent panel of experts in prevention and evidence-based medicine.  It is comprised of primary care providers such as internists, family practitioners and pediatricians, but not oncologists or urologists.  Their job is to evaluate the benefits of preventive services like screening and make recommendations about which services should be routinely incorporated into primary medical care.

Screening, or early detection, for prostate cancer is a complicated issue.  Unlike the colonoscopy, which provides clear evidence of early detection and has been determined to have saved lives in multiple studies, the PSA test has been contradictory, with some studies showing a benefit, while others did not.  There are many reasons, including the fact that most forms of prostate cancer are relatively slow-growing cancers.  Generally, a man with prostate cancer may live for many years without ever having the cancer discovered.  In fact, many men with prostate cancer will not die from it, but with it.  In addition, high or increasing levels of PSA can indicate an increased risk for prostate cancer, but can also indicate an infection or an enlarged prostate.  So, the USPSTF determined that because of these uncertainties, the risk of over treatment is greater than the benefit, and their recommendation states that PSA tests should no longer be offered as a screening tool.

The biggest issue in prostate cancer that confronts patients, their families and their healthcare providers is to delink screening with treatment.  Not all forms of prostate cancer require active therapeutic interventions, but some do.

While the PSA test is imperfect, it is – at this time – the best tool we have at our disposal for early detection of prostate cancer.  The Winship Cancer Institute of Emory University aligns with the American Urological Association, the American Cancer Society, American College of Physicians and the American College of Preventive Medicine and recommends informed decision-making.  Our recommendation is that men at average risk should receive information, including a PSA test if they want it, at an appropriate middle age, although African American men or men with a family history of prostate cancer should receive information at an earlier age, such as 40, or 45 years.

So, what do we mean when we say “informed decision-making”?  This means that doctors should discuss the potential benefits and harms of PSA screening with their patients and consider their patients’ preferences, overall health, and family history when making decisions regarding screening with a PSA test.

Unfortunately, there is no easy answer.  Each patient comes to us with his own distinctive characteristics, and those characteristics must be taken into consideration when deciding whether to have the PSA test.

About Dr. Viraj Master
Dr. Master specializes in the treatment of adrenal cancer, bladder cancer, kidney cancer, prostate cancer, testicular cancer. He is also an expert in laparoscopic surgery. Dr. Master received his Medical Degree in the University of Chicago in Chicago, Illinois, in 1997. He completed his Internship at University of California, San Francisco in 1999, where he also completed his Fellowship in 2003.