Better Equipping Primary Care Physicians to Care for Cancer Survivors
There’s encouraging news out today that Americans’ risk of dying of cancer has declined 20 percent over the past two decades. The drop in cancer deaths has translated into a growing population of survivors of the disease, particularly in children. But there’s more data recently published. It questions whether primary care doctors are prepared to provide survivorship care for young survivors once they’ve reached adulthood.
Published today in the Annals of Internal Medicine is this article: “General Internists’ Preferences and Knowledge About the Care of Adult Survivors of Childhood Cancer: A Cross-sectional Survey. “ In the study (subscription required), researchers surveyed more than 1,100 general internists and inquired about their knowledge of the special medical needs, such as increased screening, of these patients.
Here’s a recap:
- Between 25 percent and 37 percent said they would be at least “somewhat comfortable” caring for a childhood cancer survivor. Their responses varied based on the type of cancer the patient had, the researchers reported.
- When asked about screening guidelines for childhood cancer survivors, most physicians did not know the guidelines well enough to make an appropriate recommendation for their patients.
- Only 9 percent understood that women exposed to chest radiation as children need annual mammography and breast MRI scans. More than 40 percent said they weren’t sure of the guidelines.
- Only 15 percent knew that childhood chemotherapy patients need an echocardiogram every other year to check for heart problems. More than half said they would not proceed with further echocardiograms, and another 19 percent said they weren’t sure of the guidelines.
The researchers recommend that primary care physicians spend time working at a cancer survivor’s program. Further, they advise pediatric oncologists to educate patients on the necessary medical information needed by their future physicians and to partner with patients’ adult health-care providers to improve transition of care.
“I think there are many steps that are very important to improving the ability of internists to care for childhood cancer survivors,” noted Tara O. Henderson, MD, MPH, an assistant professor at the University of Chicago Medicine Comer Children’s Hospital and one of the study’s authors. “One, the oncologists and providers at the cancer center need to improve communication and transition of survivors from cancer-centered care to the primary care setting. This can be accomplished through treatment summaries and survivorship care plans that incorporate a patient’s individual summary with surveillance recommendations and long-term follow-up plan.”
“There also needs to be initiatives for improved education for primary care providers regarding the health issues of this growing population,” she added. “This education can span from medical school through residency training and can also include webinars and lectures at annual meetings. This also highlights the need for the Children’s Oncology Group to continue to disseminate the Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent and Young Adult Cancer to internal medicine websites as well as websites for other primary care societies.”
“Lastly, there should be a focus to disseminate these guidelines and education efforts through modern web-based tools such as smart phones and tablets,” Dr. Henderson said.
The study exists as one more source of reliable data that underscores the need for cancer survivorship plans and cancer survivorship planning. We at CancerForward are pleased to see that more and more in the oncology community recognize web-based platforms as appropriate guides for survivors seeking after-treatment care plans. Virtual resources are very efficient vehicles to help primary care professionals effectively care for cancer survivors.
Tags: Annals of Internal Medicine, Beth Sanders Moore, breast MRI scans, cancer survivors, cancer survivorship planning, cancer survivorship plans, CancerForward, chest radiation, childhood cancer survivor, childhood chemotherapy patients, echocardiogram, mammography, primary care physicians, smart phones, Survivorship care plans, Tara O. Henderson, web-based platforms