Cherif Boutros, M.D.

 

by Cherif Boutros, MD
Medical Director, Tate Cancer Center at UM BWMC
Chair, Surgical Oncology at UM BWMC
Associate Professor of Surgery, University of Maryland School of Medicine

 

When diagnosed with cancer, rapid access to quality cancer care is crucial. Cancer patients have the right to have timely consultation with specialized oncology providers, access to research and clinical trials and receive a coordinated multidisciplinary care with patient navigation. This timely quality care will dictate the survival outcome as well as patient satisfaction. Value of cancer care remains incompletely defined. It may include provider trust and transparency, care coordination, survivorship care, quality of life, toxicity management, limited travel for care, and limited financial risk; or in another simple term, rapid access to quality care close to the patient location.

The National Comprehensive Cancer Network Work Group examined the challenges of access, high costs, and defining and demonstrating value at the academic cancer centers. The group findings and recommendations of the Work Group were recently published in the Journal of the National Comprehensive Cancer Network. In this report, Nardi et al. identified that academic cancer center challenges to provide access of high-quality cancer care include a growing demand for oncology services in the setting of a limited oncology workforce, disparities to receiving care, and increased economic pressures [1]. Cancer care at academic cancer centers incurs higher costs driven by drug prices, acute inpatient hospitalizations in the last months of life, or high-cost imaging. On the other hand, where a patient received care clearly impacts his survival. In a recent study by Wolfosn et al., individuals aged 22 to 65 years with adult onset cancers (breast, colorectal, lung, hepatic, pancreatic, gastric), patients not treated at NCI-designated Comprehensive Cancer Centers (NCI-CCCs) had a 20% to 50% higher risk of mortality compared with patients treated at NCI-CCCs [2].

At the University of Maryland Cancer Network, while we are carefully looking in minimizing our service cost, we realize that we have ample evidence of unprecedented service justifying a potential cost difference. At any of our Cancer Centers, patients are the focus of a myriad of patient care services including genetic counselors, dieticians, social workers, survivorship and nurse navigators. In each of our cancer centers, multidisciplinary tumor boards assure that our patients are receiving the best quality of cancer care and that this is done in a coordinated manner. Our affiliation with the Greenebaum Comprehensive Cancer Center provides access to various updated clinical trials and to cancer research. Our mission extends to educating patients and care providers in the community about contemporary cancer care. In 2016, the Cancer Institute at UM St. Joseph's Medical Center had the 10th annual conference for cancer care dedicated to cancer in women. Next year, the Tate Cancer Center at UM BWMC will start its annual symposium focused on minimally invasive cancer care.  Our commitment to provide timely appointments for cancer patients will be reinforced with an app allowing rapid contact with different oncology providers. We are looking forward that our robust access program will allow easy flowing of cancer patients to our specialized cancer centers bringing the high quality cancer care closer to patients homes.

References:

  1. Nardi EA, Wolfson JA, Rosen S et al. Value, Access, and Cost of Cancer Care Delivery at Academic Cancer Centers J Natl Compr Canc Netw. 2016 Jul;14(7):837-47.
  2. Wolfson JA, Sun CL, Wyatt L, et al. Impact of care at comprehensive cancer centers on outcome: results from a population-based study. Cancer 2015;121:3885–3893;