Programme for cancer survivors could be a model

A New Zealand-first cancer survivorship programme in Dunedin which dispenses free GP visits could be a model for others, facilitator Dr Sue Walthert says.

Bridge to Health was different from other post-cancer programmes as it involved GP care, rather than dispensing general ''living well'' advice.

Increasingly, GPs are involved with oncology, and the programme included three vouchers for GP visits. Attending a GP as a follow-up to cancer treatment was affected by perceptions that GPs knew less than specialists. Also, unlike GPs, hospital appointments were free. This was why the programme attracted $60,000 from the disestablished Well Dunedin Primary Health Organisation, used solely for the vouchers. A long-term funding solution was needed if the programme became permanent.

The initiative had strong links with oncologists, one of the groups that could refer to the programme.

Dr Walthert, a breast cancer survivor, has written a paper based on a programme audit which she hopes to publish in a medical journal.

The programme strongly extols the benefits of exercise.

The biggest single barrier reported by participants was a lack of exercise programmes for them in Dunedin, she said.

With the exception of Expinkt, a University of Otago school of physical education breast cancer exercise project, opportunities were scarce. Bridge to Health participants attend a seminar covering cancer survivor evidence. The seminar helped ''normalise the awful'', and introduced a series of four subsequent workshops.

The workshops were nutrition; physical activity; sexuality and intimacy; emotional and spiritual.

Participants were grateful for the straightforward approach, which included talking about embarrassing things and ''not hiding from difficult topics'', she said.

Participants found the spiritual section the most confronting, although most misgivings were allayed once the concept was explained. Spirituality pertained to activities people found meaningful, rather than holding religious connotations.

Dr Walthert would like to see the programme developed in Central Otago and Southland, and would not be surprised to see similar programmes emerge in other parts of the country.

She has recommended refinements including streamlining the referral process, raising awareness with the health sector and NGOs, and encouraging the development of resources for GPs to use when working with cancer survivors.

eileen.goodwin@odt.co.nz