Cancer care: City of Hope experts shape new IOM report (w/VIDEO)

September 10, 2013 | by Tami Dennis

An increased demand for cancer care, the rising costs of treatment and the complex nature of cancer itself – combined with a shrinking oncology work force – add up to one thing: a crisis in cancer care. That's the conclusion of a new report from the Institute of Medicine. But the report, written by a committee that included two City of Hope experts, also recommended specific strategies to improve care for cancer patients.

Those strategies are ones that City of Hope knows well. As such, it's natural that Betty Ferrell, Ph.D., and Arti Hurria, M.D., were asked to take part in a high-profile endeavor charting the nation’s course for better cancer care. They were also featured in a video (above) released with the report.

Betty Ferrell Betty Ferrell


Ferrell, a professor in the Division of Nursing Research and Education, is an internationally known expert in pain management, quality of life and palliative care. She is a fellow of the American Academy of Nursing and has published more than 300 papers in peer-reviewed journals and texts. She is principal investigator of a program project funded by the National Cancer Institute, “Palliative Care for Quality of Life and Symptom Concerns in Lung Cancer.” She’s also principal investigator of the “End-of-Life Nursing Education Consortium” project. She has written eight books, including “Cancer Pain Management,” a text on “Suffering,” “Pain in the Elderly” and “Oxford Textbook of Palliative Nursing,” published by Oxford University Press (third edition published in 2010).

Ferrell's work on the report – “Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis" – centered around the recommendations on patient care issues and palliative care, such as the importance of having advance directives, the need for palliative care and referral to hospice and, in general, the need for patient and family support in decision-making.

"Quality cancer care means the best treatment for the cancer but also the best attention for the patient with the cancer and the family," Ferrell said of the new report and its recommended strategies.


Arti Hurria Arti Hurria


Hurria, director of the Cancer and Aging Research Program, is an expert on the requirements necessary for quality cancer care given the aging population and the special needs of geriatric oncology. She was honored this year at the annual meeting of the American Society of Clinical Oncology for her contributions to the research, diagnosis and treatment of cancer in the elderly.

Her work on the report focused on the growing percentage of elderly patients, the segment of the population most likely to be diagnosed with cancer.

"Although the majority of patients with cancer and cancer survivors are older adults, historically there have been and continue to be less research studies which include this population," Hurria said. "Critically appraising our health care system and redefining our challenges as opportunities will help us to start charting a new and better course, one that will escalate the quality of cancer care for older adults with cancer in the decades to come."

Ferrell's and Hurria's efforts on the committee behind the report – the Committee on Improving the Quality of Cancer Care: Addressing the Challenges of an Aging Population –  could ultimately improve cancer care for everyone. The report itself, released Tuesday, is already garnering media attention.  

“This report captures the urgent needs for improving cancer care at a time when resources are limited yet the demands of patients and families are high,” Ferrell said. “The future delivery of cancer care will require communication between patients and providers to ensure that care is based on the individual patient needs and preferences.”

As described on the National Academies website, the report outlines six components of high-quality cancer care, arranged by priority level:

  • Engaged patients. The cancer care system should support patients in making informed medical decisions that are consistent with their needs, values and preferences.
  • An adequately staffed, trained and coordinated work force. New models of team-based care are an effective way to promote coordinated cancer care and to respond to existing work-force shortages and demographic changes.
  • Evidence-based cancer care. A high-quality cancer care delivery system uses results from scientific research to inform medical decisions, but currently many medical decisions are not supported by sufficient evidence, the report says.
  • A learning health care information technology system for cancer care. A system is needed that can “learn” by enabling real-time analysis of data from cancer patients in a variety of care settings to improve knowledge and inform medical decisions.
  • Translation of evidence into practice, quality measurement,and performance improvement. Tools and initiatives should be delivered to help clinicians quickly incorporate new medical knowledge into routine care.
  • Accessible and affordable cancer care. Currently there are major disparities in access to cancer care among individuals who are of lower socioeconomic status, are racial or ethnic minorities, lack health insurance coverage and are older.

Full explanations of the priorities can be found on the website  and in the report itself.

The report was sponsored by the National Cancer Institute, Centers for Disease Control and Prevention, AARP, American Cancer Society, American College of Surgeons, Commission on Cancer, American Society of Clinical Oncology, American Society of Hematology, American Society for Radiation Oncology, California HealthCare Foundation, LIVESTRONG, National Coalition for Cancer Survivorship, Oncology Nursing Society and Susan G. Komen for the Cure. Established in 1970 under the charter of the National Academy of Sciences, the Institute of Medicine provides independent, objective, evidence-based advice to policymakers, health professionals, the private sector and the public. The National Academy of Sciences, National Academy of Engineering, Institute of Medicine and National Research Council make up the National Academies.

The nation’s health care workers and institutions will look at, and learn from, the report over the coming months and years, working to improve the lives and care of cancer patients and their families. City of Hope experts will have played a role in those improvements.

“It will take training of professionals and it will take big changes at a policy level, including how care is reimbursed," Ferrell said in an interview with NBC News. “But everything that we are advocating for is ultimately extremely possible.”

Above: "Delivering High-Quality Cancer Care - System In Crisis (Complete Video)" was released with the new IOM report.

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