scholarly journals Effective Cessation Treatment for Patients With Cancer Who Smoke—The Fourth Pillar of Cancer Care

2019 ◽  
Vol 2 (9) ◽  
pp. e1912264 ◽  
Author(s):  
Michael C. Fiore ◽  
Heather D’Angelo ◽  
Timothy Baker
Keyword(s):  
Cancer Care ◽  
Patients With Cancer ◽  
Cessation Treatment

Providing cessation treatment to every oncology patient who smokes: An essential component of cancer care

Cancer ◽  
2021 ◽  
Author(s):  
Michael C. Fiore ◽  
Timothy B. Baker ◽  
Margaret B. Nolan ◽  
Hamid Emamekhoo
Keyword(s):  
Cancer Care ◽  
Oncology Patient ◽  
Essential Component ◽  
Cessation Treatment

Evolving oncology provider perspectives on care delivery during the COVID-19 pandemic.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18609-e18609
Author(s):  
Divya Ahuja Parikh ◽  
Meera Vimala Ragavan ◽  
Sandy Srinivas ◽  
Sarah Garrigues ◽  
Eben Lloyd Rosenthal ◽  
...  
Keyword(s):  
Cancer Care ◽  
Care Delivery ◽  
The United States ◽  
Advanced Practice ◽  
Curative Surgery ◽  
Time Points ◽  
Patients With Cancer ◽  
Provider Perspectives ◽  
Significant Difference ◽  
The Impact

e18609 Background: The COVID-19 pandemic prompted rapid changes in cancer care delivery. We sought to examine oncology provider perspectives on clinical decisions and care delivery during the pandemic and to compare provider views early versus late in the pandemic. Methods: We invited oncology providers, including attendings, trainees and advanced practice providers, to complete a cross-sectional online survey using a variety of outreach methods including social media (Twitter), email contacts, word of mouth and provider list-serves. We surveyed providers at two time points during the pandemic when the number of COVID-19 cases was rising in the United States, early (March 2020) and late (January 2021). The survey responses were analyzed using descriptive statistics and Chi-squared tests to evaluate differences in early versus late provider responses. Results: A total of 132 providers completed the survey and most were white (n = 73/132, 55%) and younger than 49 years (n = 88/132, 67%). Respondents were attendings in medical, surgical or radiation oncology (n = 61/132, 46%), advanced practice providers (n = 48/132, 36%) and oncology fellows (n = 16/132, 12%) who predominantly practiced in an academic medical center (n = 120/132, 91%). The majority of providers agreed patients with cancer are at higher risk than other patients to be affected by COVID-19 (n = 121/132, 92%). However, there was a significant difference in the proportion of early versus late providers who thought delays in cancer care were needed. Early in the pandemic, providers were more likely to recommend delays in curative surgery or radiation for early-stage cancer (p < 0.001), delays in adjuvant chemotherapy after curative surgery (p = 0.002), or delays in surveillance imaging for metastatic cancer (p < 0.001). The majority of providers early in the pandemic responded that “reducing risk of a complication from a COVID-19 infection to patients with cancer” was the primary reason for recommending delays in care (n = 52/76, 68%). Late in the pandemic, however, providers were more likely to agree that “any practice change would have a negative impact on patient outcomes” (p = 0.003). At both time points, the majority of providers agreed with the need for other care delivery changes, including screening patients for infectious symptoms (n = 128/132, 98%) and the use of telemedicine (n = 114/132, 86%) during the pandemic. Conclusions: We found significant differences in provider perspectives of delays in cancer care early versus late in the pandemic which reflects the swiftly evolving oncology practice during the COVID-19 pandemic. Future studies are needed to determine the impact of changes in treatment and care delivery on outcomes for patients with cancer.

scholarly journals The State of Cancer Care in America: Impact of State Policy on Access to High-Quality Cancer Care

2020 ◽  
Vol 18 (4) ◽  
pp. 400-404
Author(s):  
Terrell Johnson ◽  
Lindsey A.M. Bandini ◽  
Kara Martin ◽  
Lee Jones ◽  
Jennifer Carlson ◽  
...  
Keyword(s):  
Health Policy ◽  
Cancer Care ◽  
Policy Decision ◽  
The State ◽  
Washington Dc ◽  
Patients With Cancer ◽  
Quality Cancer Care ◽  
Challenges And Opportunities ◽  
Health Policy Decision ◽  
Policy Decision Making

