Cancer Rehabilitation and Survivorship: Transdisciplinary Approaches to Personalized Care

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Foreword xvii
Section I. Evolution of Survivorship Care 1
Chapter 1. Personalized Cancer Care 3
Introduction 3
Personalized Cancer Care 3
References 5
Chapter 2. From Anecdote to Evidence: The Survivor's Perspective 7
Introduction 7
Once Upon a Time 8
Down the Winding Road 8
Transforming Wounds 9
Survivors Unite 10
The Never-Ending Story 10
Improving Survivorship Care 11
From Surviving to Thriving 13
References 14
Chapter 3. The Paradigm Shift to Survivorship Care Planning 15
Introduction 15
State of the Science 16
Survivor Care Planning: Creation, Delivery, and Outcomes 17
National Activities and Publications 17
Guidelines for Survivorship Care 19
Summary 21
References 21
Chapter 4. Survivorship Care Settings 25
Introduction 25
Planning for Survivorship Care 25
Cancer Survivorship Care Settings 28
Summary 30
References 31
Section II. Physical Challenges of the Cancer Survivor 33
Chapter 5. Pain and Discomfort 37
Introduction 37
Pain Syndromes in Cancer Survivors 37
Painful Comorbidities 41
Pain Assessment in Cancer Survivors 41
Pain Management in Cancer Survivors 42
Case Study 46
Summary 46
References 46
Chapter 6. Chemotherapy-Related Cognitive Changes 49
Introduction 49
Factors Associated With Changes in Cognitive Function 50
Hypotheses for Causality 51
Issues With Assessment 52
Multidisciplinary Care 53
Case Study 53
Summary 55
References 55
Chapter 7. Skin and Mucosal Changes 59
Introduction 59
Dermatologic Changes Related to Cancer Treatment 59
Case Study 66
Summary 67
References 67
Chapter 8. Optimizing Bone Health in Adult Cancer Survivors 69
Introduction 69
Risk Factors for Bone Loss 69
Mechanisms of Bone Loss 70
Measurement of Bone Mineral Density and Bone Loss Risk Assessment 72
Management of Osteopenia and Osteoporosis 73
Toxicities of Treatment 73
Case Study 74
Summary 75
References 75
Chapter 9. Neuropathies in Cancer Survivors 79
Introduction 79
Clinical Factors 79
Prevention and Treatment 83
The Influence of Neuropathy on Overall Survivorship 84
Case Study 85
Summary 86
References 86
Chapter 10. Cardiopulmonary Challenges 89
Introduction 89
Cardiotoxicity From Cancer Treatments 89
Prevention of Treatment-Induced Cardiotoxicity 92
Monitoring for Cardiotoxicity 93
Management of Treatment-Induced Cardiotoxicity 93
Pulmonary Toxicity From Cancer Treatments 94
Monitoring of Pulmonary Toxicity 95
Prevention and Management of Pulmonary Toxicity 95
Case Study 96
Summary 96
References 98
Chapter 11. Cancer-Related Fatigue and Sleep-Wake Disturbances 101
Introduction 101
Fatigue 102
Sleep-Wake Disturbances 106
Case Study 109
Summary 110
References 110
Chapter 12. Chronic Gastrointestinal and Genitourinary Symptoms 113
Introduction 113
Altered Gastrointestinal Motility 114
Altered Genitourinary Function 117
Case Study 119
Summary 120
References 120
Chapter 13. Sexuality and Reproductive Issues 123
Introduction 123
Rebuilding Romantic Relationships 123
Reclaiming Pleasurable Sensations 124
Reestablishing Body Self-Esteem and Rediscovering Relaxation 125
Reintroducing Eroticism 125
Case Study One 126
Recovering the Possibility of Biologic Parenthood 126
Case Study Two 128
Case Study Three 129
Summary 130
References 130
Chapter 14. Lymphedema Following Cancer Treatment 133
Introduction 133
Background 133
Quality of Life 138
Case Study 138
Summary 140
References 141
Chapter 15. Reproductive Hormonal Imbalances in Adult Cancer Survivors 145
Introduction 145
Pathophysiology and Risk Factors 145
Assessment and Management 148
Cardiovascular Disease and Risks After Cancer Treatment 151
Summary 156
References 156
Section III. Psychosocial Challenges of the Cancer Survivor 161
Chapter 16. Anxiety and Uncertainty 165
Introduction 165
Diagnosis and Assessment 167
Interventions 168
Summary 171
References 172
Chapter 17. Post-Traumatic Stress and Post-Traumatic Growth in Cancer Survivors 175
