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Online Resources


Tips for Understanding Studies
A "toolkit" of lessons for journalists and consumers on assessing medical research.
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Breast Cancer and the Environment: Questions and Answers
A publication for consumers to accompany the Institute of Medicine consensus report

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Oncology Nursing Topic Resource Center  

From the publishers of Oncology & Oncology Nurse Edition.


Continuing Education

Schwartz Rounds 

Second Thursday of the month 12:00 PM  

Second Thursday of the month, 12:00 PM. Lunch is provided. Smilow Cancer Hospital at Yale-New Haven in the Park St. Auditorium (CME)  

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Yale Bioethics Center End of Life Issues Study Group   

77 Prospect Street, Rm A002. See website for full schedule. (CME)

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April 17 - 24 &
November 7 - 13
The Program in Palliative Care Education & Practice [includes pediatric track]. Cambridge, MA. Application deadline:  Feb 6, 2012 (88+ CME)



January  2012       Volume 6 No 1


"When Primary Treatment Ends, the Cancer Journey Does Not"


This month's title was taken from the abstract of The Essential Elements of Survivorship Care: A Livestrong Brief. Livestrong convened a meeting in Washington, DC in September 2011 with the goal of developing consensus on the "essential elements" that post-treatment cancer survivorship programs should contain. The focused delivery of care, specifically during the survivorship phase of cancer, is new to cancer programs. The Essential Elements meeting was a systematic attempt to accelerate the evolution of high quality post-treatment care. The intent was not to develop guidelines or standards. Invited participants-advocates, clinicians, survivors, and other stakeholders-included the Yale Cancer Center Survivorship Program's founding medical director, Ken Miller, MD, and the current Medical Director of the Adult Survivorship Program, Tara Sanft, MD.


Prior to the meeting "element" and "essential" were defined: an element of survivorship care is a descriptor of a healthcare component that is "discrete enough to be actionable" and yet recognizes that there will be variations based on settings and specific populations. An essential element has a positive impact on survivors, can be implemented across settings, and has an evidence base or is amenable to the research required to establish it as evidence-based.


Participants were assigned to heterogeneous groups. Through a series of highly structured exercises over the course of 2 days, a list of 101 possible elements (the "universe of elements") was reduced to 20 elements in three tiers:

  1. "Consensus elements" that the participants agreed are the minimum services that must be provided (directly or through referral)
  2. "High-need elements" that are very desirable, especially for high need survivors
  3. "Strive elements" are additional services that cancer programs should work toward providing


The Tier 1 elements ranked consistently high across groups and were felt to be the most important or minimal components of a survivorship program:

  • Survivorship care plan, psychosocial care plan, and treatment summary
  • Cancer screening and surveillance
  • Care coordination between cancer and primary care providers
  • Symptom management and palliative care

The remaining 15 elements can be found here.


The meeting organizers acknowledge that this meeting was a step in a process and not an end point. Remaining tasks include refining the definitions of the essential elements for clarity and to avoid overlap; research to provide a more substantial evidence base for survivorship care and program design; and integrating survivorship care into practice and overall cancer program structure.


It remains to existing, nascent, and planned survivorship programs to use these findings as one tool in the design and evaluation of their programs and an inspiration for making the survivorship phase part of the mainstream of cancer care.



In the News

Breast Cancer and the Environment: A Life Course Approach
The Institute of Medicine has released a new consensus report,
The study was done at the request of Susan G. Komen for the Cure. The report is available as a free download.  

The primary findings are available in a shorter publication, Breast Cancer and the Environment: Questions & Answers.




The annual report on cancer statistics published by the American Cancer Society shows that cancer deaths continue to decline. There are two ways to access this information:  

Cancer Facts and Figures, 2012 and the annual peer-reviewed journal article, Cancer Statistics, 2012.


Journal Watch



Cramer H, et al. Can yoga improve fatigue in breast cancer patients? A systematic review. Acta Oncol . 2011 Dec 5.

Davison BJ, et al.   Promoting calcium and vitamin D intake to reduce the risk of osteoporosis in men on androgen deprivation therapy for recurrent prostate cancer. Support Care Cancer. 2011 Dec.

Goedendorp MM, et al. Prolonged impact of chemotherapy on fatigue in breast cancer survivors: A longitudinal comparison with radiotherapy-treated breast cancer survivors and noncancer controls.  Cancer. 2011 Nov 15.   



Grunfeld EA, et al. Andropause Syndrome in Men Treated for Metastatic Prostate Cancer: A Qualitative Study of the Impact of Symptoms. Cancer Nurs. 2012;35(1):63-69.  



Phillips KM, et al. Cognitive functioning after cancer treatment: A 3-year longitudinal comparison of breast cancer survivors treated with chemotherapy or radiation and noncancer controls.  Cancer. 2011 Dec 12.  



Ridner SH, et al. Voices From the Shadows: Living With Lymphedema. Cancer Nurs. 2012;35(1):E18-E26.  



Smith SK, et al. Post-Traumatic Stress Symptoms in Long-Term Non-Hodgkin's Lymphoma Survivors: Does Time Heal?  J Clin Oncol. 2011 Dec 1;29(34):4526-33. Read More >>




Palliative and Supportive Care

The Nov-Dec issue of Current Problems in Cancer [2011;35(6)] is devoted to "Multidisciplinary Palliative Care of Cancer Patients." See Table of Contents.



Weir AB, Brint JM. Hope is a verb: A course correction in delivering bad news. Am J Hosp Palliat Care. 2011;28(8):525-527.  





Other Articles of Interest 

Brawley O, et al. New American Cancer Society process for creating trustworthy cancer screening guidelines. JAMA. 2011 Dec 14;306(22):2495-9.  



Lees J, Chan A. Polypharmacy in Elderly Patients With Cancer: Clinical Implications and Management. Lancet Oncol. 2011 Dec 1;12(13):1249-1257.