Health policy in America has shifted rapidly over the last decade, and states are increasingly exercising greater authority over health policy decision-making. This localization and regionalization of healthcare policy poses significant challenges for patients with cancer, providers, advocates, and policymakers. To identify the challenges and opportunities that lay ahead of stakeholders, NCCN hosted the 2019 Policy Summit: The State of Cancer Care in America on June 27, 2019, in Washington, DC. The summit featured multidisciplinary panel discussions to explore the implications for access to quality cancer care within a shifting health policy landscape from a patient, provider, and lawmaker perspective. This article encapsulates the discussion from this NCCN Policy Summit.

scholarly journals NCCN Task Force Report: Bone Health and Cancer Care

2006 ◽  
Vol 4 (S2) ◽  
pp. S-1-S-20 ◽  
Author(s):  
Richard L. Theriault ◽  
J. Sybil Biermann ◽  
Elizabeth Brown ◽  
Adam Brufsky ◽  
Laurence Demers ◽  
...  
Keyword(s):  
Bone Health ◽  
Cancer Care ◽  
Task Force ◽  
Imaging Techniques ◽  
Healthcare Team ◽  
Task Force Report ◽  
Patients With Cancer ◽  
Pathologic Fractures ◽  
Education And Care

Higher incidences of osteoporosis and osteopenia are found in cancer patients, particularly in women receiving aromatase inhibitors or with chemotherapy-induced ovarian failure, or in men with prostate cancer and androgen deprivation therapy. Therefore, management of long-term bone health is emerging as an important aspect of comprehensive cancer care. Patients with cancer typically have a number of additional risk factors for osteoporosis that should prompt screening, regardless of patient age or sex. Maintaining bone health requires a broad knowledge base, including understanding underlying bone metabolism and how it is affected by both cancer itself and the drugs used to treat cancer, the effect of chemotherapy-induced menopause on bone health, bone markers and imaging techniques used to assess bone health, therapeutic strategies to maintain bone health, and treatment of bone metastases, including surgery for pathologic fractures. Multiple members of the healthcare team may need to be involved in education and care of the patient. This report summarizes discussion of these and other issues regarding bone health and cancer care from the NCCN Bone Health and Cancer Care Task Force meeting in early 2006. (JNCCN 2006;4(Suppl 2):S1-S24)

scholarly journals Pharmaceutical assistance foundations in the financing of cancer care.

2017 ◽  
Vol 35 (8_suppl) ◽  
pp. 8-8
Author(s):  
Aaron Philip Mitchell
Keyword(s):  
North Carolina ◽  
Cancer Care ◽  
Kinase Inhibitors ◽  
Care Delivery ◽  
Private Insurance ◽  
Standard Of Care ◽  
Drug Manufacturer ◽  
Cancer Drugs ◽  
Assistance Programs ◽  
Patients With Cancer

8 Background: The rising cost of cancer drugs may make treatment unaffordable for some patients. Patients often rely on drug manufacturer-administered Pharmaceutical Assistance Programs (PAPs) to obtain drugs at reduced or no cost. The overall impact of PAPs on cancer care delivery is unknown. Methods: We identified all patients obtaining cancer drugs across an academically affiliated, integrated health system in the state of North Carolina during 2014. The proportion of patients receiving PAP assistance, and the retail value of the assistance, were quantified for each oncology drug. Cancer drugs were analyzed with respect to route of administration. Results: 215 unique patients submitted a total of 478 successful PAP requests for cancer drugs. The majority of the retail value of drugs obtained was for oral cancer drugs, particularly targeted therapies including tyrosine kinase inhibitors. Among all cancer patients who received medical treatment, 5.5% required PAP assistance, whereas 10.6% receiving an oral agent required PAP assistance (Table). The proportion receiving PAP assistance varied substantially by drug, ranging from <1% of patients (e.g., carboplatin, methotrexate) to 50% of patients (e.g., ponatinib, temsirolimus). Patients obtained a total of $1,556,575 of imatinib and $1,449,633 of dasatinib, which were the two drugs with the highest aggregate retail value. 40% of PAP-utilizing patients were uninsured, 26% had Medicaid coverage, 20% had Medicare coverage, and 14% were commercially insured. Conclusions: A substantial proportion of patients with cancer receive private charitable assistance through PAPs in order to obtain standard-of-care treatments. In particular, a disproportionate share of patients treated with orally-available cancer drugs require PAP assistance. This includes patients with federal and private insurance, suggesting an inability of patients to meet cost-sharing requirements. [Table: see text]

