Primary care physicians are showing a greater interest in developing expertise in cancer survivorship — a trend some systems are leaping on.
With the decrease in cancer mortality and increase in advanced treatment has come a wave of cancer survivors — more than 18 million in the U.S. today — who require ongoing attention and care.
"This means we now have many more cancer survivors and will continue to have more," Steven Artandi, MD, PhD, director of the Stanford (Calif.) Cancer Institute, told Becker's.
But few primary care providers know how to care for this patient group, and the demand has put a strain on cancer centers and oncologists.
"It can't fall entirely on the oncologists, because they are dealing with many new cases and active cases," Dr. Artandi said. "It depends on the cancer, the circumstances of patients, and the risk of recurrence to determine the extent to which the oncologist manages that survivor versus the entire health system and the primary care physician."
More systems are shifting cancer survivorship care to primary care physicians.
A growing interest among PCPs
As demand for cancer survivorship increases, an interest has grown among primary care physicians to understand more about this specialty care.
"Primary care physicians are seeing a lot of these cancer survivors and becoming experts in what the risk factors are for these patients, how they should be surveyed for recurrence, etc.," Dr. Artandi said. "It requires building specialized expertise."
So far, the interest is a "more informal, almost apprenticeship model," he said, with physicians and specialists taking the lead in establishing education and programs.
"They develop a program for how survivors ought to be followed, and then that becomes a partnership between those experts in cancer survivorship and the primary care doctors who are just interested in this area," he said.
Systems encourage the shift
To meet demand for cancer survivorship education, Houston-based the University of Texas MD Anderson Cancer Center is launching a survivorship training program geared at primary care providers called MD Anderson Cancer Survivorship Education Program. The three tier education course consists of online modules, knowledge assessments and, at the highest level, nine monthly, live, case-based sessions. The program will launch first in Texas and expand to other states until it's released nationally in the next one or two years, Michael Roth, MD, medical director of MD Anderson's survivorship program and co-director of the AYA Oncology Program, told Becker's. Although the program is aimed at primary care providers, it is open to other provider types as well.
Stanford Health has also addressed the need by creating a mixed model that leverages oncologists and its primary care network.
"The challenge is understanding how best to follow those survivors, what their future risks are based on their genetics, and the therapies they had received," Dr. Artandi said. "It requires tight integration between the oncologist and the primary care doctor. This is what we're aiming for at Stanford."