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52 Healthy diet and lifestyle for cancer patients
Abstracts and Learning Outcomes / European Journal of Oncology Nursing 18S1 (2014) S1–S22
52 Healthy diet and lifestyle for cancer patients A. Anderson1 . 1 University of Dundee – School of Nursing and Midwifery 11 Airlie Place, Centre for Public Health Nutrition Research Level 7, Dundee, United Kingdom For patients living with cancer, healthy ways of life offer an opportunity to improve treatment outcomes, quality of life, fatigue, psychological and physical health and well-being. As the number of cancer survivors increase it becomes increasingly important to “stack the odds” against cancer recurrence, future primary tumours and lifestyle related morbidities. In addition to avoiding tobacco, The American Cancer Society and World Cancer Research Fund highlight the importance of achieving and maintaining a healthy body weight, engaging in physical activity (whilst avoiding inactivity) and following a dietary pattern that is rich in fruits, vegetables and whole grains with low intakes of alcohol, red and processed meat. No long term trials have yet reported on the impact of weight loss interventions on cancer survivorship, but observational data suggest reduced morbidity in breast and colorectal cancers and the WINS study demonstrated modest effects on relapse free survival of breast cancer patients. The impact of improvements on cancer outcomes by increased physical activity look promising based on biomarker data but have yet to be confirmed by recurrence trials. Current evidence suggests that attaining the goals of lifestyle recommendations are unlikely to be harmful. Patient views on lifestyle advice range from scepticisms over the relevance, misunderstanding (generated by media and supplement companies) and annoyance over health care providers failing in their duty of care when advice and support is not provided. Cancer Health Care Professionals often face difficulties in raising the challenge of obesity management, citing personal issues, lack of time, training and anxieties about impacting on patient relationships by discussing the (diet and physical activity) issues involved. Sensitive, well-informed, practical strategies have been demonstrated to initiate behavioural changes in cancer patients but evidence based approaches and protocols for good practice have not yet been widely disseminated and implemented. Ensuring that treatment plans include personalised lifestyle dimensions offer patients the opportunities to maximise health gain beyond drug therapies. No conflict of interest.
Parallel Session: EAUN / EONS: Prostate Cancer 53 Unmet needs in prostate cancer patients in Europe No abstract received. No conflict of interest information specified. 54 Nursing education to increase patient care No abstract received. No conflict of interest information specified.
S15
Parallel Session: SIOPE / EONS: Follow up and Psychological Needs of Young Adult Cancer Survivors 55 Developing leadership and networks in young adult oncology: report from first EONS/TCT Leadership summit No abstract received. No conflict of interest information specified. 56 Shared care, better care! S. Bunskoek1 , H. Boer1 , J.A. Gietema1 . 1 University Medical Center Groningen, Department of Medical Oncology DA 11, Groningen, Netherlands Introduction: The still increasing numbers of cancer survivors is an important health care issue for hospital-based and primary care. Among these survivors is a large number of testicular cancer survivors (TCS). International guidelines describe a clear and intensive follow up to monitor relapse and late effects, traditionally performed at specialized hospitals. Because of the growing number of survivors, cost of healthcare and higher expectations of quality of care it is important to determine the optimal model and best place to deliver appropriate follow up care. A prospective study has been initiated to evaluate the feasibility of a shared care followup strategy with the expertise of the oncology centers and the primary care physicians (PCP) combined in the follow-up of TCS. A survivorship care plan (SCP), consisting of an end-of-treatment summary and a personal follow-up plan, is mandatory and enables patients and their doctors to collaborate in a shared-care model. The patient can be in control of his own follow-up. The use of new information technologies can optimize the way patients can navigate their own shared-care follow-up. Method: Eligibility criteria are complete remission after chemotherapy for metastatic testicular cancer and age >18 years at start of follow-up. A personalized SCP is generated and discussed by the oncologist and nurse practitioner with both the patient and his PCP. The SCP defines the time-points in follow-up at which the PCP checks for e.g. cardiovascular risk and psychosocial well-being. Primary endpoints of the study are the safety and feasibility of shared-care follow-up. Results and Discussion: The study started in January 2013; 90 patients are participating at this moment. Both patients and their PCP are very motivated to participate. For optimal survivor care it is very important dedicated nurses are involved in follow up right from the start. Beside the risk of a tumor relapse and late effects like second cancers and cardiovascular disease, cancer survivors face many psychosocial issues. It can only be successful if the patient has a central role in it with appropriate responsibility. When follow-up formally starts it is crucial they are well informed and unmet needs are detected. Patients and participating caretakers should be well informed about their SCP, signs for relapse, late effects, how to deal with it and who to address to in the future. During the follow-up these issues should be addressed repeatedly. With the shift of follow-up care to the primary setting it is very important nurses and other caretakers are properly trained in cancer survivorship care. Conclusion: The results of this shared care study in TCS will determine whether shared-care follow-up is safe and feasible. Survivorship care by means of a shared care model in collaboration with the primary healthcare professionals should be combined with a proper education and training program. No conflict of interest.
