FAQs About Cancer Commons Patient Services
Overview of Services
Q: What services are provided to patients by Cancer Commons?
A: We provide general and personalized information related to a patient’s diagnosis, sometimes based on direct review of a patient’s medical records, with the patient’s consent. While corresponding with us, a patient may receive:
- Education about treatment options and treatment expectations
- A curated list of clinical trials that are most relevant for them
- Information about molecular testing services
- Information about second/additional opinions and remote second opinions
- A list of cancer type-specific experts, center-of-excellence/high-volume clinics, and National Cancer Institute-designated Cancer Centers
- Information on supportive care and management of symptoms and side effects
Q: What does Cancer Commons provide that patients cannot find anywhere else?
A: Cancer Commons provides up-to-date, evidence-based information tailored to the patient’s type of cancer, prior treatment, and goals, without suspicion of conflicts of interest, and delivered with clarity and compassion.
Q: Which cancer types does Cancer Commons address?
A: We welcome questions from people dealing with any kind or stage of cancer. Many people have come to us for guidance on all of the common types of cancer, especially breast, lung, skin, colorectal, and prostate cancer. We also have a special focus on brain and pancreatic cancers, and we have provided guidance to many people dealing with uncommon types of cancer.
Q: How does Cancer Commons communicate with patients?
A: We communicate with patients primarily through email, since it is best for capturing information. Phone calls or personal meetings are sometimes scheduled, as appropriate.
Q: What information do we collect about each patient’s situation and treatment goals?
A: We ask the patient to provide all relevant medical records, including clinic notes, scans, diagnostic reports, prior treatment records, geographical preferences, and related facts that may inform their treatment options and decisions. We ask questions to understand what each patient is truly looking for. We seek to understand their personal preferences regarding a “cure” at any cost, extension of life duration, cost-versus-care tradeoffs, quality of life, and concerns about adverse side effects.
Molecular Testing and Tumor Boards
Q: How does molecular testing inform information on personalized options provided to patients by Cancer Commons?
A: One of our standard suggestions to every patient whose diagnosis makes them a potential candidate for “precision oncology” is that they request—or even insist—that their tumor be subjected to molecular analysis. Molecular testing may show a specific actionable molecular alteration, such as a genetic mutation, in a patient’s tumor that can be targeted by a specific drug. Currently, dozens of drugs have been approved by the U.S. Food and Drug Administration (FDA) for such “targeted therapy.”
The FDA has also approved many drugs for other diseases (including cancers) that may be prescribed by any licensed American physician for “off-label” use in a cancer patient, provided there is a reasonable treatment rationale to use it against a particular cancer. Also, many hundreds of additional targeted drugs are currently being tested pre-clinically or in clinical trials.
For some patients, molecular testing is a key step for identifying the best molecular therapeutic option, which may be directly prescribed or available via a clinical trial.
For patients who have an actionable molecular alteration, Cancer Commons provides information about targeted therapies and clinical trials that target that specific alteration. We have partnered with the for-profit company xCures to facilitate access to off-label and investigational therapies for patients who are eligible. This may involve what is known as “extended use” or “compassionate use,” as permitted by the FDA, and with the cooperation of the drug manufacturer.
Q: What is a virtual tumor board, and what do patients gain by going through one at Cancer Commons?
A: A treating physician may benefit by consulting other physicians to seek their opinions based upon scientific literature, as well as personal clinical experience. An organized effort of a group of this sort may be called a “tumor board.”
Tumor boards are usually made up of physicians who all work at the same medical institution. In order to involve experts who may be located elsewhere, a “virtual tumor board” may be convened. Subsets of tumor boards called “molecular tumor boards” may be used for precision oncology.
When appropriate, Cancer Commons convenes a virtual tumor board to drive suggestions for an individual patient. By going through a Cancer Commons virtual tumor board, a patient has the opportunity to hear from multiple experts from various institutions about their treatment options. The experts’ comments include both general rationales about the treatment options and rationales specific to the patient’s profile, treatment history, molecular testing results, and preferences.
Recipients of Services
Q: What stage of cancer do patients have when they seek help from Cancer Commons?
A: We provide guidance to patients at any stage of their disease. However, most patients seek our services when they are in an advanced stage of their disease.
Q: What are the main challenges faced by patients who seek support from Cancer Commons?
A: Patients who come to us face a variety of challenges, including:
- How to best proceed as they navigate their treatment options
- How to access affordable, evidence-based care, whether the patient is in an early stage of their disease, or if their cancer has recurred or spread
- How to find trustworthy information and cancer specific specialists
- How to choose between options when there is not sufficient clinical evidence—especially in later-line treatments
- Which additional testing may be appropriate
Q: Of the patients who seek support from Cancer Commons, how many have already been given treatment options by their treating physicians?
A: Almost all patients receive some form of guidance on their options from their treating physicians as their case management proceeds. But many who turn to Cancer Commons have run out of options suggested to them by their treating physicians, and they wonder if other potential options exist, particularly in the form of clinical trials or cancer clinics with expertise that may be relevant to the patient’s unique case.
Q: Of the patients who seek support from Cancer Commons, how many have already done molecular testing?
A: About 50% of the patients we support already have some molecular testing results when they first come to us. In most cases, this means they have been tested for just one or a few specific molecular features of their cancer that could help guide treatment. But no more than 10% to 20% have had comprehensive mutational testing prior to signing up for our services. A comprehensive mutational test evaluates hundreds of genes that are often altered in cancer; for some patients, this could further expand treatment options.
Impact of Services
Q: How many patients has Cancer Commons helped?
A: We have engaged with and helped approximately 4,000 patients and caregivers.
Q: What value does Cancer Commons provide to patients?
A: A patient or caregiver who uses our services may benefit from:
- Information about care in another city, at another institution, or from another physician
- Help with navigation of the complicated cancer treatment landscape
- Help with matching to an appropriate clinical trial
- Information about treatment options to consider
- Information about their specific disease, including the science behind their molecular alterations
- Empowerment to advocate for themselves or for their loved ones
Q: What have patients said about Cancer Commons’ services?
A: Patients and caregivers have told us that they appreciate the responsiveness of our caring scientists, the opportunity to learn what further treatment may or may not be available to them, and new knowledge about their own particular type of cancer.
Based on the feedback we receive, we believe that most patients we’ve helped feel that they were provided with additional possible treatment options, provided with information about second/additional opinions, treated with respect, and given realistic—not false—hope. We believe that a successful interaction between a patient and Cancer Commons results in the patient being at peace that they have done the best they could to deal with their difficult situation.