Defining the Roles and Responsibilities of Patient Navigators

Patient navigation, which helps patients overcome barriers to accessing care, is growing in importance, particularly in cancer care. Patient navigators, sometimes also called patient advocates, health care advocates or consultants, or medical advocates, aid patients in finding doctors, understanding treatment and care options, dealing with medical paperwork, maneuvering insurance, and more. However, the exact roles and responsibilities of patient navigators remain ill-defined. In a recent article, a committee of cancer care providers, educators, and cancer research centers, led by the George Washington University Cancer Institute, lays down a consensus framework defining the roles and competencies of patient navigators and clarifying their place in the health care system. This framework is intended to help standardize the patient navigator profession.


Survivorship-Care Programs Pick Up Where Cancer Treatment Leaves Off

Thanks in part to improvements in cancer treatment, the number of cancer survivors is steadily increasing. Even after overcoming cancer, however, survivors still face numerous challenges. The cancer may return, so regular monitoring is needed. In addition, cancer treatments can damage organs or impair attention and memory. Cancer also takes an emotional toll; many cancer survivors experience depression or anxiety. Increasingly, hospitals and nonprofit groups are offering survivorship-care programs that provide treatment follow-up plans, physical rehabilitation, and psychological assistance. The Commission on Cancer, which accredits cancer centers in the U.S., will require these centers to provide survivorship-care plans starting in 2015. Moreover, a congressional committee is currently considering a bill that would require Medicare to cover care-planning services for cancer survivors.


Survivorship-Care Programs Pick Up Where Cancer Treatment Leaves Off

Thanks in part to improvements in cancer treatment, the number of cancer survivors is steadily increasing. Even after overcoming cancer, however, survivors still face numerous challenges. The cancer may return, so regular monitoring is needed. In addition, cancer treatments can damage organs or impair attention and memory. Cancer also takes an emotional toll; many cancer survivors experience depression or anxiety. Increasingly, hospitals and nonprofit groups are offering survivorship-care programs that provide treatment follow-up plans, physical rehabilitation, and psychological assistance. The Commission on Cancer, which accredits cancer centers in the U.S., will require these centers to provide survivorship-care plans starting in 2015. Moreover, a congressional committee is currently considering a bill that would require Medicare to cover care-planning services for cancer survivors.


Survivorship-Care Programs Pick Up Where Cancer Treatment Leaves Off

Thanks in part to improvements in cancer treatment, the number of cancer survivors is steadily increasing. Even after overcoming cancer, however, survivors still face numerous challenges. The cancer may return, so regular monitoring is needed. In addition, cancer treatments can damage organs or impair attention and memory. Cancer also takes an emotional toll; many cancer survivors experience depression or anxiety. Increasingly, hospitals and nonprofit groups are offering survivorship-care programs that provide treatment follow-up plans, physical rehabilitation, and psychological assistance. The Commission on Cancer, which accredits cancer centers in the U.S., will require these centers to provide survivorship-care plans starting in 2015. Moreover, a congressional committee is currently considering a bill that would require Medicare to cover care-planning services for cancer survivors.


Delays in Lung Cancer Care Are Cause for Concern

Almost half of all lung cancer patients face unwelcome delays in their cancer care, a UK survey found. The survey, conducted by the UK Lung Cancer Coalition (UKLCC), polled over 400 lung cancer patients and their care providers. Although 95% of patients named prompt referral to a hospital as a priority, only 64% had received it, and 46% had experienced delays at some stage of their care. These findings are particularly concerning given the importance of timely treatment in improving lung cancer outcomes. In addition, 57% of respondents indicated that they had not received accurate information about their lung cancer diagnosis. Based on these results, the UKLCC has developed a series of suggestions for improving lung cancer care.


Survival Rates after Lung Cancer Surgery Essentially Unchanged Since 1950s

Despite advances in cancer research, the survival rates of lung cancer patients after surgery have not changed significantly in the last 60 years, highlighting the need for better therapies. After specialist chest surgery, patients have a 5-year survival rate of 25% and a 10-year survival rate of 15%; survival rates are lower in patients whose cancer is inoperable or who are too weak to receive surgery. However, lung cancer patients are now much more likely to be treated by a chest specialist surgeon than they were in the 1950s. Nevertheless, referral rates to chest specialist units for lung cancer patients can and should still be improved. These concerns, along with other challenges facing lung cancer research, are discussed in a new book on the history of lung cancer.


Compassionate Use of Unapproved Drugs Raises Difficult Ethical Issues

Patients with terminal illnesses, including late-stage cancer patients, are understandably eager to try still-unapproved experimental drugs once other options have been exhausted. The U.S. Food and Drug Administration (FDA) recently created a program to make it easier for drug companies to grant ‘compassionate use,’ which allows patients in extraordinary need access to otherwise unauthorized treatments. However, the decision to dispense experimental drugs is left to the companies, which are often reluctant to take this risky step. Experimental drugs are just that–experimental; they may have catastrophic side effects or simply not work. When these drugs are given outside the framework of a well-designed clinical trial, it becomes impossible to decisively judge whether they actually work. And if all patients could bypass clinical trials, there would be no incentive for anyone to enroll in these clinical trials, meaning that new drugs would never be properly studied and approved. Compassionate use therefore needs to be approved by experienced medical professionals on a case-by-case basis, and remain an option of last resort only.


Compassionate Use of Unapproved Drugs Raises Difficult Ethical Issues

Patients with terminal illnesses, including late-stage cancer patients, are understandably eager to try still-unapproved experimental drugs once other options have been exhausted. The U.S. Food and Drug Administration (FDA) recently created a program to make it easier for drug companies to grant ‘compassionate use,’ which allows patients in extraordinary need access to otherwise unauthorized treatments. However, the decision to dispense experimental drugs is left to the companies, which are often reluctant to take this risky step. Experimental drugs are just that–experimental; they may have catastrophic side effects or simply not work. When these drugs are given outside the framework of a well-designed clinical trial, it becomes impossible to decisively judge whether they actually work. And if all patients could bypass clinical trials, there would be no incentive for anyone to enroll in these clinical trials, meaning that new drugs would never be properly studied and approved. Compassionate use therefore needs to be approved by experienced medical professionals on a case-by-case basis, and remain an option of last resort only.


Compassionate Use of Unapproved Drugs Raises Difficult Ethical Issues

Patients with terminal illnesses, including late-stage cancer patients, are understandably eager to try still-unapproved experimental drugs once other options have been exhausted. The U.S. Food and Drug Administration (FDA) recently created a program to make it easier for drug companies to grant ‘compassionate use,’ which allows patients in extraordinary need access to otherwise unauthorized treatments. However, the decision to dispense experimental drugs is left to the companies, which are often reluctant to take this risky step. Experimental drugs are just that–experimental; they may have catastrophic side effects or simply not work. When these drugs are given outside the framework of a well-designed clinical trial, it becomes impossible to decisively judge whether they actually work. And if all patients could bypass clinical trials, there would be no incentive for anyone to enroll in these clinical trials, meaning that new drugs would never be properly studied and approved. Compassionate use therefore needs to be approved by experienced medical professionals on a case-by-case basis, and remain an option of last resort only.