What it will mean to say “I have cancer” in Dallas-Fort Worth in 10 years
The courage it takes to say the words “I have cancer” today is arguably as difficult as it was 20 years ago – and so is the mental and emotional roller coaster that ensues. What has changed markedly, however, are the advances made in cancer care over these two decades.
- For perspective, only two decades ago, chemotherapy was the only treatment for cancer patients. We are now light years ahead with targeted therapies, immunotherapies and more specifically targeted clinical trials.
- We also rely heavily on oncology telehealth services to reach patients who have difficulty getting to the clinic due to risk of infection, transportation issues or rural living; and in new technologies, like CAR T-cell therapy, which modifies the immune system to target cancer cells.
- Over the past 20 years, we have also added vital cancer support services. Once considered a “nice to have,” these essential social and emotional support services for patient and caregivers have been a game-changer when it comes to the number of people in our community — and across the United States — who s come out of it mentally during their life-changing cancer journeys.
- Navigators and finance advocates are breaking down barriers to focus on healthier lifestyles and easier access to care. Action plans address disparities or inequities in cancer care.
Conclusion: All signs point to positive progress on the cancer front. In fact, national statistics show that cancer death rates have fallen 32% from a peak in 1991 to 2019. Additionally, social and emotional support intervention has been shown to reduce the risk of recurrence and potentially improve survival in cancer patients.
However, what the next 10 years, and even the next 20, will look like depends much more on what we, as doctors, health care providers, patients, payers and employers in North Texas, do to eliminate a significant and unspoken barrier to progress in cancer care. : compartmentalised care.
We believe that the next frontier in cancer care will be in the care of the whole person. In other words, can we manage health care more holistically, to recognize the impact of a cancer diagnosis on the whole person and what this means for the long-term health of patients, the costs of health care and quality of life?
Cancer care is not just about medicine. There is much more to cure than simple drug treatment. We are still very siloed in how we look at patient care, which slows progress, the ability of patients to survive and thrive, and costs incurred on so many fronts.
Here are some statistics to ponder:
- The Texas Cancer Prevention and Research Institute reports the state is expected to see 140,000 new cancer cases this year at a direct cost of about $44.7 billion in 2020, up $2 billion as of 2019.
- 54% of Cancer patients in the United States report mental distress which was never addressed throughout their cancer journey, and research shows that patients with depression have higher healthcare utilization (33.6 hospital visits vs 18.8 visits) , according to a study published in the National Library of Medicine.
- And yet, patients participating in a 6-week cognitive-behavioral session bill the healthcare system 23.5% less than the control group, according to a study on the effects of group therapy for breast cancer health care.
So if we know that patients feel better with mental and emotional support, cost less to the healthcare system, and recurrences are reduced, why don’t we look at treatment from a holistic perspective?
The answer is complex. The reality is that healthcare teams continue to operate in silos. Information such as lab tests is still not shared easily between different health care teams. Specialists tend to focus on the disease they are treating. Mental health issues are often overlooked. Financial toxicity is not managed. Caregiver burden is not assessed. Health-related social needs go unnoticed. It is the problems of the whole person that must be solved.
As Leslie Barker wrote in her April 2022 coin of Cancer Support Community North Texas CEO Mirchelle Louis, who is herself a cancer survivor: “My own cancer experience allows me to speak with authenticity and authority about the impact of cancer,” said Louis. “I feel like I have an added responsibility to talk and talk and do more. The problem… is hearing clients say to him, ‘I wish I had known you six years ago. We don’t even see 10% of [those diagnosed.]’ ”
Again, part of the reason for this has to do with our siled nature. The more we, as a health care system, view social and emotional support as an essential part of holistic cancer care, the more we can help improve patient outcomes and reduce hospital utilization.
In fact, this year marks the 20th anniversary of Cancer Support Community North Texas, a nonprofit that started at a small site in Oak Lawn and now provides mental health support to more than 5,000 cancer patients. and their caregivers each year at three Dallas-Fort Worth “clubhouses”. The CSCNT is considered a national flagship organization and patients even come from out of state for services and support. Now imagine what an impact we could have if this essential support were fully integrated into cancer care — if, as Louis puts it, CSCNT could reach the “other 90%” who haven’t heard of it yet.
If we can dissolve siled care, when combined with the exciting advances around the corner – individualized prevention and treatment strategies, such as first-in-kind clinical trials testing multiple drugs and digital communication technology provider -patient, to major efforts to address health equity and medical outcome issues in disadvantaged communities – we can make the next two decades of cancer care even better.
For anyone affected by cancer in North Texas, take the first important step: make sure your friends and family have access to services that help provide holistic care. Visit www.cancersupporttexas.org.
Dr. Lalan Wilfong is an oncologist and vice president of payer relations and practice transformation at the US Oncology Network. Mirchelle Louis is CEO of Cancer Support Community North Texas. Elaine DeMeyer is a nurse oncologist and founder of Beyond Oncology.
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