Integrative oncology can best be described as patient-centred, evidence-based comprehensive cancer care that includes conventional cancer treatments as well as encompassing validated complementary therapies, to achieve the best possible patient experience and outcomes.
It is a one-stop-shop for all components of cancer care, all housed in one location or connected digitally. But what does that actually look like in Australia, and how does our unique landscape affect our ability to share information in a way that makes it easier for patients to navigate cancer care pathways?
The challenges patients currently face when needing cancer care
In January to November of 2018 the All.Can patient survey was conducted across ten countries (including Australia) to identify inefficiencies across the entire continuum of cancer care – from the perspective of patients. It identified four key opportunities where patients reported areas needing improvement¹.
- Swift, accurate and appropriately delivered diagnosis
- Information, support and shared decision-making
- Integrated multidisciplinary care
- The financial impact of cancer
At the time of diagnosis patients’ are vulnerable so it’s important to them to have care that is really easy to navigate to not only avoid additional stress but also help address some of the financial concerns – such as travel costs.
What does the ideal model look like?
The ideal system is one of connection. Essentially, everyone involved in the care of a patient would be connected either physically or digitally. This could mean having everybody involved in their care in one location, housed under the same roof in a holistic clinical setting, or shared electronic medical records. Meetings of multidisciplinary teams should be scheduled either in person or virtually to discuss patients’ cases².
Being able to facilitate access to different support services as well as relevant and evidence-based complementary care in addition to standard cancer therapies would be the ultimate goal of integrative oncology – with the Society of Integrative Oncology formed to do just that.
Adapting this ideal to suit the unique landscape of Australia
Given Australia’s geography we are going to need a more flexible model of integrative cancer care. For example, the larger centres in more metropolitan areas are moving towards the medical specialties model, aiming for that gold standard in integrative care. However, beyond those highly populated areas, we need to be more adaptable when applying these principles to rural and remote settings.
For example, some regions do not have radiation oncology centres or access to complex and/or combined specialty surgeries. So patients in these areas still need to travel for their healthcare appointments. Combining services under one roof allows for a single trip to see multiple specialties at the same time, in the same location with shared electronic medical records.
There are several tertiary centres that run multidisciplinary team follow-up clinics, where the patients will get to see everyone they need to all in one day, including surgeons, radiation oncologists, medical oncologists and relevant allied health professionals like exercise physiotherapists, acupuncturist, and counsellors.
All health care professionals (HCPs) are able to input into the patient’s follow-up and confer with each other if needed. In order to make this work for more remote communities we need to embrace technology such as telehealth to allow patients and their healthcare providers to connect without the need for travel.
The most important thing to remember is that each patient will have different priorities, preferences and needs. So whatever model of integrative cancer care is implemented, it needs to be able to adapt to fit those needs to provide patients with the most value.
What you can do today to move a step closer to integrative cancer care
While there are some larger systemic shifts that need to be made in order to reach the ideal model of integrative cancer care, there are things you can start to apply to your practice to help patients navigate cancer treatment.
One thing is to take what we’ve learnt from the COVID-19 pandemic and apply it to regular practice. For example, utilising telehealth in place of face-to-face appointments with patients or to facilitate meetings of multidisciplinary teams to review patient cases and ensure everyone is on the same page.
Another, major, piece of advice is to engage our cancer care coordinators in more of the conversation. Highlighting the importance of their role as patient advocates and guides through the various treatments and support services to the patients themselves is essential. These roles are not to be confused with clinical nurse coordinators – the role of a cancer care coordinator is a more specific one, requiring intimate knowledge of what services are available in their area, what’s achievable and what is not. This allows them to connect the patient with both the specialist centres and services available in their local community.
The cancer care coordinator should be included in all correspondence of a multidisciplinary team, they should be present and actively involved in multidisciplinary team discussions. Not only is this to keep them across the full picture of the patient’s journey but so they can act as a valuable resource to help navigate the patient’s cancer journey and to facilitate further appointments and discussions that the individual patient may require. This could help close the gaps highlighted by the All.Can survey where over a quarter of patients were not given information in a way they could understand about their cancer care and treatment, and almost a third were not given information about support services such as patient groups or charities
While these actions might seem small – utilising technology and involving and championing cancer care coordinators – the potential impacts they can have on relieving stress and some of the burden of navigating cancer care for patients are enormous.
References:
- All.Can initiative [Internet]. Patient insights on cancer care: opportunities for improving efficiency; Findings from the international All.Can patient survey. Posted on 23 July 2019. Available online here. (Accessed September 2022).
- Bosserman LD, et al. J Clin Med 2021;10(2):188. Access online here.
Source: Sponsored by GenesisCare. For more information, view GenesisCare’s Company Bio page.
