Cancer follow-up care in New Brunswick: cancer surveillance, support issues and fear of recurrence

Can J Rural Med. Spring 2004;9(2):101-7.

Abstract

The purpose of this study was to find out, from the patient's perspective and using qualitative methodology, how cancer follow-up care is managed in a New Brunswick health region. From focus group discussions with 23 participants 1-year post-cancer diagnosis, 3 prominent themes emerged: fear of recurrence, cancer surveillance/testing and support issues. The fear of recurrence permeates day-to-day life for many patients. To allay these fears, some patients feel a need to be subjected to extensive cancer surveillance. Emotional support, which is important for survivors, is complex. The majority of the participants in this study received cancer follow-up care from specialists. More rural than urban participants received their follow-up care from their family physicians (FPs). Participants had high expectations for follow-up care, regardless of which type of physician--specialist or FP--provided it. If physicians did not provide the level and intensity of care expected by their patients, they were considered uncaring. We advocate a "transition of care" or "shared care" protocol between the acute cancer treatment provider and the FP, particularly in rural areas. This would ensure that cancer patients have a clear understanding of where to turn for ongoing surveillance, when they fear cancer recurrence or need support. For optimized cancer follow-up care, physicians must be cognizant that careful emotional and clinical management over an indefinite period of time is required, and they must recognize the individual needs of each patient.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aftercare*
  • Aged
  • Fear
  • Female
  • Focus Groups*
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / psychology
  • Neoplasms / psychology
  • Neoplasms / therapy*
  • New Brunswick
  • Physician-Patient Relations
  • Physicians, Family
  • Rural Population
  • Social Support
  • Socioeconomic Factors
  • Time Factors
  • Urban Population