Thanks to earlier detection and better treatments, greater numbers of cancer survivors are now living longer lives. But high-quality survivorship care can be difficult to access and coordinate. Lauren Wallner, Ph.D., M.P.H., discusses how her team is working to better understand and reduce gaps in care for for this growing population.
What are you thinking about?
I’m thinking about how to improve the quality of care for adult cancer survivors. It’s a relatively recent phenomenon to have people living for many years, even decades following curative cancer treatment. There are now more than 16 million cancer survivors living in the United States, a number that’s expected to rise to more than 22 million over the next decade. My work as an epidemiologist and health services researcher focuses on identifying gaps in the care of these patients, and designing tools and interventions to improve that care.
What are some of the challenges?
Among adults with favorable prognosis cancers, who we expect will live long after their initial diagnosis and treatment, we know a lot about how to treat their disease. Yet we don’t have great evidence about which models of care are best for those individuals’ ongoing, evolving, and often increasingly complex healthcare needs after initial treatment is complete. Delivering high-quality survivorship care involves the coordination of comprehensive services across a variety of settings. This gets particularly challenging within the interface between oncology and primary care, where roles are not well defined or specified by guidelines, and there can be gaps in communication. Survivors may also be burdened with significant financial distress and side effects from their cancer treatment, which negatively affects their overall quality of life. In addition, the current reimbursement for cancer survivorship care is also sub-optimal. To improve care delivery for cancer survivors, we need to better understand the many barriers that both patients and providers face in accessing and providing high-quality care.
What are some of the greatest opportunities you see?
Part of the work we do in our group, CanSORT (the Cancer Surveillance and Outcomes Research Team), is to develop and evaluate tools (such as mobile apps and decision aids) for survivors to help them better coordinate and participate in their care. Empowering patients to have conversations about their care with their various providers is one of the most effective things we can do. We’re also working to determine how to better support providers of survivorship care and provide them with more tailored education about the survivor population and their care needs – cancer treatments change so rapidly, and primary care providers can’t possibly stay on top of all the data to know how to best manage and coordinate care for survivors. There are also a number of promising interprofessional models for survivorship care now being rolled out and evaluated. We are also able learn a lot about how to improve the coordination of survivorship care by looking at how other chronic diseases associated with aging are effectively managed.