{"slug":"access","tag":"access","variants":["access"],"description":"No description yet","count":13,"kinds":{"technology":13},"related":[{"slug":"rejuvenation","tag":"rejuvenation","shared":13},{"slug":"survivorship","tag":"survivorship","shared":13},{"slug":"measurement","tag":"measurement","shared":12},{"slug":"equity","tag":"equity","shared":4},{"slug":"cost","tag":"cost","shared":3},{"slug":"global","tag":"global","shared":2},{"slug":"uk","tag":"uk","shared":2},{"slug":"us","tag":"us","shared":2},{"slug":"australia","tag":"australia","shared":1},{"slug":"germany","tag":"germany","shared":1},{"slug":"nordic","tag":"nordic","shared":1}],"records":[{"id":"rejuv-access-survivorship-care-uk","kind":"technology","name":"After treatment in the UK: personalised care, and follow-up you lead yourself","route":"/technologies/rejuv-access-survivorship-care-uk/","status":"standard-of-care","tldr":"In England the offer has four named parts: an assessment of what you need and a plan written with you, information and support about living well, a summary of your treatment sent to you and your GP, and a review with your GP. Follow-up is increasingly not a routine clinic appointment but a pathway you manage yourself, with tests at set intervals and a route back in."},{"id":"rejuv-access-survivorship-care-us","kind":"technology","name":"After treatment in the United States: the survivorship care plan, and what the trial found","route":"/technologies/rejuv-access-survivorship-care-us/","status":"established","tldr":"The United States answer to life after treatment was a written survivorship care plan, made an accreditation requirement for cancer centres. The randomised trial of it found no benefit on any patient-reported outcome, and the requirement was later replaced with a broader survivorship programme standard."},{"id":"rejuv-access-survivorship-care-germany","kind":"technology","name":"After treatment in Germany: a rehabilitation entitlement, not a leaflet","route":"/technologies/rejuv-access-survivorship-care-germany/","status":"standard-of-care","tldr":"Germany does something no English-speaking country does: it funds a three-week structured rehabilitation stay after cancer treatment as an entitlement, inpatient or full-day outpatient, through the pension insurance system. Retired people and some non-insured relatives can have it too."},{"id":"rejuv-access-survivorship-care-nordic","kind":"technology","name":"After treatment in the Nordic countries: rehabilitation written into the pathway","route":"/technologies/rejuv-access-survivorship-care-nordic/","status":"established","tldr":"Denmark, Norway and Sweden build rehabilitation and a named contact person into the national cancer pathway rather than leaving them to be requested afterwards. Even in tax-funded systems designed around need, the published work finds that socially disadvantaged people take up less of it."},{"id":"rejuv-access-survivorship-care-australia","kind":"technology","name":"After treatment in Australia: a stated model of survivorship care","route":"/technologies/rejuv-access-survivorship-care-australia/","status":"established","tldr":"Australia published a national model setting out what survivorship care should contain: stratified pathways by need, a treatment summary and care plan, a focus on wellness and prevention as well as surveillance, and timely access without unnecessary appointments. Exercise is recommended as part of routine cancer care by the same body."},{"id":"rejuv-access-survivorship-care-lmic","kind":"technology","name":"After treatment in low and middle income countries: mostly nothing","route":"/technologies/rejuv-access-survivorship-care-lmic/","status":"emerging","tldr":"Most people in the world who survive cancer are offered no survivorship care at all. Specialist centres are rare, follow-up is limited, late effects are poorly documented, and the household pays. This is the largest gap in recovery care anywhere, and the one with the thinnest evidence base."},{"id":"rejuv-access-who-misses-out","kind":"technology","name":"Who misses out on recovery care, measured","route":"/technologies/rejuv-access-who-misses-out/","status":"established","tldr":"Every part of recovery care is unevenly distributed, and the pattern repeats: people with less money, less education, more disability, who live further away or whose cancer is less common get less of it. These are measured gaps with sources, not an impression."},{"id":"rejuv-access-rehabilitation-referral","kind":"technology","name":"Referral to rehabilitation: the service most people who need it never see","route":"/technologies/rejuv-access-rehabilitation-referral/","status":"established","tldr":"Physiotherapy, occupational therapy, speech and swallowing therapy and lymphoedema services are the treatments for most of what cancer treatment leaves behind. The measured use of them after cancer treatment is a small fraction of the measured need, and the people delivering them say they were not trained for it."},{"id":"rejuv-access-fertility-preservation","kind":"technology","name":"Who gets told about fertility before treatment, and who does not","route":"/technologies/rejuv-access-fertility-preservation/","status":"established","tldr":"Fertility preservation has to happen before treatment starts, which makes it the most time-critical part of recovery care and the easiest to miss. Published United States rates of even having the conversation range from 9 per cent to 75 per cent depending on where a young woman is treated."},{"id":"rejuv-access-exercise-programmes","kind":"technology","name":"Exercise is the best-evidenced thing on this front, and most survivors are not doing it","route":"/technologies/rejuv-access-exercise-programmes/","status":"established","tldr":"Structured exercise has the strongest evidence of any recovery intervention, including a randomised survival benefit in colon cancer. In a population survey of blood cancer survivors, 46 per cent met neither the aerobic nor the strength guideline and 22 per cent met both, and meeting both was associated with having been to university."},{"id":"rejuv-access-what-it-costs-uk","kind":"technology","name":"What recovery costs in the UK, and what it does not","route":"/technologies/rejuv-access-what-it-costs-uk/","status":"established","tldr":"Cancer treatment makes prescriptions free in England for five years, but a wig is not a prescription and is charged for unless you qualify for help. A third of UK survivors in one survey still reported financial difficulty, which is lower than the United States and a long way from zero."},{"id":"rejuv-access-what-it-costs-us","kind":"technology","name":"What recovery costs in the United States","route":"/technologies/rejuv-access-what-it-costs-us/","status":"established","tldr":"More than half of United States survivors in a comparative survey reported financial difficulty, against a third in the UK. What a person pays for rehabilitation, psychological care, fertility preservation and a wig depends on their insurance, their state and their employer rather than on their cancer."},{"id":"rejuv-access-what-it-costs-elsewhere","kind":"technology","name":"What recovery costs in the rest of the world","route":"/technologies/rejuv-access-what-it-costs-elsewhere/","status":"emerging","tldr":"In Germany rehabilitation is an entitlement with the outpatient version free to the patient. In most of the world there is no survivorship service to be charged for, and the household pays for whatever follow-up happens. Reliable comparative figures do not exist."}]}