Authors (including presenting author) :
Chun OK, Wong WL, Wong NS, Cheng MLI, Chan CM, Chan HY, Fung WW
Affiliation :
The Breast Centre, Department of Surgery, Kwong Wah Hospital
Introduction :
Due to the advances in screening and cancer treatment, there is no doubt breast cancer patients have better survival rate and lower risk of recurrence. After active treatment, there is a transition to survivorship phase. However, patients still carry the label of breast cancer survivors and have psychological stress on disease recurrence and health problem. They would also like to have a continuous relationship with the department. Therefore, patients are referred to long term nurse clinic for follow up after discharged from doctor clinic.
Objectives :
This review aimed to evaluate the service of long term nurse clinic in KWH.
Target participants:
1. Female breast cancer patients referred by breast surgeons
2. Disease free for 5 years after completion of treatment
3. Cantonese speaking
Methodology :
In long term nurse clinic, patients would complete the Memorial Symptoms Assessment Scale questionnaires on arrival. Breast care nurse (BCN) would perform assessment including history taking, health assessment, clinical breast examination, psychological assessment and late treatment side-effects. BCN would also promote health and breast awareness, monitor of disease recurrence. Besides, BCN would provide psychological support and refer to other specialty if necessary. Survivorship care plan would be made with patients and follow up was coordinated. In case of suspected cancer recurrence, patients would refer back to breast surgeons for management.
Result & Outcome :
Since 2014, more than 1000 breast cancer survivors with over 4000 attendances were reviewed. < 3% cases referred back to surgeons and < 2% cases confirmed local recurrence or 2nd primary cancer. The 4 most frequently reported physical symptoms were numbness/tingling in hands and feet, pain, lack of energy and difficulty sleeping. The 2 most frequently reported psychological symptoms were worrying and feeling nervous.
In summary, breast cancer survivors still experience a variety of physical and psychological consequences. So, cancer care does not end after treatment. BCN has the privilege to provide education, support and advocacy for breast cancer survivors. The continuity of care improves nurse-patient relationship and survivors are willing to come back yearly for follow up. Moreover, long term nurse clinic can also share part of the caseload of doctor clinic.
