Quality Cancer Care: Making Sure You Get It

Cancer is a common disease and affects one out of every two families.  One out of every two men will get cancer and one out of every three women will get cancer.  Of Americans over 65 years old, 21% are cancer patients. Therefore, achieving the best quality in cancer care is important to each of us since we will either have cancer, have a family member with cancer, or have a friend with cancer whom we want to help.

Many new treatments have been discovered for cancer.  Indeed, these columns have reviewed many of these in the past and will review many more in the future.  But, how can a patient be certain that they are getting the most up-to-date quality cancer care? 

Recently, many organizations have developed comprehensive quality care guidelines.  These organizations include the American Society of Clinical Oncology (ASCO), The National Cancer Network (NCCN), and the Cancer Centers of Excellence (CCE).  Each of these guidelines is similar, but not identical.  Compliance of any patient’s care with any one of these set of guidelines will likely guarantee high quality care, although individual doctors would prefer to use one set of guidelines versus another. 

The largest problem in getting quality cancer care is making certain that your physician is reviewing your treatments to know that the treatments you are receiving are in compliance with what is recommended for best quality care.  Methods which your doctor can use to be certain that any patient’s personal cancer care is following a national guideline for that disease, include the Quality Oncology Program Initiative (QOPI) of ASCO, the Quality Cancer Care Project using evidence-based treatment protocols (ETPs) of the CCE,  the quality compliance project of the NCCN, and the quality care initiative of U.S. Oncology (that reviews patients according to quality measures that US Oncology Network has established for their practices).  Be aware: some of these guidelines are more comprehensive than others. So you can check with any of these organizations on the internet to be certain that for a disease in which you are interested, that a comprehensive guideline is available.

How can you be certain that your care is being compared using one of these measurement programs?  First, you must ask your cancer team which set or sets of guidelines they use to evaluate the quality care that they give.  Beware, if your cancer team says, “we don’t know,” consider your care to see if you want to get a second opinion from a program that does review their results.  Second, ask your physician when your case has last been reviewed to determine if you are in compliance with national guidelines for cancer care, and was there anything extra that you needed to add.  Beware, if your doctor is confused by your question, or if your doctor does not know the answer, or worse if your doctor has never looked at your records to see if you are compliant, consider whether you need a second opinion. 

Even if you are being taken care of by an excellent physician, the necessity for measuring your compliance is important.  Even at the finest of cancer care institutions in the country, not every patient has been found to be compliant with nationally accepted guidelines.  By simply asking these questions, your physician can understand that YOU want YOUR care to be compliant with all of these guidelines.  And YOU want the best QUALITY care that is available. If there is a reluctance to do so, perhaps it is time to shop around for another opinion.