Survivorship Clinic Helps HNC Patients

Advanced practice nurses play a vital role in healthcare delivery at Cleveland Clinic, and nowhere is that more evident than in the hospital system’s survivorship clinic for patients with head and neck cancer (HNC). Launched several years ago, the clinic is run by two nurse practitioners – Bridgett Harr, CPN, from the Radiation Oncology Department, and Joanna Bodmann, CNP, from the Medical Oncology Department.

Bridgett Harr, CPN

All HNC patients who have been treated definitively for their disease and show no evidence of disease (NED) receive follow-up care at the survivorship clinic. “We integrate the clinic into their routine follow-up to provide patients with a treatment summary and survivorship plan that addresses the treatment they received and what they can expect in the future,” Harr explains.

Appointments cover a range of topics

When the survivorship clinic first began, Harr and Bodmann only saw human papilloma virus positive oropharyngeal patients. The value of the clinic was clear, and it recently expanded to include all HNC patients. Physicians typically refer patients to the clinic after their three-month post-treatment appointment. “During that appointment, they have post-treatment scans and see otolaryngology, medical and radiation oncology physicians,” says Harr. “If they are presumed NED, they are sent our way.”

During a patient’s first visit to the clinic, the nurse practitioners review the following:

• The patient’s diagnosis and stage
• Any treatments received, including surgery, radiation and chemotherapy
• The follow-up plan of care, including appointments, imaging and lab work
• Symptoms to watch out for that might indicate cancer recurrence
• Any late effects of the treatment, such as dry mouth, fatigue and memory issues
• Other difficulties that survivors may experience, such as financial concerns, depression and anxiety
• Resources available to survivors at Cleveland Clinic and in the community

“Even though treatment is finished, side effects may linger and many of our patients have an increase in depression and anxiety post-treatment,” says Harr. “Having this opportunity to go over their disease and treatment gives patients the opportunity to reflect on what they have been through as well as validate their feelings.”

Clinic improves healthcare value

Patients typically have follow-up appointments with one of the nurse practitioners every three months for two years. “This practice model can help improve healthcare value for these patients,” says Harr. “Integrating the survivorship clinic into their routine follow-up is cheaper – no extra co-pay – and more convenient for patients.”