Georgetown University Researcher's Study Finds Gaps in Cancer Survivor Care

A study published Monday in the Journal of General Internal Medicine found that there is a need for improvement in the care given to cancer survivors, and that doctors of differing specialties may have different ideas of what that may entail.

Arnold Potosky PhD, the Director of Health Services Research at Georgetown University, Lombardi Comprehensive Cancer Center, discovered in his research, titled Differences Between Primary Care Physicians’ and Oncologists’ Knowledge, Attitudes and Practices Regarding the Care of Cancer Survivors, that there are large gaps in both confidence and knowledge between the two specialties in this area.

“We found large differences between oncologists and primary care physicians in confidence in their own knowledge of survivorship care, with PCPs less confident in knowledge of the key elements of such care; second, differences in  perceptions of the skills of PCPs to provide such care with oncologists viewing PCPs less favorably, but even PCPs somewhat uncertain about a few elements; and third, both groups, but more so PCPS, would routinely use certain blood and imaging tests to detect cancer recurrence that are not included in guideline recommendations,” Potosky said.

This research, the initial design of which was started in 2007, was done through a number of questionnaires sent to doctor’s offices who work with cancer survivors. It implies that the care given to cancer survivors by primary care physicians needs to change.

The study included results of a survey of 1,072 primary cancer physicians (PCP) and 1,130 oncologists randomly sampled from among all U.S. practicing physicians during 2009.

“I think the thing that comes most directly from the paper is the need for doctor-to-doctor communication, i.e., that follow up care can be provided in many ways: from the oncology specialists, nurse-led clinics, or primary care physicians, but whatever the setting it’s important that there be communication between [sic] everyone involved so that there’s an agreed-upon plan for both cancer follow-up and non-cancer care,” Potosky said.

Potosky said he hopes that these results can be used to help create policies and opportunities for further education and communication between oncologists and primary care physicians. The Georgetown researcher believes more research needs to be done in the future on the best models of care.

“These findings, in light of the looming shortage of oncologists and the rapid increase in the number of cancer survivors, strongly suggest that we need to find a way to improve sharing of care between specialists and generalists after diagnosis,” Potosky said.

Cancer survivors should take an active role in making sure the care they receive is adequate, Potosky advises.

“I think that a key piece of advice is that every survivor finishing treatment should set up a planned conversation with his/her treating oncologist (coordinator or last provider of cancer care) to summarize the care that was received, and delineate what follow-up should entail, i.e., have an informed discussion about that individuals’ personal treatment history/experience and recommended plan for care going forward,” Potosky said.

“This latter would included discussion of who is going to provide or be responsible for what aspects of care, and, the role the patient can play in ensuring receipt of optimal care and promotion of his/her well-being. If patients begin expecting this, physicians will realize the importance of this planning and need for documentation, and care will change, hopefully for the better.”

Read the full research study results here.

Funding for the Survey of Physicians Attitudes Regarding the Care of Cancer Survivors was provided by National Cancer Institute and American Cancer Society. All the co-authors report no personal financial interests related to the study.