Access to care, eliminating disparities and expanding quality care are the top three things leaders want changed about cancer care.
The "how" of achieving these changes differs in opinion, ranging from expanding research to democratizing care to reducing reliance on big pharma.
Here is what eight leaders would change about cancer care:
Jame Abraham, MD. Chair of the Department of Hematology and Medical Oncology at Cleveland Clinic: Improving access and affordability for cancer drugs globally. Addressing the global challenge of access and affordability for cancer drugs necessitates a comprehensive and collaborative approach. Initiatives must be undertaken to streamline regulatory processes, ensuring that life-saving medications can reach patients swiftly without compromising safety standards. Furthermore, fostering partnerships between pharmaceutical companies, governments and nonprofit organizations is crucial to drive down costs and enhance accessibility. Research and development incentives for innovative, cost-effective treatments should be prioritized to create a sustainable pipeline of affordable cancer drugs. Additionally, global health organizations should work collectively to negotiate fair pricing agreements with pharmaceutical manufacturers, enabling equitable access for patients across diverse socioeconomic backgrounds. By combining regulatory reforms, collaborative partnerships and incentivizing innovation, we can forge a path toward a more accessible and affordable landscape for cancer drugs worldwide, offering hope to individuals facing this formidable disease.
Richard Carvajal, MD. Deputy Physician-in-Chief and Director of Medical Oncology at Northwell Health Cancer Institute (New York City): You know what drives me crazy? Disparities in healthcare. The fact that they exist and the differences in outcomes by race, ethnicity and socioeconomics. I can't believe in 2023 we have not made more progress. And what I would change is access to good cancer care and equitable care.
Ken Chaij. Executive Director of Oncology Service Line at Kettering (Ohio) Health: The No. 1 thing that I would change is access to quality cancer care. We have an aging population with multiple comorbidities; many of them have socioeconomic challenges. I think it is growing and we're seeing it as a challenge that requires more attention. More baby boomers are hitting 65 every day, and our limited capacity makes it difficult at times to see all the patients that require care. All of our physicians and advanced practitioners are swamped. But another aspect of that is very complex is insurance companies and getting treatment modalities or therapies approved in a timely fashion. Sometimes we are able to see patients quickly, but can't get their treatment approved for another week. It's a back and forth that goes on and I wish there was a way to reduce that complexity with insurance companies.
Tatjana Kolevska, MD. Medical Director of the Kaiser Permanente National Cancer Excellence Program (Oakland, Calif.): If I could change one thing about cancer care, it would be to eliminate disparities in access to cancer experts related to geography. Research shows us that access to cancer experts improves treatment outcomes, yet too few Americans live close to cancer centers where these experts tend to work. If healthcare systems leverage technology to its full capacity, patients can better connect with experts in their unique cancer type, regardless of physical location.
John Oertle, MD. Chief Medical Director and Cancer Specialist at Envita Medical Center (Scottsdale, Ariz.): In our clinical experience, we find that over 90% of cancer patients were receiving the wrong medications as part of their earlier treatment protocols, because they did not have access to the latest genomic tests, immunotherapies and targeted precision care. Due to the absence of these personalized precision oncology options in standard oncology facilities, the early signs of micro metastasis are often missed, which is one of the reasons why many early-stage patients experience a recurrence or metastatic spread even after treatment completion. Given a magic wand, I would want to replace these outdated one-size-fits-all treatment protocols and their reliance on big pharma industries alone, to utilize the latest in personalized precision integrative oncology for helping not just early-stage cancer patients, but late-stage patients as well.
Michael Postow, MD. Chief of the Melanoma Service at Memorial Sloan Kettering Cancer Center (New York City): Everyone should have access to the same kinds of treatments and expertise all around the world and in our backyard.
Mothaffar Rimawi, MD. Executive Medical Director at the Dan L Duncan Comprehensive Cancer Center at Baylor St. Luke's Medical Center (Houston): It is very hard to pick one thing. We need more funding for research, improved treatment options, and personalized care with precision oncology to name a few. But if I had to change only one thing, I would have to say it is access. I would make access to cancer care universal so that every cancer patient would receive timely care at the hands of a multidisciplinary team of specialists with access to the medications and procedures they need regardless of race, ethnicity, national origin, religion, sexual orientation, gender identity, socioeconomic status, insurance status or any other consideration.
Joseph Rosales, MD. Executive Medical Director for Cancer Services at Virginia Mason Franciscan Health (Seattle): If I could change one thing, it would be my ability to deliver all the care a patient needs directly where they need it. It's hard enough to deal with something as life-changing as cancer without having to uproot and move or travel. We need to democratize the delivery and treatment of cancer.