As part of our celebration of 10 years of the Nassif Community Cancer Center, our team members will give an inside look into the services available to our patients and how they can help them along the cancer journey. Next up is Survivorship Nurse Practitioner Heather Dommer, ARNP, FNP-C, MSN, sharing more about the role of Survivorship services in a cancer patient’s care.
What does a Survivorship Nurse Practitioner do?
The Institute of Medicine identifies four domains of comprehensive cancer survivorship care. They include surveillance for new/recurrent cancers, management of late or long-term effects, risk reduction/prevention, and monitoring psychosocial functioning. At the Nassif Community Cancer Center we focus on:
- Coordination of care between specialists and primary care
- Education regarding cancer
- Prevention – promoting healthy behaviors through nutrition and exercise
- Surveillance – screening for new or recurrent cancers
- Intervention – symptom management of late or long-term side effects
I typically have 2 roles in the survivorship clinic:
- Survivorship Care Plans
- Long-term follow-up care.
When I see a patient for a care plan visit, I provide them with a written copy of a summary of their diagnosis and treatment, a plan for follow-up and surveillance, and a list of services available to them at the Community Cancer Center. I will then discuss specific concerns that they are having related to their cancer treatment and offer referrals or treatments to help with this. We also talk about healthy living such as diet and exercise recommendations.
When I see a patient in long-term follow-up care this is usually after they have been seen for follow-up with their primary oncologist for about five years. I would then take over ordering scans, labs, and doing clinical follow-up for any signs of recurrence or new cancers.
What are some of the unique needs cancer patients have that Survivorship Nurse Practitioners help with?
- Emotional concerns: Feeling nervous, anxious, or on edge. Feeling down, depressed, or hopeless. Lack of interest or pleasure in doing things. Body image/appearance concerns.
- Family concerns: concerns for family members, family relationships, family health issues, ability to have children.
- Nutritional concerns: poor appetite, unplanned weight loss or gain
- Spiritual concerns: loss of hope, loss of meaning of life, feeling disconnected
- Physical concerns: fatigue, weakness, balance/mobility, neuropathy (tingling in hands and feet), lymphedema, pain, headaches, memory/concentration (chemo brain), sleep, changes in sexual functioning, constipation, diarrhea, nausea, swallowing, shortness of breath, cardiac dysfunction, swelling, hot flashes, bone health
Hear From Our Experts
Heather Dommer, survivorship nurse practitioner at the Nassif Community Cancer Center, joins Dr. Arnold to discuss cancer survivorship. What it is, what services are offered for survivors, how the pandemic affected survivorship services and more.
How has the role of Survivorship Nurse Practitioner grown at the Community Cancer Center since the Survivorship Program began in 2015?
We continue to grow the program as much as possible. Our goal is to offer survivorship to every patient. We have developed a specific working group for the survivorship clinic that meets quarterly to work on new initiatives and pilot new interventions for getting patients seen in the survivorship clinic and for new treatment options for the late and long-term effects that occur. In 2019, we saw a large growth in the number of patients seen in the clinic. However, like most clinics our 2020 numbers were down due the COVID-19 pandemic. So far, in 2021 we are on track to get back to our 2019 numbers. I have also grown in my role as the survivorship nurse practitioner and began writing a specific survivorship article for our monthly newsletter this year. I am also participating in a national survivorship group called the Cancer Survivorship Provider Network. This group provides an educational meeting once a month along with a business meeting once a month to provide further resources and information for others providing cancer survivorship care throughout the country.
How do you see your role advancing in the next 10 years?
I hope to see more research being done in the area of cancer survivorship. Right now we still do not have a lot of good interventions to help manage cancer treatment related side effects, such as neuropathy, fatigue, pain, hot flashes, and cognitive dysfunction. I hope that more research will focus on this important topic. I also feel like the Cancer Survivorship Provider Network will help us to be able to connect with others who are doing this very important work. As advancements in cancer treatment continue we will continue to see more people in need of cancer survivorship care.
What is your favorite thing about being an Survivorship Nurse Practitioner?
My favorite thing is meeting new people and sharing in their journeys. My favorite role is that of educator.
ARNP, FNP-C, MSN
Heather has been a Survivorship Nurse Practitioner with the Community Cancer Center since October 2018.