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Seth H. Berk, MD, says that even in this era of electronic medical records and text messaging, primary care physicians and other clinicians too often find themselves relying on their patient – rather than the patient’s oncologist – for key information about the person’s cancer treatment.
“The idea that a person facing cancer should bear primary responsibility for outlining her treatment regimen, which may entail doublet or even triplet therapy, to her PCP is unreasonable and is unfair to both the patient and physician,” says Dr. Berk, a board-certified medical oncologist and hematologist.
As Board Chairperson for Regional Cancer Care Associates (RCCA), one of the nation’s largest networks of oncology specialists with more than 20 locations near you across New Jersey, Connecticut, Massachusetts, and the Washington, D.C., area , Dr. Berk works closely with his colleagues to ensure close communication and collaboration between RCCA oncologists and their patients’ other physicians.
He explains, “Thanks to virtual tumor boards and similar platforms, I think that oncologists across the country do a pretty good job of coordinating with other physicians directly involved in the patient’s cancer treatment, such as surgeons, radiation oncologists, and pathologists. However, at RCCA, we extend our focus beyond the immediate multi-specialty cancer care team to ensure that the patient’s primary care physician, Ob/Gyn, urologist, gastroenterologist, and other physicians are kept in the loop about the treatment plan and, in particular, how that plan may affect non-oncologic conditions they are managing.”
Charanjeev Kapoor, MD, says that this communication is critical given the high prevalence of comorbid conditions in people with cancer and, as a result, their use of concomitant medications that carry the potential for drug-drug interactions with cancer therapies.
“A recent study involving more than 27,000 people with one of the four most-common cancers found that 54% of patients with breast cancer, 57% with prostate cancer, 65% with colorectal cancer, and 76% with lung cancer had at least one other serious condition, with about 20% having two or more comorbidities,”1 notes Dr. Kapoor, a board-certified medical oncologist and hematologist who practices at RCCA’s Manchester, CT, office.
Dr. Kapoor adds that the prevalence of comorbidities increases with age, as does the use of polypharmacy. “A second study that examined medication use in almost 200,000 people with cancer found that one year following their cancer diagnosis, 18.9% were taking five to nine drugs on a regular basis and 37.8% were taking 10 or more medications. Among those patients age 65 years and older, 80% were taking five or more medications, including a majority – 54% — who were taking 10 or more drugs.”2
“Unfortunately, many of the therapeutics that play a key role in our management of those ‘Big Four’ cancers can have adverse interactions with medicine widely used to treat common chronic conditions,” Dr. Kapoor. By way of example, he notes that the tyrosine kinase inhibitor (TKI) agents prescribed for non-small cell lung cancer, HER2-positive breast cancer, and other solid tumors and hematologic malignancies can interact with statins, warfarin, macrolide inhibitors, and other medications because they are predominantly metabolized by the CYP3A4 enzyme system.
Echoing Dr. Kapoor’s comments, Dr. Berk says, “We know how hard our colleagues work to control their patients’ hypertension, dyslipidemia, diabetes, and other conditions, so we communicate with those physicians when our treatment plan involves the potential for significant drug-drug interactions with a medication used to manage those diagnoses.”
The key to RCCA’s approach, Dr. Berk adds, is to stay in touch with the patient’s other physicians throughout the course of cancer care and, as appropriate, during long-term follow-up.
The oncologist/hematologist, who practices at RCCA’s Moorestown, NJ offices, says that effective collaboration means communicating at several points, including:
Dr. Berk says, “I think that one of the great strengths of RCCA is that our offices and oncologists are based in the community. For patients, this means access to the latest therapies and clinical trials in a convenient setting close to their homes. For those patients’ other physicians, however, it means ready access to colleagues who they often know from the hospital staff or local medical society, and who frequently are on the same EMR platform. Dozens of area PCPs and other physicians on the front lines of cancer detection have my cell phone number, and I’m always available for a quick consult, to expedite a patient’s first visit, or to coordinate our response to a treatment-related concern. Putting the patient at the center of care means working closely with the other clinicians in that patient’s orbit, and that is a priority for all of us at RCCA.”
Dr. Kapoor adds, “Thanks to the advances that have transformed cancer care in recent years, we have more therapies available to us than ever before, and those therapies are enhancing outcomes and extending survival to a greater degree than ever before. These are wonderful developments, but they add complexity to the treatment decisions that oncologists and other physicians need to make to optimize patients’ health both during and following cancer treatment. We’re committed to communicating and closely collaborating with our patients’ other physicians to protect and promote those patients’ overall well-being.”
Dr. Berk and Dr. Kapoor are among 90+ medical oncologists and hematologists who practice with Regional Cancer Care Associates (RCCA), one of the nation’s largest networks of oncology specialists. RCCA has more than 20 locations near you across New Jersey, Connecticut, Massachusetts, and the Washington, D.C., area. RCCA’s cancer specialists see more than 30,000 new patients each year and provide care to more than 265,000 established patients, collaborating closely with those patients’ other physicians. RCCA physicians offer patients innovative therapies, including immunotherapies and targeted therapy, as well as access to approximately 300 clinical trials. In addition to serving patients who have solid tumors, blood-based cancers, and benign blood disorders, RCCA care centers also provide infusion services to people with a number of non-oncologic conditions—including multiple sclerosis, Crohn’s disease, asthma, iron-deficiency anemia, and rheumatoid arthritis—who take intravenously-administered medications.
To learn more, call 844-346-7222 or contact RCCA.
References
For more information or to schedule an appointment,
call 844-346-7222. You can also schedule an appointment by calling the RCCA location nearest you.
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