Making the transition back to a primary care provider after cancer treatment

When you have been in the care of doctors and nurses who specialize in cancer treatment, transitioning to a provider who does not know all the small details can seem daunting. Sometimes people refer to this feeling of security from oncology specialists as a “safety net.” Many cancer survivors recognize that the transition from receiving care from their oncology team and resuming care with their primary care physician, or “PCP,” can feel scary. This transition can be sudden and lead to feelings of uncertainty.

Coping with a new way of living

Transitioning back to a life after treatment can significantly change your day-to-day activities. Once you have completed treatment, another common worry is that you are not doing anything to fight cancer as you have been for months — or even years. Survivors may begin to experience mental hardships such as anxiety or depression after completing treatment. Moving on from the emotional experience during treatment takes time, mental energy and a strong support system of friends and family.

If you find yourself having trouble with this process, ask people you trust to help you through this transition. Seeking support can be one of the best ways to get through this time —and there’s no shame in asking for help when you need it. In times of hardships, remember that regular moderate exercise may help keep you in a positive state of mind. However, seeking professional counseling can also ease this shift back into the “real world” or towards a “new normal.” These various methods of support may provide you the peace of mind that is often sought after treatment.
 
A visit to the Survivorship Clinic at Swedish Cancer Institute is part of your care; one of the nurse practitioners can help you reflect on where you are now, and what resources might be useful to you. During the visit, you will receive a treatment summary and care plan you can share with your other providers. Clinicians recommend that each patient should have a visit to the Survivorship Clinic as part of their care at Swedish.

Fears of recurrence

It is very common for survivors to be nervous about new health-related symptoms they experience soon after treatment. You have been trained to pay extremely close attention to any signs your body tells you about complications, and changing that mindset takes time.

It is not easy to leave the world of oncology behind, filled with the safety net of medical professionals who are able to give trustworthy clarification and validation that things are going okay.

Worrying about the cancer returning is very common among survivors. New or persisting aches and pains might cause you to assume the worst. Catching a cold or getting a fever can be concerning as well, since you have been living with a compromised immune system during treatment. The Survivorship Program nurse practitioners can provide resources so that you can get help from professionals if you are feeling overwhelmed by worry. Your treatment summary and follow-up care plan can help.

Specialists in oncology are excellent at providing care within their specialty, but they cannot care for all your other medical needs. If you are planning on staying with the same PCP after treatment, keeping in contact during and after treatment will make the transition much smoother. If your PCP is “in the loop” with all the treatments, medications and hardships that you have gone through during your treatment, they will be able to help you make the transition.If you have not seen your regular PCP during treatment, or if you are planning to start seeing a new PCP after your treatment, let them know some background information so they know how to best help you. 

A treatment summary and care plan from the Survivorship Clinic at the Swedish Cancer Institute can be shared with any clinician. Your treatment summary and care plan addresses the following:

• Cancer diagnosis and treatment you received. This includes a detailed diagnosis, specifics about any chemotherapy drugs, surgeries, and radiation therapy, depending on your course of treatment.
• After effects of treatment. Some kinds of treatments are associated with a higher chance of developing other medical conditions later on in life. Monitoring, treating or preventing symptoms from progressing are addressed.
• Other health needs or concerns that came up following treatment. Sometimes life after treatment looks much different than life before treatment for a variety of reasons. Let your clinician know what has changed so they can best help you.

If you would like to learn more about strategies to help you understand your “new normal” or have any concerns about making the transition back to a PCP, please visit the Survivorship Clinic. During your visit, you will review the in-depth summary about the treatment you received and follow-up care with an experienced nurse practitioner who can be a liaison between your PCP and oncology team. This clinic helps address “what’s next” for you and your family/loved ones during this important health transition and can provide resources and referrals specific to your needs.

Reference List
• Cherven, B., Meacham, L. (2011). Primary care providers after cancer treatment. CURE Childhood Cancer Newsletter. Retrieved from Cancersurvivorlink.org
• U.S. Department of Health and Human Services National Cancer Institute (2010). Enhancing life after treatment. Lifelines from the National Cancer Institute. Retrieved from Cancer.gov
• U.S. Department of Health and Human Services, National Cancer Institute (2014). Facing forward: Life after cancer treatment. Patient Education. Retrieved from Cancer.gov
• U.S. Department of Health and Human Services, National Cancer Institute (2014). When someone you love has completed cancer treatment. Patient Education. Retrieved from Cancer.gov

This article is from the Spring/Summer 2017 issue of Life to the Fullest, the newsletter from the Swedish Cancer Institute (SCI) dedicated to those with cancer, cancer survivors, and their family members and caregivers.