Alique Topalian: Integrated Cancer Care & Survivorship

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A new model of care-embedding primary care directly within a cancer center-is proving transformative for patients, offering more thorough and continuous support after treatment.

Comprehensive Cancer Care: A New Model for Survivors

Researchers have demonstrated the feasibility and benefits of integrating primary care services within a tertiary cancer center, leading to improved management of comorbidities and enhanced long-term survivorship.

• The Oncology Primary Care Clinic at the University of Cincinnati Cancer Center has cared for over 1,100 patients since 2021.
• The majority of patients (87.8%) had adult-onset cancers, with a important portion (15.7%) facing second primary malignancies.
• More than half of the patients treated had existing cardiovascular conditions, highlighting the need for integrated care.
• Patient satisfaction remained consistently high across all areas of care.
• A dedicated Patient Outcomes Registry (REDCap) facilitated continuous evaluation and quality improvement.

For cancer survivors, the journey doesn’t end with treatment. Often, they face a complex web of long-term health challenges, from managing lingering side effects to navigating new or worsening chronic conditions. Recognizing this gap in care, researchers at the University of cincinnati Cancer Center developed an innovative approach: an Oncology primary Care Clinic.

The clinic, which began seeing patients in 2021, has provided care for 1,138 unique individuals to date.The majority, 87.8%, were diagnosed with adult-onset cancers, while 4% were childhood cancer survivors and 8.3% were adolescent and young adult (AYA) survivors. Notably,15.7% of patients had experienced a second primary malignancy. Over half of the patients treated also had cardiovascular comorbidities, underscoring the importance of integrated care for this vulnerable population.

What is survivorship care? Survivorship care encompasses the ongoing medical, psychological, and social needs of individuals after cancer treatment ends. It focuses on managing long-term side effects,preventing recurrence,and promoting overall well-being.

Bridging the Gap in Cancer care

The research, published in BMJ Family and Community Medicine, details the development, implementation, and impact of the oncology Primary Care Clinic. The model is designed to strengthen survivorship care and ensure continuity for patients with complex cancer histories. Researchers found that embedding primary care directly within a specialized cancer center isn’t just possible-it fundamentally changes the experience for patients.

“This model enhances continuity,improves comorbidity management,and supports long-term survivorship in a truly comprehensive way,” researchers noted. The clinic’s success is also attributed to the use of a dedicated Patient Outcomes Registry (REDCap), which allows for continuous evaluation and quality improvement, offering a scalable framework for other institutions to adopt.

Did you know?-Cancer survivors are at increased risk for developing other chronic health conditions, such as heart disease, diabetes, and osteoporosis. Integrated primary care helps manage these risks.

Pro tip-Regular screenings and preventative care are crucial for cancer survivors. Discuss a personalized screening plan with your primary care provider.

Reader question-“How often should I see my primary care doctor after cancer treatment?” The frequency depends on individual needs, but annual check-ups are generally recommended.

Oncology providers have emphasized the clinic’s essential role in managing medically complex survivors. High patient satisfaction scores across all domains further validate the positive impact of this integrated approach.

The success of the clinic wouldn’t have been possible without the dedication of individuals like Melissa Erickson, who created something remarkable, and the guidance of mentors