Primary care could help meet growing needs of cancer survivors

Thanks to new advances in cancer care, more and more people are surviving cancer, with a projected total of 22.5 million survivors by 2032. The need for proper cancer survivorship care grows with each new case of remission, but according to new research from the University of Missouri School of Medicine, primary care could fill that need, given enough support. 

Cancer survivorship care is complex, particularly after primary treatment has ended. Standard care addresses side effects from the treatment, encourages healthy lifestyle habits, discusses the patient's mental health, monitors cancer recurrence and screens for new cancers. 

Previous research indicates that involving primary care clinicians (PCCs) during and after cancer treatment can support the patient's overall, comprehensive health. In this study, we found patients did not always have a consistent PCC." 

Jane McElroy, study author 

This study looked at the experiences of 57 women in cancer survivorship care. Only a third of the patients consistently saw the same PCC, which complicated the transition from active cancer treatment to survivorship care. 

"Going from seeing an oncologist to seeing a PCC is often associated with fragmented care – gaps in the patient's care that occur because of miscommunication and a lack of coordination," McElroy said. "This is often because of uncertainty regarding which roles and responsibilities belong to primary care and not oncology, or vice versa." 

In addition, many PCCs expressed feeling uncomfortable or inadequately trained to provide robust survivorship care, though they are very willing to go through additional training. Past research has shown PCC-led care or a shared-care model with primary care and oncology have equivalent or better patient outcomes. 

"Our research identified several educational opportunities that exist for PCCs who provide survivorship care," co-author Mirna Becevic said. "This includes online classes, workshops, webinars and tele-mentoring sessions using programs like our ECHO program." 

According to past research, cancer survivors frequently prefer shared-care models. McElroy and Becevic said future research will focus on identifying other preferences of cancer survivors and what they deem important during their cancer survivorship journey. 

Jane McElroy, PhD is a professor of Family and Community Medicine at the Mizzou School of Medicine and is also an Opal Lewis Distinguished Faculty Scholar. Mirna Becevic, PhD, is an associate professor of dermatology and the lead project evaluator for the Show-Me ECHO program. 

"Continuity of Cancer Care: Female Participants' Report of Healthcare Experiences After Conclusion of Primary Treatment" was recently published in Current Oncology. In addition to McElroy and Becevic, Mizzou study authors include medical student Garren Powell and Allison Anbari, PhD, RN, assistant professor at the Mizzou Sinclair School of Nursing.