One of the biggest challenges of surviving breast cancer is not the physical recovery, but recovery from the experience of having cancer. It can last years after everything has healed in the body.
An emerging area in the health-care field is "cancer survivorship," a treatment approach focusing on a patient's overall healing and not solely on getting rid of the cancer.
As Dr. Amy Shaw explains it, "A survivorship program partners with a patient's primary-care doctor and is the bridge between the cancer world and the rest of your life."
Shaw, formerly medical director of Sutter Pacific Medical Foundation's Women's Health Center, joined Redwood Regional Medical Group in Santa Rosa in June and has created its new Cancer Survivorship Program.
The goals of the Cancer Survivorship Program are two: staying well during treatment and strategizing what to do to achieve optimum health afterward.
Shaw is helping coordinate care for people who have finished treatment and is doing ongoing evaluation for treatment side effects, including late-onset problems such as heart disease or skin disorders that may surface several years after surgery, radiation or chemotherapy.
She and nurse practitioner Marlene Lennon are also asking patients about their quality of life before getting cancer and about prior medical issues.
When people complete cancer treatment, their appointments with cancer specialists typically may end and their care is entrusted to a primary-care doctor. A key part of the Cancer Survivorship Program is educating those physicians about health issues that might arise in patients who have had cancer.
While the Survivorship Program is for anyone who has had cancer, Shaw said the biggest need is among patients just finishing treatment or those who might halt treatment before they're completely done. She expects many of her patients in the new program will have had breast cancer, but the services are open to people who've had any type of cancer.
Clinical psychologist Cynthia Wilcox-Rittgers of Petaluma was diagnosed with breast cancer in 2007, and she was excited when she heard about the survivorship program. She described it as a way to link her primary care with her oncology care.
"My medical oncologist left the area, and after that I felt like I was falling through the cracks," Wilcox-Rittgers said.
"The concept of being done is fuzzy," said Wilcox-Rittgers, who facilitates a cancer support group in Petaluma. "I teach other cancer patients to keep informed and look for what they need."
She said symptoms can crop up after initial treatment, and many people give up on hormone treatments because "it's so challenging to be on medicine. This is why it's so important to have doctors like Amy Shaw who really understand the issues. She knows so much about what we're facing.
"She's exactly what I need now. I don't need a full-fledged oncologist," she said.
A key element of the Cancer Survivorship Program is a summary of cancer history that Shaw prepares for clients. Shaw created the detailed four-page report to pull together in one document precisely what cancer they had, what treatment took place and what the person can do to reduce the chance of reoccurrence. This is also a useful tool for primary-care doctors to have as they follow a patient's future care following cancer.
"It's a template to know what you had. Care is fragmented and patients don't know what happened to them," she said.