Introduction 175
Post-Traumatic Stress Disorder 176
Post-Traumatic Growth 179
Summary 181
References 181
Chapter 18. Assessing Risk for Potential Substance Abuse With Opioid Therapy 185
Introduction 185
Differentiation of Cancer Survivors From Other Pain Populations 186
Opioid Use in Survivors With or Without Histories of Abuse and Addiction 187
What Is Addiction? 187
Summary 191
References 191
Chapter 19. Depression and Suicide in Long-Term Cancer Survivors 195
Introduction 195
Prevalence and Risk of Depression in Long-Term Cancer Survivors 196
Suicide and Suicide Ideation in Long-Term Cancer Survivors 198
Screening and Assessment of Long-Term Cancer Survivors 199
Assessment and Referral 200
Resources for Survivors With Psychological Concerns 201
Summary 202
References 202
Chapter 20. Spirituality and Cancer Survivorship 205
Introduction 205
Spirituality as a Source of Comfort 205
Spirituality as a Resource in Cancer Survivorship 206
How Do We Explain the Impulse to Spirituality? 206
Spirituality and the Biopsychosocial Model of Cancer Care 208
Considerations for Addressing Spiritual Issues With Patients 209
Personalized Cancer Care 209
Final Reflections: My Spiritual Journey Through Cancer 210
Summary 211
References 212
Chapter 21. Transitioning to End of Life 215
Introduction 215
End-of-Life Discussion 216
Advance Care Planning 219
Hospice 220
Case Study 221
Summary 222
References 222
Section IV. Practical Issues for Survivors 225
Chapter 22. Personalizing Information to Meet Survivors’ Needs 229
Introduction 229
Common Sources for Information 229
Common Information Needs 230
Examining Ways of Personalizing Information Needs 232
Summary 234
References 237
Chapter 23. Economic Burden of Cancer Survivorship in the United States 239
Introduction 239
Components of the Economic Burden of Cancer 239
Future Directions 244
Summary 246
References 246
Chapter 24. Employment and Cancer Survivorship 249
Introduction 249
Balance of Work and Treatment 249
Disclosure of Cancer Diagnosis and Symptoms 250
Family and Medical Leave Act 251
Long-Term Employment 251
Cancer-Related Disability 252
Social Resources at Work 253
Health Insurance 253
Summary 253
References 255
Section V. Maximizing Health Outcomes for the Cancer Survivor 259
Chapter 25. Recurrence and Second Primary Cancers 263
Introduction 263
Nonmodifiable Risk Factors 263
Modifiable Risk Factors 265
Summary 269
References 269
Chapter 26. Nutrition and Cancer Chemoprevention Within an Integrative Health Promotion Model 273
Introduction 273
Cancer Prevention and Survivorship 274
Case Study 279
Summary 280
References 281
Chapter 27. Motivation for Lifestyle Changes After Cancer 285
Introduction 285
Exercise Adoption 286
Dietary Change 287
Multiple Behaviors: Exercise With Dietary Change 288
Smoking Cessation 289
Summary 290
References 291
Chapter 28. Promoting Inner Strength 295
Introduction 295
Theory of Inner Strength in Women 296
Case Study 303
Summary 304
References 304
Chapter 29. Healthy Lifestyles in Cancer Survivorship: Personalized Approaches to Change and Maintenance 307
Introduction 307
Individual Differences in Healthy Lifestyles Among Survivors 308
Individual Differences in Survivors’ Health Behaviors 308
A Personalized Approach to Facilitate Survivors’ Healthy Lifestyles 311
Nurses Facilitating Adaptive Change 312
Summary 312
References 313
Chapter 30. Mind-Body Wellness and Integrative Medicine 317
Introduction 317
Integrative Medicine Affirms the Whole Person 318
Mindfulness-Based Stress Reduction 320
Mindfulness in Motion: A Mind-Body Approach for Cancer Survivors 322
Summary 323
References 323
Chapter 31. Empowering Survivors Through Expressive Arts 327
Introduction 327
Moving Beyond Traditional Psychosocial Support 328
Transforming Trauma and Empowering Survivors Through Expressive Arts 329
Trusting the Process and Discovering Meaning 330
Case Study 332
Summary 333
References 334
Section VI. Survivorship Care, Now and in the Future 337
