Primary care docs participating in breast cancer decisions


MOST women in a new U.S. survey said their primary care physician was involved in their breast cancer care during treatment, and rated their doctor’s engagement and communication levels as high.
Researchers found, though, that more primary care provider (PCP) involvement was only tied to a better perception of treatment decisions by the survey participants, who all had newly diagnosed breast cancer, when compared to low PCP involvement.
“While we hypothesized that many women receive high quality primary care during breast cancer treatment, we were surprised that the majority of women in our study also reported high levels of engagement and communication with their PCP during cancer treatment, when the care is typically focused primarily on treating the cancer,” said lead author Lauren P. Wallner of the University of Michigan in Ann Arbor.
“In team-based cancer care, oncology care teams work together with primary care and other specialty care teams to ensure patients receive high-quality, coordinated cancer care,” she said.
The researchers randomly surveyed more than 2,000 women six months after their breast cancer diagnosis, finding them via registries in California and Georgia in 2013 and 2014. The mailed surveys included six questions about primary care provider access and awareness and three questions about doctors’ involvement in treatment. The participants rated how informed their primary care doctors were about breast cancer, how often they talked with their primary care doctors and how often doctors were involved in treatment decisions.
Most women were white and over age 55, had private insurance and some college education.
More than 60 percent of women said their primary care quality was high, and their doctors were highly informed and highly communicative. About 35 percent said doctors participated considerably in treatment decisions. More decision participation tended to align with higher rating of primary care quality, according to the results published in the Journal of Clinical Oncology.
Primary care doctors often know the patient best and are most attuned to their values, preferences and needs, Wallner said, but how involved they should be during treatment depends upon the patient’s clinical situation, including whether they have other medical conditions and the preferences of the patient, their oncologist and the primary care doctor.

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