Rising Cancer Survivorship Brings New Policy Challenges

February 7, 2017

More patients are living longer with cancer – and that’s good news.  But some face policies, health care providers and workplaces that are unprepared to support survivors.  So explained a February webinar, “Global Cancer Survivorship: The Need for Integrative Care,” sponsored by Bristol-Myers Squibb.

Lack of Physicians and Training

As five-year survival rates surpass 50% in many high-income countries, the number of oncologists cannot keep pace, explained Martin Koehring of The Economist Intelligence Unit.  The group recently published new research on the topic.

And the time-strapped health care providers who are available may feel unprepared to meet survivors’ needs.  David M. Waterhouse, MD, of Cincinnati’s Oncology Hematology Care credited immuno-oncology, precision medicine and the application of big data for improvements in survivorship.  But he agreed that “as health care providers, we’ve been ill-equipped to handle” the challenges of serving survivors.

Need for Improved Pathways and Cancer Aftercare

Nations across the globe need more professionals and more training in how to care for survivors.  But care pathways must also evolve, as they seldom include “aftercare,” or treatment for patients who survive cancer.  Yet, one in four of these patients struggles over the long term, particularly with emotional and psychological challenges such as post-traumatic stress disorder, anxiety and depression.

“The mental piece is huge,” reiterated Kathleen Barnard of the cancer advocacy group Save Your Skin. “Survivors don’t even call themselves ‘survivors,’” she explained, because they’re afraid to “jinx themselves.”

Issues of Coverage and Value

In some countries, however, services that address these symptoms may not qualify for insurance coverage.  Few nations provide “holistic care,” Koehring explained.

The issue of value also comes into play. “We talk about value,” Dr. Waterhouse noted, “yet we don’t know how to measure value; we neglect to talk about the escalated value of survivorship as we talk about the escalating cost of care.”

Kathleen Barnard echoed his concerns.  Separate from cost value, Barnard explained, “We need to talk about the value…of innovative treatments to patients, the meaning of being integrated back into life.”

Role of National Cancer Plans

Carey Adams of the Union for International Cancer Control emphasized that national cancer plans are crucial for advocacy efforts.  A national cancer plan is a public health program that uses evidence-based strategies to reduce cancer deaths and improve patients’ quality of life.  Such plans can help prioritize health care spending, Adams explained, noting that funds could go to cancer treatment but also for related efforts such as tobacco control, risk factors, vaccinations and screenings.

Increasing survival rates is a marked achievement, the webinar concluded.  But it also clears the way for the next challenge: creating policies and health care systems that meet the needs of survivors.

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