Weekly Wednesday 6 March 2019

Personalized Risk-Stratified Cancer Follow-Up Care: Its Potential for Healthier Survivors, Happier Clinicians, and Lower Costs

An interesting new take on managing the increasing numbers of people surviving cancer with high needs.

Abstract ONLY: The growth in the number of cancer survivors in the face of projected health-care workforce shortages will challenge the US health-care system in delivering follow-up care. New methods of delivering follow-up care are needed that address the ongoing needs of survivors without overwhelming already overflowing oncology clinics or shuttling all follow-up patients to primary care providers. One potential solution, proposed for over a decade, lies in adopting a personalized approach to care in which survivors are triaged or risk-stratified to distinct care pathways based on the complexity of their needs and the types of providers their care requires. Although other approaches may emerge, we advocate for development, testing, and implementation of a risk-stratified approach as a means to address this problem. This commentary reviews what is needed to shift to a risk-stratified approach in delivering survivorship care in the United States.

Why Do Only Eight Percent Of Cancer Patients In The U.S. Participate In Clinical Trials?

Most cancer clinical trials don't meet their enrollment targets and it has been previously thought that patient reluctance was behind this. Now a new study published today in the Journal of the National Cancer Institute, led by researchers from the Fred Hutchinson Cancer Research Center in Seattle challenges that by suggesting that other factors are primarily responsible.

"Patients are often fearful of participating in clinical trials, and many consider trial participation as appropriate only for those with no other choices. This is unfortunate since patients receive excellent cancer care in trials," said Dr. Joseph Unger, a health services researcher and biostatistician who led the study. Read more…

HPV stigma and misunderstanding really concerning, say campaigners

A “really concerning” level of stigma and misunderstanding about the human papilloma virus could be putting women off going for vital smear tests, campaigners have warned.

A survey of more than 2,000 women by Jo’s Cervical Cancer Trust suggested incorrect knowledge about the virus, known as HPV, is commonplace.

Meanwhile there are a wide range of stigmas associated with HPV that lead to high levels of misplaced “fear or shame”, according to the responses.

HPV is a common infection spread through close skin-to-skin contact, usually during sex or oral sex.

Eight in 10 women will have some form of HPV infection in their lifetime, but only very few who have specific high-risk types of the virus will go on to develop cancer. Read more...

The Challenges of Care-Giving and Supporting

Canopy TV – an online news channel for the cancer community.

Canopy TV aims to provide interesting and topical information to cancer patients and their families, increase people’s understanding of cancer and showcase interesting clinical developments in cancer treatment.

Life after cancer: More survivors live longer, face new health challenges

When Susan Leigh finished treatment for Hodgkin lymphoma in 1972, she says, “no one knew what was going to happen.”

Certainly, no one knew the Arizona woman would develop three more cancers and heart damage, all probably linked to the aggressive radiation and chemotherapy treatments that helped save her life.

Those treatments were new at the time. When Leigh finished them, apparently cancer-free, she was a pioneer.

“I remember saying to my radiation doctor, 'What do I do now?' " says Leigh, 71, a retired cancer nurse. " 'What do I do to keep this from coming back and to recover?'

"He said he really didn’t know. He said maybe I could try taking a good multivitamin pill.”

Four decades later, doctors know much more. They know some cancer survivors are at increased risk for other cancers and for problems ranging from brittle bones to heart failure.

They also know more about how to help patients head off or manage those risks.

But few patients get that help – even 13 years after the influential Institute of Medicine warned that many survivors were “lost in transition” and weren't getting adequate follow-up care.

The number of cancer survivors continues to grow, yet high-quality, coordinated survivorship care is still infrequent,” experts from the National Academies of Sciences, Engineering, and Medicine said in a recent follow-up report (the nonprofit group includes the former Institute of Medicine).

“Strides have been made, but there’s also been an acceleration in the demand,” says Neeraj Arora, associate director for science at the nonprofit Patient-Centered Outcomes Research Institute. Read more here….

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Diana Ayling

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