Oncologists Need to Inform Primary Care Physicians About Late and Long-Term Effects of Chemotherapy

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A nationally representative survey of 1,130 oncologists and 1,072 primary care physicians found that primary care physicians had limited awareness of late or long-term effects of chemotherapy agents. This was attributed to primary care physicians not typically encountering chemotherapy agents and/or their late/long-term effects in their clinical practices or perusing relevant literature. 

“In the transition of patients from oncology to primary care settings, [primary care physicians] should be informed about potential [late/long-term effects] so that they are better prepared to recognize and address them among the cancer survivors in their care,” Larissa Nekhlyudov, MD, MPH, of Harvard Medical School and Harvard Vanguard Medical Associates, Boston, and colleagues wrote in the Journal of Oncology Practice.

Physicians responding to the Survey of Physician Attitudes Regarding the Care of Cancer Survivors (SPARCCS) were asked to describe the late and long-term effects they had either observed or seen reported for chemotherapy agents used to treat breast and colon cancers. Most of the responding physicians were white men who were trained in the United States and board-certified. Among the primary care physician group, 40% were family practitioners, another 40% were internists, and 20% were obstetricians/gynecologists. 

Major Findings

“Almost all oncologists (95%) reported awareness of cardiac dysfunction as [a late/long-term effect] of doxorubicin and peripheral neuropathy as [a late/long-term effect] of paclitaxel (97%) and oxaliplatin (97%). These [late/long-term effects] were reported by 55%, 27%, and 22% of primary care physicians, respectively,” the researchers found. 

“Most oncologists reported awareness of premature menopause (71%) and secondary malignancies (62%) as [late/long-term effects] of cyclophosphamide, compared with only 15% and 17% of [primary care physicians], respectively. Main [late/long-term effects] associated with all four agents were identified by 65% of oncologists and only 6% of [primary care physicians],” they added.

“Education for all providers caring for the growing population of cancer survivors is needed,” the authors concluded. ■

Nekhlyudov L, et al: J Oncol Pract. November 12, 2013 (early release online). 




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