Throughout this series, we have evaluated various challenges and barriers to optimizing care for patients with cancer. While it is evident that we have a long way to go with regard to making cancer therapy logistically easy, better tolerated, and less emotionally exhausting, the past decade has arguably brought us closer to achieving these goals. New oral chemotherapy drugs have freed some patients from the restraints of treatment within a cancer center’s infusion suite. New targeted therapies have increased survival and treatment-related efficacy while reducing adverse events.
In an era when oral drugs are increasingly becoming a part of our approach to care for patients with cancer, adherence to prescribed therapy is essential. Yet the statistics cited by Dr Hansen are a stark reminder that despite our best intentions, cancer patients do not and will not always take oral medications the way in which they are directed. For the clinician, this poses a challenge as to how best to confront this troublesome issue in order to improve outcomes for the patients entrusted to our care. The details of such an effort may vary from cancer center to cancer center.
The evolution of drug research and development toward oral therapies for cancer over the past decade has created a number of questions for the oncology healthcare provider. Will insurance companies pay for these exceptionally expensive medications? How and when will patients receive their medication? Who will be responsible for ensuring patient education and monitoring to maximize safe drug administration and patient compliance?
The diagnosis of cancer is arguably one of the most emotionally exhausting and potentially psychologically debilitating medical conditions we may experience during our lifetime. However, the impact of this diagnosis is not limited to the patient and frequently resonates among family members, friends, and caregivers as well. When the impact of cancer on the human condition is combined with the knowledge that healthcare practitioners are frequently unable to detect psychological distress in this patient population, the effects can be profound.1
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