The HOLA COVID-19 study: Evaluating the impact of caring for patients with COVID-19 on cancer care delivery in Latin America.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 1537-1537
Author(s):  
Carolina Bernabe Ramirez ◽  
Ana I. Velazquez Manana ◽  
Coral Olazagasti ◽  
Cristiane Decat Bergerot ◽  
Enrique Soto Perez De Celis ◽  
...  
Keyword(s):  
Latin America ◽  
Latin American ◽  
Cancer Care ◽  
Online Survey ◽  
Care Delivery ◽  
Healthcare Delivery ◽  
Significant Proportion ◽  
Multiple Choice Questions ◽  
Patients With Cancer ◽  
The Impact

1537 Background: The severe acute respiratory syndrome 2 (SARS-cov-2) virus causing COVID-19 has brought great challenges to global health services affecting cancer care delivery, outcomes, and increasing the burden in oncology providers (OP). Our study aimed to describe the challenges that OP faced while delivering cancer care in Latin America. Methods: We conducted an international cross-sectional study using an anonymous online survey in Spanish, Portuguese, and English. The questionnaire included 43 multiple choice questions. The sample was stratified by OP who have treated patients with COVID-19 versus those who have not treated patients with COVID-19. Data was analyzed with descriptive statistics and Chi-square tests. Results: A total of 704 OP from 20 Latin American countries completed the survey (77% of 913 who started the survey). Oncologists represented 46% of respondents, followed by 25% surgical-oncologists. Of the respondents, 56% treated patients with COVID-19. A significant proportion of OP reported newly adopting telemedicine during COVID-19 (14% vs 72%, p=0.001). More than half (58%) of OP reported making changes to the treatments they offered to patients with cancer. As shown in the table, caring for patients with COVID-19 significantly influenced practice patterns of OP. Access to specialty services and procedures was significantly reduced: 40% noted significantly decreased or no access to imaging, 20% significantly decreased or no access to biopsies, 65% reported delays in surgical oncology referrals, and 49% in radiation oncology referrals. A vast majority (82%) reported oncologic surgeries were delayed or cancelled, which was heightened among those treating patients with COVID-19 (87% vs 77%, p=0.001). Conclusions: The COVID-19 pandemic has significantly affected the way cancer care is delivered in globally. Although changes to healthcare delivery are necessary as a response to this global crisis, our study highlights the significant disruption and possible undertreatment of patients with cancer in Latin America that results from COVID-19.[Table: see text]

scholarly journals Patient Factors Associated With Delays in Obtaining Cancer Care in Botswana

2018 ◽  
pp. JGO.18.00088
Author(s):  
Rohini K. Bhatia ◽  
Sarah Rayne ◽  
William Rate ◽  
Lame Bakwenabatsile ◽  
Barati Monare ◽  
...  
Keyword(s):  
Cancer Care ◽  
Help Seeking ◽  
Cancer Type ◽  
Patients With Cancer ◽  
Systemic Factors ◽  
Potential Risk Factors ◽  
Male Sex ◽  
Cancer Of The Cervix ◽  
Delays In Diagnosis ◽  
Advanced Cancer Stage

