Survivorship Care for Cancer Survivors

(CASCADE Trial)

Overseen By Bijal Balasubramanian, MBBS, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: The University of Texas Health Science Center, Houston

Disqualifiers: No cancer history

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

5584 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

The purpose of this study is to implement a clinic-level cancer survivorship care delivery intervention in partnership with community health center clinicians, patients, and community representatives to test effectiveness of the intervention to improve patient and clinician outcomes and to evaluate implementation of the intervention using an iterative, concurrent mixed-methods approach guided by the Practice Change Model.

Do I need to stop my current medications for this trial?

The trial information does not specify whether you need to stop taking your current medications.

Is survivorship care for cancer survivors safe?

The research articles do not provide specific safety data for survivorship care, but they focus on improving care coordination and communication for cancer survivors, which suggests a focus on enhancing patient well-being. ^{1 2 3 4 5}

How is the Survivorship care delivery intervention treatment different from other treatments for cancer survivors?

The Survivorship care delivery intervention is unique because it focuses on the ongoing care and support of cancer survivors, addressing their specific needs and concerns after initial treatment. Unlike standard treatments that focus on eradicating cancer, this intervention emphasizes follow-up care, symptom management, and improving quality of life through personalized care plans and support systems. ^{6 7 8 9 10}

What data supports the effectiveness of the treatment Survivorship care delivery intervention for cancer survivors?

Research shows that survivorship care plans (SCPs) can improve patient satisfaction with information and care, and help tailor follow-up care to individual needs, which suggests that structured survivorship care interventions can be beneficial for cancer survivors. ^{10 11 12 13 14}

Who Is on the Research Team?

Bijal Balasubramanian, MBBS, PhD

Principal Investigator

The University of Texas Health Science Center, Houston

Simon Craddock Lee, PhD

Principal Investigator

The University of Kansas Medical Center

Are You a Good Fit for This Trial?

This trial is for individuals who have survived cancer and are receiving care at community health centers. It aims to involve clinicians, patients, and community members in enhancing survivorship care.

Inclusion Criteria

Participants: at least one visit to the Community Health Centers (CHCs) in the prior year

Clinicians: employed clinicians (e.g. physicians, nurses, pharmacists, or other allied health professionals) and non-clinician staff of the participating CHC clinics

Exclusion Criteria

I have never had cancer before.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Control

Clinics operate under control conditions to establish baseline data

6-24 months

Intervention

Implementation of cancer survivorship care delivery intervention

12 months

Follow-up

Participants are monitored for safety and effectiveness after intervention

6 months

What Are the Treatments Tested in This Trial?

Interventions

• Survivorship care delivery intervention

Trial Overview The study tests a new way of delivering care to cancer survivors at clinics. It looks at how effective this approach is in improving outcomes for both patients and doctors using mixed methods guided by the Practice Change Model.

How Is the Trial Designed?

Group I: Step 4 (2 clinics)- 24 months control then 12 months intervention Experimental Treatment 1 Intervention

Group II: Step 3 (2 clinics)-18 months control then 12 months intervention Experimental Treatment 1 Intervention

Group III: Step 2 (2 clinics)-12 months control then 12 months intervention Experimental Treatment 1 Intervention

Group IV: Step 1 (2 clinics)-6 months control then 12 months intervention Experimental Treatment 1 Intervention

Who Is Running the Clinical Trial?

The University of Texas Health Science Center, Houston

Lead Sponsor

Trials

974

Recruited

361,000+

National Cancer Institute (NCI)

Collaborator

Trials

14,080

Recruited

41,180,000+

Published Research Related to This Trial

The Robert H Lurie Comprehensive Cancer Center successfully implemented cancer survivorship care plans (SCPs) for patients completing primary cancer treatment, utilizing clinician and patient feedback to create customized templates that streamline the process.

The SCP templates significantly reduced the time clinicians spent completing them, averaging just 12 minutes, and auto-populated 20% of the required fields, enhancing efficiency and supporting better patient care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Survivorship care planning in a comprehensive cancer center using an implementation framework. Garcia, SF., Kircher, SM., Oden, M., et al.[2016]

The CDC's National Program of Cancer Registries collects comprehensive cancer data on 96% of the U.S. population, which is crucial for understanding cancer incidence, treatment, and outcomes.

Recent advancements in cancer surveillance by the CDC enhance the ability to recruit participants for survivorship research and improve the sharing of treatment summaries, ultimately benefiting cancer survivors and their healthcare providers.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Connecting the Dots: Linking the National Program of Cancer Registries and the Needs of Survivors and Clinicians. Ryerson, AB., Eheman, C., Styles, T., et al.[2019]

There are over 13 million adult cancer survivors in the U.S., but their care is often poorly coordinated, highlighting the need for effective survivorship care plans (SCPs) as recommended by the Institute of Medicine.

Despite the requirement for SCPs by the American College of Surgeons, many cancer centers face significant barriers in implementing these plans, such as time constraints and resource limitations, although research is emerging to support effective delivery models.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Implementing the commission on cancer standards for survivorship care plans. Stricker, CT., O'Brien, M.[2022]

Citations

1. United States pubmed.ncbi.nlm.nih.gov

Impact of an Automatically Generated Cancer Survivorship Care Plan on Patient-Reported Outcomes in Routine Clinical Practice: Longitudinal Outcomes of a Pragmatic, Cluster Randomized Trial. [2015]

2. United States pubmed.ncbi.nlm.nih.gov

ePRO-based individual follow-up care for women treated for early breast cancer: impact on service use and workflows. [2021]

3. United States pubmed.ncbi.nlm.nih.gov

An Analysis of Factors Related to Care Engagement along the Cancer Survivorship Care Continuum for Cancer Survivors in Florida. [2023]

4. England pubmed.ncbi.nlm.nih.gov

Defining a patient-centered approach to cancer survivorship care: development of the patient centered survivorship care index (PC-SCI). [2022]

5. United States pubmed.ncbi.nlm.nih.gov

Implementing survivorship care planning in two contrasting health systems: lessons learned from a randomized controlled trial. [2022]

6. United States pubmed.ncbi.nlm.nih.gov

Leveraging epidemiology and clinical studies of cancer outcomes: recommendations and opportunities for translational research. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

Survivorship care planning in a comprehensive cancer center using an implementation framework. [2016]

8. Netherlands pubmed.ncbi.nlm.nih.gov

Connecting the Dots: Linking the National Program of Cancer Registries and the Needs of Survivors and Clinicians. [2019]

9. United States pubmed.ncbi.nlm.nih.gov

Implementing the commission on cancer standards for survivorship care plans. [2022]

10. United States pubmed.ncbi.nlm.nih.gov

Models of cancer survivorship health care: moving forward. [2018]

11. United States pubmed.ncbi.nlm.nih.gov

Prevalence and correlates of patient-reported symptoms and comorbidities in breast cancer survivors at a tertiary center. [2018]

12. United States pubmed.ncbi.nlm.nih.gov

A Vanguard Approach to the Design and Delivery of Nurse-Led Survivorship Care. [2023]

13. United States pubmed.ncbi.nlm.nih.gov

Survivorship programs and care planning. [2022]

14. United States pubmed.ncbi.nlm.nih.gov

Survivorship care: essential components and models of delivery. [2022]