A new study released earlier this month from the Journal of Clinical Oncology forecasts a major shortage in radiation oncologists across the coming decade. Seeking to replicate the work done by ASCO forecasting future demand for medical oncologists, researchers at MD Anderson conducted a comprehensive assessment of radiation oncology supply and demand. According to their findings, between 2010 and 2020, the total number of patients receiving radiatoin therapy as their initial course of treatment will grow by 22% (from 470,000 to 575,000), while supply of FTE radiation oncologists will grow by just 2%. They estimate to meet this new demand the number of radiation oncology residents would have to double for the years 2014 to 2019. While the gap isn't as significant as in medical oncology, it is sizable and currently there are no plans to address it.
Valuable data embedded in the study
When ASCO released their medical oncology study, there was some great data embedded within, and the same holds true here. The data that caught my eye in particular are their forecasts of patients receiging radiation in 2010 and 2020. I've reproduced their table below:
Shortage of Radiation Oncologists Forecast
Earlier this month, the Archives of Internal Medicine published a study which examined the prevalence of physical symptoms among cancer patients experiencing pain and/or depression. Not surprisingly, all 405 patients included in the analysis reported at least one physical symptom. Fatigue (97.5%), difficulty sleeping (79%) and pain in limbs or joints (78%) were the most common. Overall the presence of physical symptoms was very high - 15 of the 22 symptoms assessed were reported by more than half of patients.
Given that pain and depression are very common among cancer patients, and these study findings suggest they are highly correlated with other debilitating symptoms, the authors call on cancer providers to improve their symptom management efforts. They note that while patients indicate they are bothered by their symptoms, they do not necessarily report them to their care team. Consequently the onus falls on providers to proactively and repeatedly ask patients about their well being.
The multidisciplinary clinic, in which a patient sees all of his or her providers - medical oncologist, radiation oncologist and surgeon - in consecutive visits, concluding with a consensus treatment recommendation has long been held up as the gold standard in cancer care. That said, there is surprisingly little data documening the value - at least from a clinical perspective. So, this press release
from the UNC Lineberger Cancer Center
caught my attention. UNC researchers recently published a study in the journal Urologic Oncology
showing a multidisciplinary approach to to care changed the initial diagnosis or treatment in almost 65% of cases. The study evaluated 269 prostate cancer patients who came to their multidisciplinary second opinion clinic. Changes in diagnosis were most common in bladder cancer (44%), followed by kidney (36%), testicular (29%) then prostate (22%). This is striking data and speaks to the importance of multidisciplinary collaboration in not only determining optimal treatment, but also simply confirming the diagnosis.