The increasing numbers of women now surviving early stage breast cancer has led to a need for better 'survivorship care', according to a new Irish study.

The study looked at the physical, psychological, social and spiritual concerns of breast cancer patients following their discharge from hospital.

Due to improvements in early detection, diagnosis, and treatment, the breast cancer death rate in Ireland has reduced by nearly one quarter in the past five years.

Cancer survivorship refers to the stage of cancer care after treatment is finished and how to promote healthy behaviour, management of complications of therapy, and monitoring for signs of recurrence of the cancer.

The authors, from Tallaght and Waterford Regional Hospitals, point out that in Ireland, this stage of cancer care is managed mainly by hospital services. 

The authors point out that hospitals are not always best-placed to provide ongoing care to the growing number of survivors who have completed treatment.

The study of 44 patients found that:
• The commonest physical needs disclosed included: fatigue (51%), and second cancers concerns (69%)
• The most common psychological concern was fear of recurrence, demonstrated in 69% of the patients surveyed.

The authors point out that services that could benefit cancer survivors face major challenges.

These include the increasing numbers of survivors, limited numbers of cancer specialists, health cuts, and 'a disconnect between hospital-based care and community-based resources'.

"As the number of breast cancer survivors continues to grow, a model of comprehensive care is needed to address the specialised needs of this cohort of patients," the authors say.

The authors recommend: " a considerable proportion of survivorship care be delivered by community-based services. Primary care expertise in survivorship care could be supported by the facilitation of direct communication between GPs and cancer specialists as well as further training and access to services."

The study is published in the Irish Medical Journal.