Partnership with Primary Care Providers Key to Cancer Survivorship

In 2016, there were approximately 16 million cancer survivors in the United States, according to a study published in Cancer Epidemiology, Biomarkers, & Prevention. That number jumps to 26 million in 2040 when 73% of cancer survivors will be 65 years of age and older.

This increase in cancer survivors bumps up against a projected shortage of nearly 2,400 oncologists and radiation oncologists in 2025, according to a Journal of Oncology Practice study. That means provider executives must figure out how to care for more patients with fewer cancer specialists.

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Kate Sweeney, RN, addresses this problem at Milwaukee’s Froedtert Hospital, where she’s director of Froedtert & MCW Clinical Cancer Center’s hematology and transplant services, by building partnerships with primary care providers who are interested in attending to the complex needs of cancer survivors. The needs of cancer patients are complex because of the long-term side effects of treatments such as radiation and chemotherapy, she says.

Take, for example, a younger patient who had whole-body radiation to treat a hematological malignancy prior to a transplant, says Sweeney. These patients often return with cancers that are believed to be caused by radiation.

That’s why customized survivorship plans that are specific to the cancer the patient endured and the treatment they received are key, she adds.

Communicate with providers and patients

To support Froedtert’s clinicians, her team has created different survivorship templates in the EHR for various cancers, such as breast, pancreatic, colorectal, and lung cancers. The health system focused on breast, pancreatic and colorectal cancers initially, since they’re the most common among patients and these patients tend to have a long lifespan after treatment.

Catherine Lee, MD, professor of medicine in the division of hematology/blood and marrow transplantation at University of Utah’s Huntsman Cancer Center Institute, recommends giving the patient a printed copy of their survivorship plan, in addition to creating templates within the EHR. This is helpful because patients may move away or leave the health system, and their new provider may not have access to an electronic version of their survivorship plan, she adds.

Train primary care providers

Sweeney’s team at Froedtert also partners with primary care physicians who are interested in learning about cancer survivorship.

She points out that primary care providers don’t provide cancer treatment for these patients, who continue to see their oncologist during their treatment. Instead, the primary care provider monitors the patient’s high blood pressure, diabetes, high cholesterol, and other non-oncology issues. “It’s still really important to a cancer patient to see a primary care provider during their cancer treatment as the oncologist is focused on cancer,” adds Sweeney.

To launch this partnership with primary care providers, she recommends outreach to primary care groups that are interested in treating patients during their cancer journey and throughout survivorship. Training could include monthly in-person “lunch and learns” with an oncologist or online training.

“This needs to be a partnership in which a primary care provider gains some additional knowledge about long-term cancer implications,” she says. “That training will inform primary care providers’ work with cancer survivors, and oncologists can transition their cancer patients to someone who has the expertise to follow them and ‘clue into’ concerns.”

Aine Cryts is a writer based in Boston.