SAN FRANCISCOIn an era of increasing fragmentation and
specialization in cancer care, and a trend toward ambulatory care,
the family physicians role as a coordinator of care is more
important than everfor both patients and cancer specialists,
David Rosenthal, MD, president of the American Cancer Society (ACS),
said at the American Academy of Family Physicians meeting.
Not only is the family physician vital in detecting the disease, but
also in helping ensure quality of life and support for cancer
survivors and their families . Today, there are more than 10
million cancer survivors facing an array of psychosocial, family, and
financial issues, said Dr. Rosenthal, director of Health
Services at Harvard.
Role of the Family Physician in Cancer Care
Adapted from Clark EJ, Stovall EL: Cancer
The American Cancer Society has established three goals for the year
2015: a 25% reduction in overall cancer incidence, a 50% reduction in
cancer mortality, and better quality of life for all cancer survivors.
Many of the concerns of physicians in achieving these goals
center on how to follow cancer patients and screen for cancer,
Dr. Rosenthal said. He noted that follow-up guidelines for certain
cancers are controversial. But we certainly need to integrate a
patients cancer history into our wellness programsprograms
that can be centered around the family physicians office,
Family physicians are also more likely to take on the role of social
worker with cancer survivors, helping to answer questions and arrange
for psychosocial support. Many cancer patients are filled with
questions ranging from How much pain will I have? to
Why am I depressed? Dr. Rosenthal said.
Well-validated quality of life studies by the ACS and other
organizations also show that cancer survivors face many common
problemsfatigue, loss of strength, fear of recurrence, and
sleep and sexual performance difficulties. We need to offer
these patients more supportive care with the goal of making them feel
and function better, he said.
Family physicians also need to be aware of the growing interest among
cancer patients in complementary therapies, such as vitamins,
relaxation therapy, special diets, and meditation, he said, noting
that 72% of cancer survivors have used at least one of these
therapies. Not only do we need to urge our patients to stay in
the mainstream for treatment with evidence-based therapies, but we
need to encourage them to talk to us about their use of alternative
and complementary therapies, Dr. Rosenthal said.
Certainly, the family physician has to be an integral part of the
cancer treatment team, he said. The family doctor often diagnoses the
cancer and makes sure that the patient receives care for treatment
side effects. The family physician may also act as a detective,
piecing together clues about whether symptoms during treatment are
related to the cancer, the treatment, or another cause.
Family physicians may feel uncomfortable dealing with patients
undergoing newer cancer therapies, he said, but at the same
time, the family physician knows the patient best. Thats why
family physicians can help provide the cancer patient with more
integrated care, as well as offer the patient hope and be his or her
advocate for the best care possible.