Invited discussant of the abstracts on the virtual mind-body fitness program and the BRIDGE intervention from the 2023 ASCO Quality Care Symposium, Daniel Curtis McFarland, DO, MS, of Wilmot Cancer Center, University of Rochester Medical Center, New York, said they highlight the unmet need associated with adverse cancer outcomes and with limited meaningful interventions.
Daniel Curtis McFarland, DO, MS
With respect to the Integrated Medicine at Home intervention, Dr. McFarland underscored the high underreporting and undertreatment of cancer-related fatigue, which he called “a distressing neuropsychiatric symptom.” He observed: “We are essentially acculturating patients to adapt to a lifestyle of fatigue. We lack a mechanistic understanding of what this is about, but we know it interferes with care. Nonpharmacologic treatments are certainly available, and guidelines are there, but they are not followed. This is really a paradigm of care question.”
The results of the intervention showed fewer urgent care visits and hospitalizations as well as a decrease in fatigue, depression, and other physical symptoms. According to Dr. McFarland, the mechanisms leading to the success of the intervention could relate to the trial’s structure and guidance, much like smoking cessation efficacy. “The home environment may be the right foundation for addressing this important symptom, fatigue,” he said.
With respect to the BRIDGE intervention, Dr. McFarland called the reduction in disruptions of care among patients with severe mental illness and cancer “remarkable” and emphasized the intervention is both scalable and needed. Ultimately, he added, there is a dire need for scientifically guided, ethical care value additions to current cancer care processes, which may improve patient outcomes—especially for those most vulnerable because of mental illnesses or persistent cancer-related fatigue.
Dr. McFarland concluded his comments by advocating for greater participation by physicians in the political realm and for greater investment in health-care innovations as well as interventions that ensure fairness and justice in patient care delivery.
DISCLOSURE: Dr. McFarland has served as a consultant or advisor to Pharmacosmos.
