Despite accumulating advances in cancer care, clinical oncology faces mounting challenges, including an aging workforce, growing patient population, financial instability, and increasing costs, according to a new report by the American Society of Clinical Oncology (ASCO).
“This year’s report clarifies multiple stresses in our nation’s cancer care system, but there is reason to be hopeful,” said ASCO President Peter Yu, MD, yesterday at a Congressional briefing to detail the new report’s findings.
“We can identify ways to ensure that all patients with cancer receive high-quality care and help oncology practices adapt, survive, and succeed in today’s demanding healthcare environment.”
The past year saw 10 new FDA-approved cancer treatments and approval of several new medical devices and tests that might improve early detection rates for cancers, according to ASCO’s newly released State of Cancer Care in America: 2015, published this week in the Journal of Oncology Practice.1
The cancer treatment research and development pipeline includes more than 770 investigational therapies. But problems are impeding the ability to deliver those advances to some patients.
“There are a lot of pressures we’re facing and problems we have in being able to realize the progress that’s being made, at a real level, at the patient level,” warned Robin Zon, MD, FACP, of Michiana Hematology Oncology in South Bend, IN.
Demand for cancer care is climbing as baby boomers age, the report notes—and the field is struggling to keep pace as the oncology workforce ages.
The next 15 years will see an estimated 45% jump in cancer incidence, but oncologists are nearing retirement at a faster rate than new oncologists are being trained. Nearly 1 in 5 oncologists is currently age 64 years or older.
“It takes 10 years to get a new oncologist into the workforce,” noted Dr. Zon. “That includes four years of medical school and six years of training.”
Compounding that trend, professional burnout among oncologists is “on the rise,” the report warns, affecting a third of oncologists surveyed.
“Oncology is a very demanding field emotionally; we’re dealing with patients who are dying, they have life-threatening disease,” Dr. Zon explained. “It’s intellectually demanding. There have been such great advances that you need to spend a lot of time to stay on top of all the new science, all the new technology, so you can make sure you are taking the best care of your patients that you possibly can.”
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Ethnic disparities in cancer care outcomes persist, and access to cancer treatment in rural areas is worsening, in part because of mergers and the shuttering of small community practices, ASCO experts warned.
A quarter of community-based oncology practices report that they will likely merge with a hospital over the coming year. As smaller practices diminish, there will be problems with distance and timely access to care, cautioned Dr. Zon.
“I was talking to a practice who regrets every day that they merged,” Dr. Zon noted. “They were in an area covering quite a few rural communities, and their patients were coming back to them and crying—crying because there’s [increased] distance to travel, they can’t get the access they want, and it’s [more costly].”
In Indiana, there are “too many” patients from rural areas who arrive at outreach centers with “very late-stage” cancers, Dr. Zon said. “Cancers that could have been cured if they had just gotten to us sooner.”