Blog Entry: October 8th, 2009
In a recent NCI commentary, (http://www.cancer.gov/ncicancerbulletin/090809/page4) the Associate Director of the NCI's Division of Cancer Control and Population Sciences outlined the critical role that primary care providers can and should play in helping their patients with cancer.
Dr. Rachel Ballard-Barbash noted that as the array of cancer treatment options becomes increasingly complex, we need to be able to count on primary care providers who can play a role in the appropriate coordination and delivery of care. In fact, as her commentary noted, a recent NCI study indicated that some primary care providers are already actively engaged in coordination of their patients' cancer care and management of co-morbid conditions.
At ENACCT, we share the concerns of Dr. Ballard-Barbash-and in addition, believe that primary care providers have an important role in helping facilitate patient understanding of broad treatment options, including clinical trials, as they make their first referrals to the local oncologist. Yet, only 2% of primary care providers routinely discuss cancer trials with their patients; thirty-seven percent lack awareness of local trials for patients (Crosson J Cancer Educ, 2001).
If we are to make further advances and help patients to fully benefit from the growing ranges of treatment options that continue to be discovered, we believe that all primary care providers must be committed to sharing information about cancer clinical trials. Recognizing the different time/resource commitments that exist, ENACCT's training programs propose provider engagement along a continuum, from "low intensity" involvement through placement of patient education materials in office waiting rooms to higher levels of involvement through basic discussions of cancer clinical trials with patients to referrals to trial-participating oncologists.
It is imperative that we promote greater primary care provider education about cancer clinical trials; however, ENACCT has been challenged in promoting this goal. Some providers feel it is not their responsibility to discuss treatment options, and prefer to leave that discussion to the oncologist. Others simply lack knowledge or awareness about clinical trials, or share common myths about their appropriateness for all cancer stages. A 2004 article by Sherwood et. al ('To Refer or Not to Refer: Factors that Affect Primary Care Provider Referral of Patients with Cancer to Clinical Treatment Trials', Journal of Cancer Education, 19:1, 58 - 65) confirmed the importance of educating primary care providers about cancer clinical trials; the more training they had the more likely they were to make a patient referral to providers conducting clinical trials.
ENACCT is pleased to offer an introductory online workshop "Your Role in Cancer Clinical Trials: Why They Are Important for My Practice" to help address this important need. A free one-hour course, offering free continuing education credits for physicians, nurses and social workers, the course focuses on prompting primary care provider action on referral to local oncologists who participate in clinical trials; educating patients about the importance of clinical trials as an option for first line treatment; and encouraging patients to ask about clinical trials when meeting with oncologists. To learn more about the course for primary care providers and how to register, please visit www.enacct.org/yourrole.