Cancer Survivor Care Lacks Pharmacist Perspective

Pharmacists are conspicuously absent from treatment teams for cancer survivors.

Even the Institute of Medicine (IOM) leaves out pharmacists in its list of health care professionals who can play a role in survivorship care.

But Daniel Zlott, PharmD, of the National Cancer Institute, told Pharmacy Times that because pharmacists are medication experts, they could greatly improve a cancer survivor’s situation if they were directly integrated into survivorship plans.

“From a medication standpoint, a lot of cancer therapies have lasting adverse effects—neuropathy, heart failure, and so on,” Dr. Zlott said. “All of those problems would be best managed by pharmacists who can assess treatment effectiveness and then work with patients to optimize their regimens.”

Allowing pharmacists to manage a cancer survivor’s medications and long-trem toxicities would also permit primary care providers to play a more significant role in addressing the physical, mental, psychosocial, and financial strain that often accompanies a cancer diagnosis and continues through survivorship.

“Patients are always wondering ‘Is [the cancer] coming back?’ and ‘What happens next?’” Dr. Zlott explained. “Other health care providers could address this more psychological side” of a patient’s recovery.

The potential for pharmacists’ contribution to survivorship care is especially high when considering the communication gaps between health care professionals during a cancer survivor’s transition from an acute oncology setting to primary care.

In fact, a 2014 survey of oncologists and primary care physicians revealed that only 32% of oncologists inform cancer survivors about who they should see for cancer-related and follow-up questions, and just 12% of primary care physicians have such discussions concerning survivorship care regularly.

“Cancer survivorship is complicated and we’re still learning quite a bit about it,” Dr. Zlott told Pharmacy Times. “Having a pharmacist as a core part of an oncology team is somewhat of a new concept…but people are discovering that [their inclusion] is a natural outgrowth.”