- Promote and support the efforts of Connecticut hospitals to meet the standards of the American College of Surgeons’ Commission on Cancer (CoC)
- Promote and support increased participation in cancer-related clinical trials
- Advocate for policy, systems and environmental changes that lead to equal access to treatment for underserved groups
“The Connecticut Cancer Partnership has provided me with key resources with respect to patient education, available trials and the latest technologies.”
Nancy Teixeira, MSN, RN Administrator
52 Two-year Partnership member
- Share implementation strategies and best practices, including development of survivorship care plans (which include treatment summaries) and patient navigation programs
- Support regional cancer task force development
- Address issues at the state and regional levels, such as barriers to participation in clinical trials and strategies to address these challenges, including the establishment of a system to monitor the level of participation in clinical trials by people living in Connecticut diagnosed with cancer
- Monitor efforts at the National Cancer Institute to consolidate Clinical Trials Cooperative Groups regarding molecularly-based therapy clinical trial approaches as appropriate and educate the cancer control community on new development
- Establish system-wide changes to disseminate information about available clinical trials using culturally and linguistically appropriate methods
- Support efforts to make information on underlying genetic/ heritable causes of common cancers and the importance of genetic counseling and early detection more readily available to the public
- Reduce disparities in access to treatment related to geography, income, insurance status, etc. through policy, systems and environmental changes that address barriers and increase access to quality treatment
- Support patient navigation programs
- Disseminate information about medical home approaches to cancer care
- Support efforts to establish policy, systems and environmental changes for an umbilical cord blood collection program, focusing on collection of minority cord blood
Why This is Important
- Clinical trials are the critical final step towards determining the efficacy of new cancer treatments. Minority, low income and elderly populations are often underrepresented in clinical trials, making it difficult to extrapolate treatment protocols to all patients. Barriers include fears of increased costs, distance to clinic and lack of information about trials. Only five percent of cancer patients participate in clinical trials (American Cancer Society).
- Targeted cancer therapies block the growth and spread of cancer by interfering with specific molecules involved in tumor growth and progression. Targeted molecular cancer therapies may be more effective than other types of treatment and less harmful to normal cells. Many targeted cancer therapies have been approved by the U.S. Food and Drug Administration (FDA) for the treatment of specific types of cancer. Others are being studied in clinical trials and many more are in preclinical testing (research studies with animals) (47). This is leading to new challenges in clinical trial accruals, because patients will be required to have a particular molecular lesion to qualify.
- Gene expression profiling (genetic profiling) is a promising tool to help guide breast cancer treatment. These tests do not show genetic information about a person, but rather information about the genes in a tumor. The gene profiles of some tumors may help predict whether the cancer is more likely to recur and metastasize. Tumors with gene profiles showing a high risk of recurrence or metastasis may be more likely to respond to chemotherapy than tumors with gene profiles showing a low risk
- Blood and marrow transplant are proven therapies for some leukemias and lymphomas. Minority populations are less likely to find an unrelated donor match for transplant than whites. Umbilical cord blood can be a bridge for patients needing a transplant and unable to find an adult donor. There is a need for more publicly available cord blood units.
- Patients with medical homes are more likely to report better access to care, better coordination of care, improved communication with their primary care provider and fewer medical errors. A survey also showed that medical homes do not just improve, but actually eliminate disparities in getting needed medical care. (49, 50)
- ACOS CoC Cancer Program Standards 2012 Ensuring Patient-Centered Care establish new requirements around patient-centered needs and expand the focus on improving the quality of care and patient outcomes. Standards ensure that clinical services provide state-of-the-art pretreatment evaluation, staging, treatment and clinical follow-up for cancer patients seen at the facility for primary, secondary, tertiary or end-of-life care. The hospital’s cancer committee leads the program through setting goals, monitoring activity, evaluating patient outcomes and improving care. The cancer conferences provide a forum for patient consultation and contribute to physician education. The quality improvement program is the mechanism for evaluating and improving patient outcomes. Finally, the cancer registry and database is the basis for monitoring the quality of care. (51)
- Commission on Cancer Program Standards 2012:Best Practices Repository related to accreditation standards.
Eligibility Requirement 9 Clinical Trial Information:
A policy or procedure is used to provide cancer-related clinical trial information to patients.
Standard 1.9 Clinical Trial Accrual:
As appropriate to the cancer program category, the required percentage of patients is accrued to cancer-related clinical trials each year.
Standard 2.3 Risk Assessment and Genetic Counseling:
Cancer risk assessment, genetic counseling and testing services are provided to patients either on-site or by referral by a qualified genetics professional.
Standard 3.1 Patient Navigation Process:
A patient navigation process, driven by a community needs assessment, is established to address health care disparities and barriers to care for patients.