Sharing The Load: A Novel Approach to Cancer Care

21 January 2019
mark harris

Rates of cancer survival are increasing – in Australia, people diagnosed between 2010-2014 had a 69 per cent chance of surviving at least five years, up from 49 per cent in the 1980s. But as survival rates increase, so too do rates of diagnosis, leaving specialist cancer services struggling to meet demand.

Enter the E-Cancer Shared Care Plan, a project led by researchers in the Continuum of Care flagship at the TCRN. Currently being piloted at Sydney’s St George Hospital, the initiative will test the acceptability and utility of sharing the care of long-term cancer survivors between specialist cancer services and general practitioners. 

The research aims to alleviate the pressure on public hospital cancer services while ensuring that long-term cancer survivors remain connected to the specialist medical system.

“We’re particularly focused on the period after active treatment is stopped and people are finished with their chemotherapy, radiotherapy and so forth,” says Scientia Professor Mark Harris, Deputy Director of the TCRN and Chief Investigator on the project.  

During the pilot, the research team aims to recruit 20 colorectal cancer patients receiving treatment at St George Hospital, as well as their GPs and specialists. After active treatment is completed, the GPs and specialists will work together to create patient care plans using a secure cancer services system that’s well integrated in the general practice setting.

The care plans, which are created using a pre-existing template, will outline a list of tasks – determined by the cancer service – to manage the patient’s health needs into the future. Responsibility for each task is then assigned to either the GP, the specialist or the patient themselves.

These tasks might include monitoring for cancer recurrence or the development of new cancers, managing the long-term physical and emotional side effects of cancer treatment, and supporting the patient to achieve a range of lifestyle goals, such as maintaining a healthy weight, eating a balanced diet and doing regular exercise. It will also outline specific appointments, tests and treatments that the patient needs to attend.

“So, the care plan might indicate that the patient needs to be reviewed three-monthly by the GP and when they need to do certain tests, and then every 12 months they might need to see the cancer service, and those tests will need to be available to the cancer service at that time,” Harris says.

Research conducted in an earlier stage of the project showed that while GPs are well placed to manage patients’ long-term care, maintaining an ongoing connection to specialist cancer services was critical for both clinicians and patients to feel comfortable with the new arrangement. This shared care approach ensures that GPs are well supported in delivering effective post-cancer care, and that patients feel more confident with the care that they receive.

“Because cancer treatment is changing so rapidly and there’s so many different forms of treatment that are being used, it’s hard for GPs to keep up to date with the latest cancer treatment and what the long-term consequences might be.  The e-care plan provides guidance on what they need to be on the lookout for,” Harris says. 

“It’s reassuring for the GP to know that specialist backup is there, and if they have a problem they can liaise with the cancer service for advice.”

The pilot will run until the end of 2019, with plans for further expansion in 2020.