Report: US is facing a crisis in cancer care

The United States is on the brink of a crisis in cancer treatment, as an undermanned workforce of oncologists faces a projected explosion in the number of cancer patients over the next 15 years or so, according to a report released Tuesday by the Institute of Medicine, the health arm of the National Academies.

More than 1.6 million new cases of cancer are diagnosed in the United States each year. The report predicts that by 2030 that number will have increased by 45 percent, to 2.3 million.  The majority of cancer diagnoses occur in patients over 65, and the baby boomer generation is about to enter its 60s and 70s.

“Just because we are having an expansion of that age group, we’re going to see many more diagnoses, many more deaths and many more individuals surviving the disease,” said Dr. Patricia Ganz, chair of the committee that wrote the report and the director of cancer prevention and control research at the UCLA Jonsson Comprehensive Cancer Center. 

The report says "workforce shortages among many of the professionals involved in providing care to cancer patients are growing, and training programs lack the ability to rapidly expand."

It's difficult to recruit people to become oncologists because the difficulties of dealing with cancer lead to a high level of "stress and career burnout," the report notes. It says the health care community is trying to address the problem, by implementing  "several strategies to improve the recruitment of oncology and other health professionals, including national campaigns, early exposure to health professionals, and loan forgiveness and scholarship programs."

The report  expressed concern that cancer care "is often fragmented and poorly coordinated." It recommends a series of steps, including providing patients with better information about their treatment options, incorporating team-based care by trained specialists and clinicians, and making sure patients receive only the treatments they need.

“If we know that something is not beneficial, we should not be doing it to someone,” said Ganz. “And if it is, we should make sure that they get it. This is where we have the problems.”

The rising cost of cancer care is also a major cause for concern, according to the report, which cited an increase from $72 billion in 2004 to $125 billion in 2010. 

“We’re spending 17 percent of GDP on health care," said Ganz. "It can’t go any higher. We’re going to break the bank. We need to do something, and cancer is kind of the poster child for where we need to get controls on things. We need to improve the quality and reduce the waste.”

The Institute of Medicine report, titled “Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis,” is an update to an earlier one released in 1999.  It was sponsored by several organizations, including the National Cancer Institute, the Centers for Disease Control and Prevention, and the American Cancer Society.

Ganz was among a group of experts who briefed members of Congress Tuesday in Washington, DC. She said that the report is intended to act as a blueprint for future care and that, while seemingly dire, is meant to ensure equal, improved coverage for all.

“We don’t want to frighten people about their care. That’s not the intent here,” Ganz said. “Many people are actually getting very good care, and they feel very comfortable with what’s being done, but we know that there are substantial gaps in quality, and that’s what we want to raise. We want to make sure that everyone has a level playing field and opportunity to get the best care that’s appropriate for their diagnosis and phase of illness.”