People with disabilities

Disability, which can be physical, intellectual or psychological, may have existed before the cancer diagnosis or may be new in onset (occurring due to the cancer treatment or incidentally). Adjusting to life with a disability adds another challenge to cancer care and survivorship. Several barriers prevent people with disabilities from accessing timely and effective health…

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5.1 Transitioning from active treatment

The transition from active treatment to post-treatment care is critical to long-term health. In some cases, people will need ongoing, hospital-based care, and in other cases a shared follow-up care arrangement with their general practitioner may be appropriate. This will vary depending on the type and stage of cancer and needs to be planned. Shared…

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7.2 Research and clinical trials

Clinical trials may help improve palliative care and in managing a patient’s symptoms of advanced cancer (Cancer Council Victoria 2019). The treatment team should support the patient to participate in research and clinical trials where available and appropriate. For more information visit the Cancer Australia website. See ’Resource list’ for additional clinical trial databases.

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5.2 Follow-up care and survivorship care plan

Responsibility for follow-up care should be agreed between the lead clinician, the general practitioner, relevant members of the multidisciplinary team and the patient. This is based on guideline recommendations for post-treatment care, as well as the patient’s current and anticipated physical and emotional needs and preferences. The options for follow-up should encompass the following: A…

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6.3 Multidisciplinary team

If there is an indication that a patient’s cancer has returned, care should be provided under the guidance of a treating specialist. Each patient should be evaluated to determine if referral to the original multidisciplinary team is necessary. Often referral back to the original multidisciplinary team will not be necessary unless there are obvious aspects…

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7.1 Multidisciplinary palliative care

If the treatment team does not include a palliative care member, the lead clinician should consider referring the patient to palliative care services, with the general practitioner’s engagement. This may include inpatient palliative unit access (as required). The multidisciplinary team may consider seeking additional expertise from these professionals: clinical psychologist clinical nurse specialist or practitioner…

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6.4 Treatment

Treatment will depend on the location, extent of recurrent disease, previous management and the patient’s preferences and may include all modalities of therapies (surgery, radiation therapy and systemic therapy). Antiresorptive therapy may be warranted if bone metastases are present. In most cases, a combination of anti-cancer and supportive therapies will provide the most effective overall…

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6.7 Research and clinical trials

The treatment team should support the patient to participate in research and clinical trials where available and appropriate. For patients with metastatic breast cancer, participation in clinical trials should be revisited by the multidisciplinary team due to alterations in the patient’s disease such as resistance to current treatment or new trials available. For more information…

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6.5 Advance care planning

Advance care planning is important for all patients with a cancer diagnosis but especially those with advanced disease. Patients should be encouraged to think and talk about their healthcare values and preferences with family or carers, appoint a substitute decision-maker and consider developing an advance care directive to convey their preferences for future health care…

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