The Future of Breast Cancer Care is at Home: Why Continuous Support is the New Standard
Nearly 30% of patients discontinue oral cancer therapies within the first three months, often due to manageable side effects or financial hurdles. This startling statistic underscores a critical shift in breast cancer care: efficacy alone isn’t enough. As oral therapies become increasingly dominant – and they are, rapidly eclipsing infusion-based treatments for many – the focus is pivoting from the clinic to the patient’s everyday life, demanding a more proactive and supportive approach.
The Rise of Oral Therapies and the Monitoring Gap
Dr. Michael Hassett, Chief Quality Officer at Dana-Farber Cancer Institute, highlighted this evolving landscape at a recent event hosted by The American Journal of Managed Care®. He emphasized a fundamental difference between traditional intravenous (IV) therapies and the new wave of oral medications. With IV treatments, clinicians directly administer the drug and closely monitor the patient’s immediate response. **Breast cancer treatment** with oral therapies, however, relies heavily on patient adherence and self-management, creating a significant monitoring gap.
“We have a lot of work to do to monitor and improve therapy for oral medicines,” Dr. Hassett stated. “It’s different than having someone coming into an infusion center… We have to be really attentive to the symptoms they’re experiencing and how we manage those symptoms.” This attention requires moving beyond infrequent clinic visits and embracing continuous data collection.
Leveraging Patient-Reported Outcomes (PROs)
One promising solution lies in the expanded use of patient-reported outcomes (PROs). Tools that allow patients to regularly share their experiences – including symptom severity, side effects, and quality of life – provide clinicians with a real-time window into the patient’s journey. This proactive approach allows for earlier intervention, potentially preventing minor issues from escalating into treatment-disrupting problems. The goal isn’t just to react to problems, but to anticipate them.
Several companies are developing sophisticated PRO platforms, integrating with wearable sensors and mobile apps to streamline data collection. These technologies aren’t meant to replace the physician-patient relationship, but to enhance it, providing more informed and personalized care. For example, platforms like those offered by Flatiron Health are increasingly being used to aggregate and analyze real-world data, including PROs, to improve treatment outcomes.
Beyond Symptoms: Addressing Financial Toxicity and Education
While symptom management is crucial, Dr. Hassett rightly points out that it’s only one piece of the puzzle. Financial barriers – including high co-pays, deductibles, and prior authorization requirements – can significantly impede access to and adherence with oral therapies. This “financial toxicity” is a growing concern, disproportionately affecting vulnerable populations.
“If we can address the financial barriers… we have some opportunity,” Dr. Hassett noted. This requires a multi-pronged approach, including advocating for policy changes to reduce out-of-pocket costs, expanding financial assistance programs, and streamlining the prior authorization process. Hospitals and oncology practices are also increasingly employing financial navigators to help patients navigate the complex insurance landscape.
The Need for Continuous, Tailored Education
Equally important is robust and ongoing patient education. Many oral cancer therapies have unique and often unexpected side effects that patients may not be prepared for. A one-time information dump is insufficient. Education must be continuous, tailored to the individual patient’s needs and learning style, and delivered through multiple channels – including in-person consultations, online resources, and mobile apps.
This tailored approach recognizes that patients have varying levels of health literacy and different preferences for receiving information. Simply providing a six-page handout and scheduling a follow-up appointment in three months is no longer adequate. Instead, clinicians should proactively check in with patients, address their concerns, and reinforce key information at each visit.
Precision Oncology and the Future of Support
The advancements in precision oncology, particularly the identification of biomarkers like HER2, have revolutionized breast cancer treatment. However, even targeted therapies require diligent monitoring and support. As we move towards even more personalized treatments, the need for robust patient support systems will only intensify.
The future of breast cancer care isn’t just about developing more effective drugs; it’s about creating a holistic ecosystem that empowers patients to navigate their treatment journey with confidence and minimizes disruptions. This means embracing technology, addressing financial barriers, and prioritizing continuous, tailored education. What are your predictions for the role of technology in improving adherence to oral cancer therapies? Share your thoughts in the comments below!
