publication date: Jul. 19, 2019

Guest Editorial

Community oncology at a glance; How we got here and where we are going

Michael Kolodziej

By Michael Kolodziej

Vice president and chief innovation officer,
ADVI Health


Most Americans receive cancer treatment close to home, at community hospitals or in community oncologists’ offices. And based on patient satisfaction surveys, most Americans are very happy with the care they receive.

The rapid diffusion of scientific advances to the bedside of patients treated in the community has allowed state-of-the-art care to be widely accessible. 

But a number of factors, including changes in reimbursement, challenges with technology and administrative burden, and market forces are threatening community oncology and forcing practice realignment and consolidation, which will forever alter how cancer care is delivered.

To understand today’s market, it is worthwhile to review the evolution of oncology practice. Until the 1980’s, cancer was exclusively a hospital-based specialty. Surgery was the mainstay of treatment, with limited contributions from radiation therapy and medical oncology.

But over the course of the 1980s, several advances changed this:

First, combination chemotherapy was proven to be of value in advanced adult malignancies, initially in Hodgkin’s Disease, and then in breast cancer. More importantly, these treatments did not require hospitalization.

Second, supportive care to counteract the side effects of chemotherapy were developed. Anti-emetics and growth factors reduced the acute toxicity of … Continue reading Community oncology at a glance; How we got here and where we are going

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