Breast Cancer Survivorship Clinic

Cancer

Survivorship is often defined as the process of living with, through, and beyond cancer and cancer treatment.  Living life with a history of cancer is unique for each person.  Survivorship care helps breast cancer survivors shift from illness-oriented treatment to wellness-focused care. 

In some ways, moving from active treatment to survivorship is one of the most complex aspects of the cancer experience because new anxieties and fears may surface at this time, such as physical problems, emotional challenges, fertility concerns, sexual dysfunction, recurrence fears, and spiritual and financial concerns.  The cancer care team at the Parkview Cancer Institute wants to ensure that after treatment has been completed, resources continue to be available to assist in the journey ahead.

The Breast Survivorship Clinic is part of the cancer care team and is staffed with a survivorship advanced practice provider that specializes in the care of the cancer patient that has completed treatment.  Your visit at the clinic will include:

  • A review of your cancer and the treatment you received

  • A comprehensive physical exam

  • Evaluation and identification of emotional, social, financial and spiritual effects of your cancer and treatment

  • Assessment of your risk for other cancers

  • Evaluation of wellness needs and desires that will decrease the chance of recurrence and development of new cancers

Upon the completion of the visit you will receive a personalized plan of care that includes:

  • The follow-up plan of care to assess your current cancer diagnosis

  • A plan for screening for other cancers

  • Education so you can distinguish the difference between concerning and normal signs and symptoms

  • A plan to address the physical, emotional, social, financial, educational, and spiritual needs.  This plan may include referrals to community resources and/or other specialty services.

  • A wellness plan that fit your needs and desires, this may include smoking cessation, vaccines, and weight management

  • This personalized plan will be created in collaboration with you and your health care team

  • This plan will be communicated with your entire health care team, including your primary health care provider 

What are some of the late and long-term psychosocial and physical problems that may occur?

  • Cardiac (heart) issues resulting from certain types of treatment

  • Anxiety and depression

  • Cognitive function impairment, such as Increased forgetfulness, confusion or loss of focus and concentration

  • Fatigue

  • Pain

  • Sleep disorders

  • Sexual dysfunction

  • Bone mineral loss

  • Hot flashes

What can I do to reduce the risk of cancer recurrence or development of another cancer?

  • Maintain a healthy weight

          o   The body mass index (BMI) is a guideline to help determine your weight management goal.

          o   BMI Calculator: http://www.smartcalculator.com​

​BMI ​Weight ​Goal
Below 18.5 ​Underweight Gain weight to achieve a BMI between 18.5-24.9​
18.5-24.0​ ​Healthy weight ​Maintain weight
25.0-29.9 ​Overweight
​Lose weight to achieve a BMI between 18.5-24.9
30.0 and above​​ Overweight​ ​Lose weight to achieve a BMI between 18.5-24.9
 

  • Basic principles of weight loss include:

    •    ​​​​​Limit foods high in calories especially those with few nutrients (e.g., sweet desserts, fried foods, fast food)

    • Replace high caloric food with fruits, vegetables, and whole grains

    • Avoid processed or red meats

    • Use smaller plates and limit yourself to one helping to control portion size

    • Read labels to ensure that it meets the healthy requirements

  • Regular physical activity

    • Include physical activity into your daily living (e.g., walking, water exercise, strength training)

    • Physical activity should be within your abilities

    • Weekly exercise should consist of at least 150 minutes of moderate intensity activity

    • Strength training 2-3 times a week should be included

    • Incorporate general physical activity (e.g., take stairs when possible, park in the back of the parking lot)

    • Track caloric intake and physical activities

    • Weight yourself at least three times a week

    • Weight loss should be gradual, losing approximately 2 pounds per week

    • Nutritional and exercise counseling may be beneficial

  • Min​imize alcohol intake

    • ​Men should have no more than 2 alcoholic servings per day and women should have no more than 1 alcoholic serving per day.  The following defines a serving of alcohol:​

​​Beverage ​Serving
Beer ​12 ounces
Wine ​5 ounces
Liquor
(gin, rum, tequila, vodka, whiskey, etc.)
1.5 ounces​

 

  • Avoid tobacco products

    • ​Smoking has been proven to adversely affect a person’s overall health and quality of life and is an associated risk of developing many cancers.  It is strongly recommended to avoid all tobacco products.  There are smoking cessation resources available and some are listed below. 

  • Practice sun safety

    • Use a sunscreen with an SPF of at least 30 that protects against UVA and UVB and is water resistant

    • Reapply sunscreen every 2 hours and after swimming or excessive sweating

    • The use of a physical barrier is recommended (hats and swim shirts)

    • Do not use tanning beds

  • Follow cancer screening recommendations​


 

Breast Cancer

 

Age

                             Recommendation

25-39

Every 1-3 years CBE   

*Breast self-awareness

40-74

Annual Mammogram while in good health

 Annual clinical breast exam

 

*Women should be familiar with their bodies and promptly report any changes to their health care provider.

 

Tomosynthesis should be considered in women with dense breast and/or increased risk factors.   

 

Women should discuss with their physician what may be appropriate screening for them

Pap/pelvic exam

Age 21-29 

PAP smear every 3 years without HPV testing


Age 30-65    

PAP smear and HPV testing every 5 years or a PAP smear every 3 years


Above 65     

Depends on previous screening results; if previous negative results than no more screening

 

Colorectal

Colonoscopy every 10 years beginning @ age 50.  Detection can be done by an annual Fecal Immunochemical Test (FIT)

Lung

Annual low-dose lung CT for the following:

50 years and older with a > 20 pack-year history of smoking (packs per day x years

smoking) with additional risk factors

·       COPD, Chronic Bronchitis 

·       History of any cancer

·       Family history of lung cancer

·       Radon Exposure

55-74 with a > 30 pack year history of smoking

Former smokers must have quit within the past 15 years

Esophageal

Patients with chronic GERD (reflux x 10 years) and multiple risk factors should undergo a screening upper gastrointestinal endoscopy.  The additional risk factors include:

·       Male

·       Age 50 and older

·       Caucasian race

·       Hiatal hernia

·       Obesity

·       Smoking

·       Family history of esophageal cancer

 

Additional Survivorship Resources:

ACS

https://www.cancer.org/health-care-professionals/national-cancer-survivorship-resource-center/tools-for-cancer-survivors-and-caregivers.html

LIVESTRONG

https://www.livestrong.org/we-can-help/healthy-living-after-treatment/your-survivorship-care-plan

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