52 Healthy diet and lifestyle for cancer patients A. Anderson1 . 1 University of Dundee – School of Nursing and Midwifery 11 Airlie Place, Centre for Public Health Nutrition Research Level 7, Dundee, United Kingdom For patients living with cancer, healthy ways of life offer an opportunity to improve treatment outcomes, quality of life, fatigue, psychological and physical health and well-being. As the number of cancer survivors increase it becomes increasingly important to “stack the odds” against cancer recurrence, future primary tumours and lifestyle related morbidities. In addition to avoiding tobacco, The American Cancer Society and World Cancer Research Fund highlight the importance of achieving and maintaining a healthy body weight, engaging in physical activity (whilst avoiding inactivity) and following a dietary pattern that is rich in fruits, vegetables and whole grains with low intakes of alcohol, red and processed meat. No long term trials have yet reported on the impact of weight loss interventions on cancer survivorship, but observational data suggest reduced morbidity in breast and colorectal cancers and the WINS study demonstrated modest effects on relapse free survival of breast cancer patients. The impact of improvements on cancer outcomes by increased physical activity look promising based on biomarker data but have yet to be confirmed by recurrence trials. Current evidence suggests that attaining the goals of lifestyle recommendations are unlikely to be harmful. Patient views on lifestyle advice range from scepticisms over the relevance, misunderstanding (generated by media and supplement companies) and annoyance over health care providers failing in their duty of care when advice and support is not provided. Cancer Health Care Professionals often face difficulties in raising the challenge of obesity management, citing personal issues, lack of time, training and anxieties about impacting on patient relationships by discussing the (diet and physical activity) issues involved. Sensitive, well-informed, practical strategies have been demonstrated to initiate behavioural changes in cancer patients but evidence based approaches and protocols for good practice have not yet been widely disseminated and implemented. Ensuring that treatment plans include personalised lifestyle dimensions offer patients the opportunities to maximise health gain beyond drug therapies. No conflict of interest.
Parallel Session: EAUN / EONS: Prostate Cancer 53 Unmet needs in prostate cancer patients in Europe No abstract received. No conflict of interest information specified. 54 Nursing education to increase patient care No abstract received. No conflict of interest information specified.
S15
Parallel Session: SIOPE / EONS: Follow up and Psychological Needs of Young Adult Cancer Survivors 55 Developing leadership and networks in young adult oncology: report from first EONS/TCT Leadership summit No abstract received. No conflict of interest information specified. 56 Shared care, better care! S. Bunskoek1 , H. Boer1 , J.A. Gietema1 . 1 University Medical Center Groningen, Department of Medical Oncology DA 11, Groningen, Netherlands Introduction: The still increasing numbers of cancer survivors is an important health care issue for hospital-based and primary care. Among these survivors is a large number of testicular cancer survivors (TCS). International guidelines describe a clear and intensive follow up to monitor relapse and late effects, traditionally performed at specialized hospitals. Because of the growing number of survivors, cost of healthcare and higher expectations of quality of care it is important to determine the optimal model and best place to deliver appropriate follow up care. A prospective study has been initiated to evaluate the feasibility of a shared care followup strategy with the expertise of the oncology centers and the primary care physicians (PCP) combined in the follow-up of TCS. A survivorship care plan (SCP), consisting of an end-of-treatment summary and a personal follow-up plan, is mandatory and enables patients and their doctors to collaborate in a shared-care model. The patient can be in control of his own follow-up. The use of new information technologies can optimize the way patients can navigate their own shared-care follow-up. Method: Eligibility criteria are complete remission after chemotherapy for metastatic testicular cancer and age >18 years at start of follow-up. A personalized SCP is generated and discussed by the oncologist and nurse practitioner with both the patient and his PCP. The SCP defines the time-points in follow-up at which the PCP checks for e.g. cardiovascular risk and psychosocial well-being. Primary endpoints of the study are the safety and feasibility of shared-care follow-up. Results and Discussion: The study started in January 2013; 90 patients are participating at this moment. Both patients and their PCP are very motivated to participate. For optimal survivor care it is very important dedicated nurses are involved in follow up right from the start. Beside the risk of a tumor relapse and late effects like second cancers and cardiovascular disease, cancer survivors face many psychosocial issues. It can only be successful if the patient has a central role in it with appropriate responsibility. When follow-up formally starts it is crucial they are well informed and unmet needs are detected. Patients and participating caretakers should be well informed about their SCP, signs for relapse, late effects, how to deal with it and who to address to in the future. During the follow-up these issues should be addressed repeatedly. With the shift of follow-up care to the primary setting it is very important nurses and other caretakers are properly trained in cancer survivorship care. Conclusion: The results of this shared care study in TCS will determine whether shared-care follow-up is safe and feasible. Survivorship care by means of a shared care model in collaboration with the primary healthcare professionals should be combined with a proper education and training program. No conflict of interest.