Key recommendations for improving care of ovarian cancer patients in the United States have been published as part of a collaborative, in-depth initiative spearheaded by the Association of Community Cancer Centers (ACCC) and involving a joint partnership between OCRA, the Society of Gynecologic Oncology, the National Society of Genetic Counselors, and the Association for Molecular Pathology.
The initiative was guided by an expert steering committee made up of gynecologic oncologists, pathologists, a genetic counselor, a nurse navigator, social workers, and cancer center administrators across the United States. This multidisciplinary group provided comprehensive recommendations for high-quality advanced epithelial ovarian cancer management that exceed the scope of current patient-level guidelines. Their findings were published in Cancer and contributors included corresponding author Sarah M. Temkin, MD, now of the National Institutes of Health, and OCRA’s Oncology Social Worker, Tracy Moore, LCSW.
“The objectives of this study were to identify and assess key components in the provision of high-quality care delivery for patients with ovarian cancer, identify challenges in the implementation of best practices, and develop corresponding quality-related recommendations to guide multidisciplinary ovarian cancer programs and practices,” according to the authors.
The study’s contributors identified seven core components that should ideally be included as part of ovarian cancer care in the U.S.: care coordination and patient education, prevention and screening, diagnosis and initial management, treatment planning, disease surveillance, equity in care, and quality of life. They developed recommendations for each category and determined that multidisciplinary team care, genetic counseling/testing, and clinical trials are key areas for improvement across the U.S. ovarian cancer care continuum.
Multidisciplinary Team Care
While the critical importance of being evaluated and treated for ovarian cancer by a gynecologic oncologist is underscored in this study, the authors note as well that a multidisciplinary cancer care team can also have a positive impact on a patient’s health outcome. They recommend that patients have ongoing access to multidisciplinary cancer care members, particularly since there are a limited number of practicing gynecologic oncologists in the United States, meaning many have scarce time to assist with nonmedical concerns. Sharing the care with multidisciplinary team members can mean a better opportunity for patients to have concerns addressed and potential barriers to treatment assessed, such as financial and transportation issues.
Genetic Counseling and Testing
Genetic testing is another area of crucial importance in the ovarian cancer care continuum. As explained by the study’s authors, testing for the presence of inherited genetic mutations can be of help to both ovarian cancer patients and their family members. This type of testing can not only be used to guide treatment decisions for someone who has been diagnosed with ovarian cancer but also to establish if the patient’s relatives should also be tested to see if they carry these same mutations that may put them at a higher risk of developing ovarian cancer.
The study’s contributors found that despite its usefulness, genetic testing remains low in many settings, even in specialized centers. They recommend that health systems centralize their genetic counseling services to facilitate access for newly diagnosed cancer patients, as well as provide these offerings via telemedicine and other alternative care delivery methods. Additionally, they advise incorporating reminder systems to ensure that patients and their relatives are referred and receive genetic testing.
An evaluation for clinical trials should be a component of any general treatment plan, according to the study’s authors. However, they note challenges in this area as well, including inadequate enrollment of elderly patients and those from historically underserved racial and ethnic groups. Their recommendations for increasing enrollment include keeping physicians and team members updated on clinical trial opportunities, encouraging communication between clinical and research staff, and engaging patient navigators who are familiar with clinical trial availability.
“Navigator-driven and person-centric programs are the need of the hour, with emphasis on critical aspects, such as multidisciplinary team-based care, access to clinical trials, and provision of ancillary services, including genetic counseling, supportive care, fertility preservation, and nutritional counseling, all of which can significantly help improve the lives of patients affected by ovarian cancer,” the study’s authors concluded.
Read more in Cancer.