Purpose Delays in diagnosis and treatment of cancers can lead to poor survival. These delays represent a multifaceted problem attributable to patient, provider, and systemic factors. We aim to quantify intervals from symptom onset to treatment start among patients with cancer in Botswana and to understand potential risk factors for delay. Patients and Methods From December 2015 to January 2017, we surveyed patients seen in an oncology clinic in Botswana. We calculated proportions of patients who experienced delays in appraisal (between detecting symptoms and perceiving a reason to discuss them with provider, defined as > 1 month), help seeking (between discussing symptoms and first consultation with provider, defined as > 1 month), diagnosis (between first consultation and receiving a diagnosis, defined as > 3 months), and treatment (between diagnosis and starting treatment, defined as > 3 months). Results Among 214 patients with cancer who completed the survey, median age at diagnosis was 46 years, and the most common cancer was cancer of the cervix (42.2%). Eighty-one percent of patients were women, 60.7% were HIV infected, and 56.6% presented with advanced cancer (stage III or IV). Twenty-six percent of patients experienced delays in appraisal, 35.5% experienced delays help seeking, 63.1% experienced delays in diagnosis, and 50.4% experienced delays in treatment. Patient income, education, and age were not associated with delays. In univariable analysis, patients living with larger families were less likely to experience a help-seeking delay (odds ratio [OR], 0.31; P = .03), women and patients with perceived very serious symptoms were less likely to experience an appraisal delay (OR, 0.45; P = .032 and OR, 0.14; P = .02, respectively). Conclusion Nearly all patients surveyed experienced a delay in obtaining cancer care. In a setting where care is provided without charge, cancer type and male sex were more important predictors of delays than socioeconomic factors.

Comprehensive Geriatric Assessment for Older Patients With Cancer

2007 ◽  
Vol 25 (14) ◽  
pp. 1824-1831 ◽  
Author(s):  
Martine Extermann ◽  
Arti Hurria
Keyword(s):  
Older Adults ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Cancer Care ◽  
Older Patients ◽  
Morbidity And Mortality ◽  
Psychological State ◽  
Future Research ◽  
Oncology Patient ◽  
Patients With Cancer

Purpose During the last decade, oncologists and geriatricians have begun to work together to integrate the principles of geriatrics into oncology care. The increasing use of a comprehensive geriatric assessment (CGA) is one example of this effort. A CGA includes an evaluation of an older individual's functional status, comorbid medical conditions, cognition, nutritional status, psychological state, and social support; and a review of the patient's medications. This article discusses recent advances on the use of a CGA in older patients with cancer. Methods In this article, we provide an update on the studies that address the domains of a geriatric assessment applied to the oncology patient, review the results of the first studies evaluating the use of a CGA in developing interventions to improve the care of older adults with cancer, and discuss future research directions. Results The evidence from recent studies demonstrates that a CGA can predict morbidity and mortality in older patients with cancer. Accumulating data show the benefits of incorporating a CGA in the evaluation of older patients with cancer. Prospective trials evaluating the utility of a CGA to guide interventions to improve the quality of cancer care in older adults are justified. Conclusion Growing evidence demonstrates that the variables examined in a CGA can predict morbidity and mortality in older patients with cancer, and uncover problems relevant to cancer care that would otherwise go unrecognized.

scholarly journals The Effect of Natural Disasters on Cancer Care: A Systematic Review

2019 ◽  
Vol 34 (s1) ◽  
pp. s48-s48
Author(s):  
Ralph Xiu-gee Man ◽  
David Lack ◽  
Charlotte Wyatt ◽  
Virginia Murray
Keyword(s):  
Systematic Review ◽  
Natural Disasters ◽  
Health Effects ◽  
Cancer Care ◽  
Extreme Weather ◽  
Extreme Weather Events ◽  
Survival Outcomes ◽  
Patients With Cancer ◽  
Weather Events ◽  
Oncology Care

Introduction:As the incidence of cancer and the frequency of extreme weather events rise, disaster mitigation is becoming increasingly relevant to oncology care.Aim:To investigate the effect of natural disasters on cancer care and the associated health effects on patients with cancer through the means of a systematic review.Methods:Between database inception and November 12, 2016, Embase, ScienceDirect, MEDLINE, Scopus, PsycINFO, Web of Science, and CINAHL were searched for articles. Those identifying the effect of natural disasters on oncology services, or the associated health implications for patients with cancer, were included. Only articles published in English were included. Data extraction was done by two authors independently and then verified by all authors. The effects of disaster events on oncology services, survival outcomes, and psychological issues were assessed.Results:Natural disasters cause substantial interruption to the provision of oncology care. Of the 4,593 studies identified, only 85 articles met all the eligibility criteria. Damage to infrastructure, communication systems, medication, and medical record losses substantially disrupt oncology care. The effect of extreme weather events on survival outcomes is limited to only a small number of studies, often with inadequate follow-up periods.Discussion:To the best the authors’ knowledge, this is the first systematic review to assess the existing evidence base on the health effects of natural disaster events on cancer care. Disaster planning must begin to take into consideration patients with cancer.

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