Cancer care is becoming more complicated, creating a larger gap between specialty hospitals and local physicians, The Wall Street Journal reported Oct. 22.
Here are four things to know:
1. Physicians now think of cancer as more than 100 distinct diseases among the various affected organs. The growing awareness of this complexity has led to greater care options, but not access. Oncologists at magnet cancer centers tend to have expertise in a few cancer subtypes and can draw from an evolving array of drugs and experimental treatments. However, most patients are seeking care locally, and local oncologists often lack the specialized expertise and knowledge on the latest treatments.
2. The National Comprehensive Cancer Network has updated its nearly 90 guidelines for cancer more than 200 times in the past year. The American Society of Clinical Oncology also regularly updates a "living guideline" on newer drug treatments for cancer.
"The [American Society of Clinical Oncology] guideline is almost impossible to read," Julie Gralow, MD, the ASCO's chief medical officer, told the Journal.
3. Local oncologists have a hard time staying up to date on the latest changes. To close the knowledge gap, some oncologists at small practices listen to cancer treatment podcasts on their way to work, cold-call specialists at large centers for advice, and often advise patients to go to large centers when possible. For some patients, these centers are out of state.
4. About one in five patients in the nation may have their cancer misdiagnosed and be receiving the wrong treatment, Peter Pisters, MD, president of MD Anderson Cancer Center in Houston, told the Journal. MD Anderson found that about 20% of its new patients are rediagnosed or restaged. New York City-based Memorial Sloan Kettering Cancer Center also found about a third of its patients who sought a second opinion had their treatment changed.