Chapter 32. Survivorship Education: Professional Education Needs 341
Introduction 341
Survivorship Care Content 341
Principles of Adult Learning 342
Developing the Survivorship Education Program 343
Evaluating the Survivorship Education Program 345
Summary 347
References 347
Chapter 33. Theoretical Framework for Survivorship 349
Introduction 349
Models Related to Cancer Survivorship 350
A Biopsychosocial Model of Cancer Survivorship 354
Summary 355
References 355
Chapter 34. Cancer Survivorship Care Plans 359
Introduction 359
Key Terms 360
Survivorship Care Plan 361
Barriers in the Provision of Survivorship Care Plans 365
Summary 368
References 368
Chapter 35. Survivorship Care for People With Metastasis 371
Introduction 371
Healthcare Disparities and Patients With Metastasis 372
A Challenging New Paradigm: Palliative Cancer Care 374
Palliative Cancer Care as a Chronic Disease Management Approach 375
Case Study 377
Summary 378
References 378
Chapter 36. Survivorship Issues in the Geriatric Population 381
Introduction 381
Impact of Aging on Health Status 382
Side Effects of Cancer Treatment With Older Adults 382
Geriatric Syndromes 386
Summary 387
References 387
Chapter 37. Survivorship Advocacy 391
Introduction 391
The Six Basic Advocacy Skills 392
Using Advocacy Skills Across a Continuum 394
The Importance of Being an Advocate 396
The Role of Healthcare Professionals in Advocacy 397
Integrating Advocacy Training Into Practice 398
Summary 398
References 399
Chapter 38. Patient Navigation Across the Continuum of Care 401
Introduction 401
History of Patient Navigation 401
Evidence for Patient Navigation 402
Recommendations for Use of Patient Navigators Across the Cancer Care Continuum 406
Summary 407
References 407
Chapter 39. The Promise of Healthy Survivorship 409
Introduction 409
Healthy Survivorship 410
The Three-Step Approach to Personalized Care in Healthy Survivorship 410
Meaning and Happiness 415
Summary 416
References 416
Chapter 40. Cancer Survivorship Care in the Future 417
Introduction 417
Paradigm Shifts in Cancer Survivorship Care 418
Successful Survivorship Care Planning 418
Cancer Rehabilitation as the Foundation for Cancer Survivorship Care 419
Reducing the Burden of Unmet Psychosocial Needs Through Survivorship Care Planning 420
Empowering Survivors Through Health Promotion 421
Enhanced Cancer Survivorship Care 422
Summary 423
References 423
Appendices 427
Appendix A. Progress Toward Identifying and Meeting Cancer Survivors’ Needs, With a Focus on Nursing 429
Appendix B. Recommendations From the State of the Science on Nursing Approaches to Managing Late and Long-Term Sequelae of Cancer and Cancer Treatment 431
Appendix C. Master Tactical Plan: Identifying Ways Nurses Can Help to Improve Outcomes Among Survivors of Adult Cancers 432
Appendix D. Multidimensional Cancer Survivorship Agenda for Nursing 433
Appendix E. Organizing Framework for Understanding Cancer-Related Fatigue in Cancer Survivors 434
Appendix F. Fatigue Survivorship Care Plan 435
Appendix G. Insomnia Survivorship Care Plan 437
Appendix H. Fertility Options 439
Appendix I. Practice and Selected Treatments for Lymphedema 440
Appendix J. Follow-Up Resources for Survivors With Psychological Distress 442
Appendix K. Mental Health Teaching Sheet for Depression and Suicide Risk 444
Appendix L. A Prescription for Living 447
Appendix M. Sample Cancer Treatment Plan and Summary 449
Appendix N. Colon Cancer Adjuvant Treatment Plan and Summary 452
Appendix O. Colon Cancer Survivorship Care Plan 454
Appendix P. LIVESTRONG™ Care Plan Results for Breast Cancer 455
Appendix Q. Survivorship Care Plan for Breast Cancer 468
Appendix R. Selected U.S. Adult Invasive Cancers, Survival Rates and Distribution by Stage, and Advanced-Stage Survival Rates 479
Appendix S. Selected U.S. Adult Invasive Cancers, Overall Survival Rates, and Advanced-Stage Survival and Mortality Rates 481
Appendix T. Skills for Attaining Quality Cancer Care 483
Index 485
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