Primary Health Care: Open Access

Treatment of Cancer Patients: Role of Family Physicians

Edward Foy^{* *}Correspondence: Edward Foy, Department of Primary Health, University of New South Wales, Australia, Email:

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Overview

The health-care system must have measures in place to increase cancer control. Prevention (change of behaviours that increase cancer risk) and early diagnosis in the asymptomatic stage of the disease, which allows for curative therapies, are the most effective ways of minimising cancer morbidity and mortality. Barriers that make preventive and early diagnostic measures more challenging for both patients and physicians have been identified in this article. Discontinuity of care is one of the challenges that both patients and clinicians face. From both sides, the barriers were discussed. There were suggestions for lowering these barriers such that incentives could encourage the provision of preventive and early diagnosis. The incentives are doable; but, large-scale changes will necessitate the participation of the general population, physicians, and the health-care system [1-3].

The management of the spectrum of cancer by family physicians involves eight functions of health care: identifying and monitoring risk factors, early disease screening, diagnosis, staging, treatment, shared care (between referring physicians and cancer specialists), followup monitoring, and advanced disease management. Continuity of care, comprehensive care, human behaviour, preventative medicine, community medicine, and integration and management skills are all emphasised in family practise training programmes [2-4]. As a result, family physicians are in charge of entire patient care. Graduates of family practise residency training are prepared for responsibilities in the care of chronic diseases such as cancer at every stage of their natural course. The author outlines the roles that family physicians are willing to play in the treatment of cancer patients at each of the disease's eight stages: 1) keeping track of risk factors-determine cancer risks for each patient and conduct necessary periodic reviews; 2) Early disease screening-use the American Cancer Society's screening recommendations and build an office strategy to keep this effort going; 3) Diagnosis-Follow up on positive test results and look into the causes of the symptoms you're experiencing; 4) staging-use the outcomes of staging procedures to advise patients' treatment choices; 5) Treatment-while some family physicians prefer to give chemotherapy under the supervision of cancer specialists, they will all be involved in counselling patients and their families, providing family support, and coordinating the use of community services ; 6) shared care (comanagement)-share the monitoring of treatment progress and side effects; this comprises patient and family support throughout the disease's course; 7) advanced illness management - manage symptoms, pain, and quality of life when cure is no longer an option; and 8) followup monitoring - continued follow-up of patients once they are considered "cured" (e.g., monitor for recurrence or second primary disease) [5].

References

1. Cheung, W.Y., et al. “Physician preferences and attitudes regarding different models of cancer survivorship care: a comparison of primary care providers and oncologists.” J Cancer Surviv 7.3(2013):343-354.
2. American Society of Clinical Oncology. American Society of Clinical Oncology policy statement update: genetic testing for cancer susceptibility. J Clin Oncol 21.12(2003):2397-2406.
3. Griffith, R.S., & Williams, P.A. “Barriers and incentives of physicians and patients to cancer screening.” Prim Care 19.3(1992):535-556.
4. Schor, E.L. “American Academy of Pediatrics Task Force on the Family. Family pediatrics: report of the Task Force on the Family. Pediatrics.” 111.6 Pt 2(2003):1541-1571.
5. Lawrence, R.A., et al. “Primary Care Physicians' Perspectives of Their Role in Cancer Care: A Systematic Review.” J Gen Intern Med 31.10(2016):1222-1236.