Moncrief Cancer institute proposes an evidence-based, community-led survivorship program that addresses the psychosocial/ behavioral and medical needs of Fort Worth cancer survivors, particularly those in medically underserved areas.
uT Southwestern/Moncrief Cancer institute will lead an innovative effort to unite the major cancer care providers and agencies within Fort Worth to establish an evidence-based, coordinated, cancer survivorship program. This multi-disciplinary program, known as The Fort Worth Program for Community Survivorship (ProComS), will be available to all cancer survivors in Fort Worth and surrounding rural communities who meet enrollment criteria.
The maximum number of subjects to be consented for this protocol is 5000.
a limited number of subjects will be consented to participate in a Cardio-oncology sub-study. Due to limited funding the maximum number of cancer survivors to be consented for the sub-study is 115.
ProComS aims to establish a survivorship program dedicated solely to the ongoing physical, psychosocial and behavioral needs of all cancer survivors in Fort Worth and some rural counties, with special emphasis toward engaging the uninsured, underinsured and medically underserved. This Survivorship program, the first of its kind in Fort Worth, will be staffed by a Survivorship nurse, a Survivorship navigator, and a Clinic assistant. Bilingual (english/Spanish) staff will be available. ProComS will serve as the [Quote]next stop[Quote] following primary treatment on the survivor's journey into survivorship. in an effort to reduce disability, restore function, facilitate behavior change, and improve quality of life, survivors will be provided post-treatment needs assessments accompanied by survivor intervention plans, as well as coordinated referrals to evidence-based tertiary services. This program will place primary focus on psychosocial and behavioral needs as well as medical needs including the promotion of healthy behaviors for the cancer survivor.
The ProComS clinic will utilize a psychosocial/medical model to focus on the survivors' psychosocial/behavioral needs and medical needs and incorporate the four essential components of care. They include: 1) prevention of recurrent and new cancers, and of other late effects; 2) surveillance for cancer spread, recurrence or second cancers; assessment of medical and psychosocial and behavioral late effects; 3) intervention for consequences of cancer and its treatments, for example: a) psychological distress experienced by survivors and caregivers; b) concerns related to employment, insurance, disability; c) nutritional and dietary concerns; d) tobacco cessation; e) and physical effects of treatment such as cardiotoxicity, lymphedema, sexual dysfunction, pain and fatigue; and 4) coordination between specialists and the patient's primary care physician to ensure all health concerns are addressed. 
in addition, an aggregate analysis from a limited dataset of non-study participant demographics, and limited medical history including diagnosis, cancer treatment and treatment-related side effects will be conducted.
A. Cancer Survivor Group:
1. Any cancer survivor that is calculated at 30 days prior to and 30 days following the last primary treatment date. This timeframe will be the segment targeted for recruitment, but anyone that has been diagnosed with cancer and has completed primary treatment will be eligible to participate in the program as well.
2. Both men and women 18 years of age and over that are cancer survivors (English or Spanish speaking) are included in the study.
B. Cardio-Oncology Sub-group:
1. The same criteria listed in 1 and 2 above AND
2. Treatment included Adriamycin, Herceptin, Taxotere or Taxol and/or
3. Treatment included chest radiation
C Cancer Predisposition Syndrome Group:
1. Any patient diagnosed with a cancer predisposition syndrome based on genetic mutation: and referred by a UT Southwestern genetic counselor.
1. Both men and women 18 years of age and over (English or Spanish speaking) are included in the study.