Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2017

Uncertainty in immunotherapy raises the question: what is the GP role in primary cancer treatment? (#110)

Geoffrey Mitchell 1
  1. University of Queensland, Herston, QLD, Australia

Immunotherapy offers precision cancer management. However, it comes at the cost of significant fatigue and malaise, which are also markers of disease progression, and may be the presenting symptoms of oncological emergencies like sepsis. How does the GP distinguish between the them when a patient on immunotherapy presents?

This question raises questions about the role of general practice in the acute phase of cancer management. This presentation will challenge the assumption that there is little role for the GP to play in the treatment phase.

The physical and financial burden of attending for treatment and review include personal health and anxiety, opportunity costs in income and time foregone, for the patient, family and friends.  These are obvious for regional and rural patients, but can apply to urban patients. Maximising the roles of GPs to reduce the need to travel  could alleviate these burdens. GPs could potentially provide some routine elements of the treatment cycle, such as between-cycle surveillance and pre-treatment preparation. How can the system be adapted to include the GP part of the oncology team?

GP-related roles may include interpretation of clinical advice and assistance with rational decision making, taking advantage of their knowledge or the patient’s health and psychosocial profile, and practical circumstances.  GPs should be the treating physician in the ongoing management of pre-morbid diseases which still need surveillance and management, and they can play an important role in ancillary problems like pain control.

GPs are also in an excellent position to care for the burdens of carers – a role which could and probably should be a routine part of the patient’s cancer treatment plan.

A thorough analysis of the skills of GPs and piloting of how these skills can be utilised to reduce the workload and burden of oncology services is warranted.