Innovative Care - Healing Environment
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Transcript of Innovative Care - Healing Environment
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Case Study
Screening
Diagnosis
Treatment
Survivorship
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Diagnosis•Stage IIIA ER+ HER2- Cancer of the Left Breast
Screening
Diagnosis
Treatment
Survivorship
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Treatment•Left mastectomy with bilateral DIEP reconstruction
•Right prophylactic mastectomy and left axillary node dissection
•Chemotherapy Taxol/Carbo
•Antihormonal Therapy 5 years
Screening
Diagnosis
Treatment
Survivorship
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12 months later…
•Range of motion complications <30%
•Chronic discomfort 54%
•Infertility <50%
•Cardiovascular disease <30%
•Lymphedema 15-20%
•Chronic fatigue 99%
•Anxiety & depression >70%
•Financial burden 43%
Screening
Diagnosis
Treatment
Survivorship
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Distress Screening•If additional information was obtained…
•Marital status
•Employment history
•Personal history
•Family history
Screening
Diagnosis
Treatment
Survivorship
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Survivorship Program
Screening
Diagnosis
Treatment
Survivorship
•Distress Screening
•Multidisciplinary Team
•Transitions consult
•Surveillance
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Key PlayersGenetic
Counseling •Family history
Rehab •Rotator cuff issues
Medical Oncology
•Neoadjuvantchemotherapy
Plastic Surgery
•Staged reconstruction
Fertility •Family planning
Cardiology •Vessel salvage
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Elements of Success•Maintained range of motion
•Fertility preserved
•Successful CABG
•Improved fatigue
•No radiation effects
•No chronic pain
•Ability to work
•Survivor mentor
Screening
Diagnosis
Treatment
Survivorship
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Multidisciplinary Team
Communication is key!
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Transitions Consult•Education
•Health promotion
•Surveillance
•Care plan & treatment summary
•Support services
Screening
Diagnosis
Treatment
Survivorship
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12 months later…•Anxiety
•Difficulties at work
•Body image
•Sexual dysfunction
•Coping mechanisms
•Fear of recurrence
Screening
Diagnosis
Treatment
Survivorship
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What can be done?•Patient education
•Physician communication
•Psychosocial support
•Health promotion
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THANK YOU
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