Patients with cancer often receive treatment from a care team that includes medical experts ranging from doctors and nurses to supportive care staff. While most people know that an oncologist is a cancer doctor, care teams may also include clinicians with less familiar-sounding roles, for example, advanced practice providers (APPs).
“An advanced practice provider is a health care professional who has advanced clinical training and education beyond that of a registered nurse or general health care provider, but is not a physician,” explains Amy Grasman, M.S.N., F.N.P.-B.C., manager of advanced practice providers at City of Hope® Cancer Center Atlanta.
So, what part do advanced practice providers play in cancer care? This blog covers the basics on APPs, covering the following questions:
- What is an advanced practice provider?
- What can APPs do?
- Where do APPs work?
- What’s the role of an APP on a cancer care team?
If you or a loved one is concerned about possible signs or symptoms of cancer and would like an initial appointment or a second opinion, call us 24/7 at (877) 460-4673.
What Is an Advanced Practice Provider?
Advanced practice providers (APPs) are health care professionals who have completed additional training that allows them to offer treatments or services to patients that would normally be provided by a physician.
“APPs are qualified to evaluate, diagnose, treat and manage patient care, either working closely with doctors or independently, depending on state or federal laws,” Grasman says. “APPs in oncology often have advanced training in hematology, chemotherapy protocols, survivorship care, surgery, supportive specialties and symptom management.”
Some of the most common types of health care providers who become APPs are:
- Registered nurses
- Nurse practitioners
- Physician assistants
- Clinical nurse specialists
- Certified registered nurse anesthetists
- Certified nurse midwives
To be licensed as an APP in their home state, advanced practice providers have to complete a graduate degree, undergo APP training and pass a national exam.
“Including APPs on a care team also increases access to health care, especially in underserved areas,” Grasman explains. “They often provide high-quality care, with a strong focus on a patient-centered approach and preventative options.”
Having an APP on the team may shorten wait times for new patient consults, follow-up visits and urgent symptom management and ensure continuity of care when the physician gets busy, Grasman adds.
What Can APPs Do?
Advanced practice practitioners are able to offer a wide range of clinical services and care. Although there are some small differences in what APPs are able to do, depending on which state they are licensed in, most APPs may:
- Perform physical exams
- Diagnose medical conditions
- Treat illnesses
- Order tests, such as blood work or imaging, and interpret the results
- Assist with certain surgical procedures
- Educate patients about their treatment options
- Prescribe medications, in most but not all states
- Perform education and consent regarding chemotherapy and immunotherapy
- Discuss treatment side effects
- Perform palliative and end-of-life care
- Participate in tumor boards and care planning
Where Do APPs Work?
Advanced practice practitioners often play a key role in providing care at cancer centers like City of Hope. However, APPs may work in just about any health care setting, including:
- Hospitals
- Emergency rooms
- Clinics
- Specialty practices, such as cancer centers or heart health centers
- Long-term care facilities, such as hospices or memory care centers
What’s the Role of an APP on a Cancer Care Team?
Cancer patients may work with an APP at almost any stage of their care, from undergoing diagnostic tests like biopsies to receiving treatment to follow-up appointments after active treatment is complete.
"APPs extend the reach of our oncologists and improve access and responsiveness — especially in a busy cancer center like ours,” Grasman says. “Their presence allows for more personalized, timely and comprehensive care.”
Some of the services an APP may offer as a member of a patient’s cancer care team include:
- Performing and interpreting tests and biopsies, conducting physical exams and managing the cancer screening process
- Helping manage the symptoms and side effects of cancer and its treatments
- Educating patients and loved ones about a cancer diagnosis or a patient’s treatment options
- Coordinating care, including referrals to other specialists and supportive care options
- Assisting surgeons with certain types of surgical procedures
- Conducting follow-up appointments and supporting patients’ health after treatment ends
- Identifying any clinical trials that a patient may be eligible for and helping them enroll
The advanced practice providers at City of Hope tend to work with teams of doctors that specialize in a particular cancer type. However, there are also inpatient APPs who provide critical care for patients admitted to the hospital.
According to Grasman, the benefits are clear: “Having APPs working with our patients allows for more personalized, timely, and comprehensive care for cancer patients.”
If you or a loved one is concerned about possible signs or symptoms of cancer and would like an initial appointment or a second opinion, call us 24/7 at (877) 460-4673.