"Oftentimes, we don't have the resources in our low-resource healthcare centers so patients can't access things like a dietitian," said Melinda Stolley, associate director of prevention and control at the Medical College of Wisconsin Cancer Center in Milwaukee.
Survivorship programs are a relatively new concept in oncology care. About 10 years ago, the National Cancer Institute implemented protocols for providers to create survivorship care plans for their patients as an increasing number of patients were surviving cancer. The side effects of their cancer are discussed as well as the importance of maintaining a healthy lifestyle to prevent recurrence.
Big name cancer centers like the University of Texas' MD Anderson have taken the concept a step further and established survivorship clinics for patients, said Dawn Wiatrek, strategic director of cancer treatment access at the American Cancer Society. These clinics have specialists available to help patients create a treatment plan and ensure they keep their health in check. Lifestyle coaching and support groups are also often available.
But community-based cancer centers are frequently strapped for resources and can't provide the same breadth of programs as their academic counterparts, Wiatrek said. "Community cancer centers are moving in the direction of recognizing the importance of survivorship . . . but the incentive isn't always there when you have limited resources."
Because of that, both Wiatrek and Stolley said it's vital for the centers to engage with the community and grass-roots organizations to help their patients.
There is also evidence that community-based approaches work. Prior to joining the Medical College of Wisconsin, Stolley worked at the University of Illinois at Chicago, a safety-net provider located on the city's West Side. There, she piloted a study that evaluated the health outcomes of African-American breast cancer survivors who participated in two lifestyle and fitness programs at local public health facilities over a six-month period. African-American women are 40% more likely to die from breast cancer than white women, and they are more likely to die from the cancer because of co-morbid conditions like diabetes and hypertension, according to the CDC.