The study, by researchers from the Indiana University School of Medicine, the Regenstrief Institute and the Roudebush Veterans Administration Medical Centre, is the first to look at the effect of primary care on health outcomes in cancer patients.
Receiving care from a primary care physician (a general internist or family practice doctor) during cancer treatment from an oncologist appears to improve cancer survival rates, likely due to the comprehensiveness of care that is received in primary care, according to study authors Caroline Carney Doebbeling, M.D., M.Sc. and Laura Jones, Ph.D. The researchers focused on lung cancer because of the low one-year lung cancer survival rate in these patients.
"We cannot afford to ignore the chronic medical conditions that most cancer patients have because treating these conditions may bring increased longevity as well as improved quality of life. Lung cancer patients are often faced with many additional health issues, such as high blood pressure, emphysema and other respiratory conditions, all of which can and should be treated," said Dr. Carney Doebbeling, associate professor of medicine and of psychiatry at the Indiana University School of Medicine and a Regenstrief Institute research scientist.
"When doctors think their patients have a higher risk of mortality, as they do with lung cancer, chronic disease management may be not as big a focus," said Dr. Jones, who is with the Roudebush VA Medical Centre's Centre of Excellence on Implementing Evidence-Based Practice and is a health services researcher.
Lack of primary care utilization in the first six months following lung cancer diagnosis had a marked effect on survival even when controlling for extent of the disease. The researchers looked at electronic medical record data of 323 male veterans diagnosed with lung cancer. The median survival rate was only 3.68 months for those without primary care utilization, but increased by a factor of more than four if the patient had at least three primary care visits during the first 6 months following cancer diagnosis.
"Further investigation is needed to gain a better understanding of how and why primary care utilization improved outcomes in lung cancer patients. What we do know is that over 80% of lung cancer patients have at least one additional serious medical condition. The take home message to cancer patients is to not stop seeing your primary care doctor even if you have cancer," said Dr. Carney Doebbeling. "The importance of managing the health of the whole person, not just one disease at a time, cannot be overstated."
