Australian women who have undergone surgery for early-stage breast cancer could be monitored afterwards by their GP instead of a hospital clinic, under a federal government project that acknowledges there will not be enough specialist doctors for the coming wave of cancer cases among ageing baby boomers.
Christine Giles, executive director and head of policy and strategy at the federal agency Cancer Australia, said GPs would be responsible for examining women and ordering mammograms, and discussing any psychological or other problems caused by the cancer.
Pilot schemes are already running through four centers, including the Calvary Mater Newcastle, with the expectation cancer follow-up care could eventually become a standard Medicare-funded consultation for patients.
Associate Professor Giles said shared care between a GP and hospital clinic was already widespread in obstetrics and diabetes and in cancer would make “better use of scarce resources [and ensure] equitable access across Australia,” especially in areas where specialists were in short supply. The frequency of post-cancer check-ups varied, she said, but typically was every three to six months in the first two years following initial treatment, falling to once a year after the first five years. “Active follow-up is reasonably intensive,” she said.
Professor Giles said 144,000 Australian women had at some time received a breast cancer diagnosis, and another 12,000 new cases were detected annually, putting pressure on the health system as survival increased and the disease became a long-term chronic condition. Among the 1200 women already recruited to the scheme, 800 had had their first cancer check-up with their GP and seven had been escalated back to hospital specialists using a fast-track referral form, because of medical concerns.
Professor Giles said formal evaluation of the project, which also includes hospitals in Adelaide and Melbourne, would be completed early next year and recommendations would then be made to government. “We believe this model … also has relevance to other cancers,” she said.
Tony Hobbs, a Cootamundra GP and chairman of the project's steering committee, said shared care was “of great importance for rural women in particular,” because of the large distances they must otherwise travel for routine check-ups. Preliminary results had shown there was no difference in the likelihood of picking up any recurrence or complication, Dr Hobbs said, and the main challenge would be to reassure women of this.
Breast cancer awareness bracelets raise debate
In another story it was reported that bracelets intended to raise breast cancer awareness are proving to be a distraction at Medomak Valley High School, where several students have been suspended. The rubbery bracelets, which say “I (heart) boobies,” have triggered similar responses elsewhere across the country when students wear them in schools.
“They're disruptive to the education process,” Medomak Valley High School Principal Harold Wilson said. Students across the country have sued their school districts on free speech grounds. Earlier this year, a federal judge in Pennsylvania sided with two girls who sued after they were told not to wear the bracelets. “Students who are choosing to advocate for breast cancer awareness should not be censored,” said Shenna Bellows, executive director of the Maine Civil Liberties Union.
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