Medical oncologist–reported challenges of treating metastatic cancer.

Abstract

e13576 Background: The treatment of metastatic cancer requires complex resources for effective care delivery. We evaluated associations between challenges of delivering metastatic cancer care and oncology practice resources, as reported by medical oncologists. Methods: From 2023-24 we surveyed 824 medical oncologists, identified using SEER registry data, in Georgia and Los Angeles. We asked oncologists about challenges of delivering care to patients with metastatic cancer and about resources available at their practice, including administrative and clinical support. We also asked about frequency of encounters with patients who do not speak the same language. We generated descriptive statistics and assessed bivariate associations between challenges and practice resources and language-discordant encounters. Results: We present results for a preliminary sample (N = 370). The Table shows the proportion of oncologists who endorsed each challenge. Challenges related to social factors were more likely to be endorsed as “often” or “almost always” a challenge than those related to system factors. 28% of oncologists did not have patient navigators in their practice, 18% did not have financial counselors, 13% did not work with advanced practice providers, 17% did not have nurses to help patients with treatment side effects, 11% did not have dedicated pharmacists, 22% did not have social workers, 28% did not have genetic counselors, 6% did not have interpreters. 35% of oncologists had language-discordant clinical encounters “often/very often.” System-level challenges were associated with lack of practice resources (all p < 0.05). Social-level challenges were associated with increased frequency of language-discordant clinical encounters (all p < 0.05). Conclusions: Oncologists endorsed system-level and social-level challenges of delivering metastatic cancer care. Lack of practice resources and frequent language-discordant clinical encounters were endorsed by a substantial proportion of oncologists. Improving the availability of practice resources may help mitigate system-level challenges; alternate approaches are needed to address social-level challenges. Oncologist-reported challenges to metastatic cancer care. Sometimes a Challenge% Often/Almost Always a Challenge% System Factor: Unable to obtain molecular testing/sequencing 23 8 System Factor: Unable to obtain PD-L1 testing 20 6 System Factor: Unable to obtain germline genetic testing 19 7 System Factor: Unable to obtain genetic counseling 15 9 Social Factor: Patient doesn’t have reliable transportation to appointments 55 11 Social Factor: Patient lives far from treatment center 57 20 Social Factor: Patient doesn’t have help with medication management 64 14 Social Factor: Patient can’t afford out-of-pocket treatment costs 52 31 Social Factor: Patient can’t take time off work for appointments 51 10