As recently as 1980, the sum total of medical knowledge doubled approximately every 7 years. New doctors could be confident they could rely on much of what they learned in medical school, and most doctors could keep up with the medical advances their patients needed for best-in-class care. Medical knowledge is projected to double every 73 days.
The oncology field is considered one of the most complex areas of medical care. Cancer is not just one disease – it’s thousands of increasingly individualized diseases with more than 100 major cancer categories. Today’s cancer treatments can take the form of surgery, chemotherapy, radiation, targeted therapy, immunotherapy, stem cell transplant, bone marrow transplant, hormone therapy, and observation. Depending on the patient and the cancer subtype, an individual treatment plan can include any number and any combination of therapies.
Cancer is complex. So are cancer guidelines.
The National Comprehensive Cancer Network (NCCN), an alliance of 33 leading cancer centers, has developed expert panels for more than 50 cancer types – and each of those types has subtypes. NCCN’s evidence-based guidelines have become a critical tool to help all oncologists ensure their patients receive treatment that will lead to the best outcomes.
In 2012, for example, the NCCN’s guidelines for breast cancer covered 20 to 30 pages. Today, guidelines span around 100 pages, depending on the version and format, including detailed information on treatment options, risk factors, and recommendations for different types of breast cancer.
Community oncologists care for the large majority of cancer patients – approximately four of every five – treating all types of cancer and playing a key role in keeping patient care close to home. While they have access to the NCCN guidelines, the review process is manual and inefficient. The volume and complexity of these guidelines make it unrealistic for community oncologists, who are not affiliated with academic medical centers, to discern every nuance for each patient they see.
Consultations bring expert cancer care to patients
Despite the volume and complexity of today’s oncology guidelines, data show that nearly 80% of oncology care follows NCCN guidelines. The remaining 20% of cases represent the most rare or complicated cancers, raising challenges for community oncologists.
Fortunately, support is available from programs pairing hyperspecialized oncologists, who dedicate themselves full-time to specific types of cancer (including breast cancer, leukemia, multiple myeloma, ovarian cancer, and more) with community oncologists when needed. Evernorth’s Expert Cancer Consult services, available within Evernorth Oncology Benefit Services, allows members to initiate an expert consultation. Once initiated, the Evernorth Cancer Consult team works to help patients looking for a second expert oncologist to review their case. The patient’s primary physician is matched to an NCCN-designated community oncologist or a National Cancer Institute (NCI)-affiliated oncologist specializing in the patient’s cancer type for case review and diagnosis, testing and therapy recommendations. Evernorth coordinates the consult process on behalf of the patient with the added goal of ensuring they stay in their local community for care.
For plan sponsors, simplifying the cancer care experience can improve health outcomes for members diagnosed with cancer. This also leads to reducing waste and lower costs, because community oncologists are guided to the right treatments.
Originally published on 5/23/22 and updated on 12/10/24.
