If you were diagnosed with cancer today no doubt you want to believe you would get excellent care. Sadly, that may not be the case.
The United States cancer care delivery system is in crisis according to a new report by the Institutes of Medicine (IOM), part of the National Institutes of Health called “Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis”.
The report cited a growing demand for care, a shrinking oncology work force, rising costs of cancer care, and the complexity of the disease and its treatment, as factors that can prevent patients from getting the best possible care.
An already overstretched cancer care delivery system is facing increased demands as aging baby boomers reach age 65 and older — the segment of the population that accounts for the largest share of new cancer diagnoses.
The report was sponsored by 13 U.S. professional health and nonprofit organizations.
The rise of new cancer diagnoses is expected to rapidly increase from 1.6 million new cases already diagnosed each year to 2.3 million new diagnoses per year by 2030 — a 45 percent increase.
“The oncology work force may soon be too small to care for the rising number of people diagnosed with cancer, and training programs lack the ability to rapidly expand,” according to the report.
New personalized cancer treatments targeting specific abnormalities, including those often present only in subsets of patients, have proven to offer new hope to patients where there might have been none previously. However, incorporating those therapies into an overstressed clinical care system is proving to be challenging, the report said.
In a strained medical delivery system patients may be getting the wrong care, too little care, or too much care through unnecessary procedures.
“Given the disease’s complexity, clinicians, patients, and patients’ families can find it difficult to formulate care plans with the necessary speed, precision, and quality; as a result, decisions about cancer care are often not sufficiently evidence-based.”
Patricia Ganz is chair of the 17-member committee that wrote the report and a professor at the School of Medicine and School of Public Health, University of California, Los Angeles. Ganz said in a written statement that identified barriers are making it increasingly difficult for clinicians to provide patients with optimal care despite their best efforts to do so.
“As a nation we need to chart a new course for cancer care. Changes are needed across the board, from how we communicate with patients, to how we translate research into practice, to how we coordinate care and measure its quality,” wrote Ganz.
The cost of cancer care, which is rising faster than other sectors of medicine, is another challenge. Costs have increased from $72 billion in 2004 to $125 billion in 2010, said the report. At the current rate, it will increase another 39 percent to $173 billion by 2020.
And like patients and their families, the single largest insurer for those over 65, the Centers for Medicare and Medicaid Services (CMS), is financially struggling, according to the report.
The report recommended common sense approaches to respond to these critical challenges and improve cancer care delivery, including by strengthening clinicians’ core competencies in caring for patients with cancer, shifting to team-based models of care, and communicating more effectively with patients.
Patients can greatly improve their cancer care right now by being proactive and asking their clinical care team the right questions before starting therapy. The IOM has prepared a “cheat sheet” of patient questions that’s available for download online. The document can be printed so you can take it with you to your first oncology appointment.
One potential glimmer of good news in a sea of gray: The Patient Protection and Affordable Care Act, also known as Obamacare is expected to make significant changes in accessibility and affordability of cancer care, the report noted.
But because much of the law has not yet been implemented, these issues will need to be revisited once the law’s full impact is known.
Lynette Summerill is an award-winning writer and Scuba enthusiast who lives in San Diego with her husband and two beach loving dogs. In addition to writing about cancer-related issues for EmpowHER, her work has been seen in publications internationally.
Sources:
Institute of Medicine report “Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis”.10 Sept. 2014. Full report, video and companion information available online at
http://www.iom.edu/Reports/2013/Delivering-High-Quality-Cancer-Care-Charting-a-New-Course-for-a-System-in-Crisis.aspx
U.S. Faces Crisis in Cancer Care Because of Aging Population, Rising Costs, Complexity of Care, Says New Report; Shift Needed Toward Patient-Centered, Evidence-Based Care. Press Release.
http://www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=18359
Reviewed October 22, 2013
by Michele Blacksberg RN
Edited by Jody Smith