Last Friday, Amgen's "Breakaway from Cancer" initiative hosted a star-studded panel discussion at the 2010 American Society of Clinical Oncology annual meeting. The focus was on potential areas for improvement throughout the spectrum of cancer care. Complex topics were covered, ranging from prevention and screening to delivery and access to patient support and survivorship.Healthcare reform is going to have a tremendous impact on the way care is delivered in the United States. Many uninsured and underinsured families are finally going to have access to quality care, which is a great thing. But what happens when thousands of new patients enter a system that's already maxed-out? Fewer docs are choosing oncology as a specialty, and those currently in practice are struggling to keep up with heavy patient demand. "In order to mount a successful fight against cancer, it's crucial to focus on people who haven't yet become patients. We need a more collaborative approach to prevent cancer," said Carolyn "Bo" Aldige, president and founder of the Prevent Cancer Foundation. She went on to say that half of all cancers would be eradicated if people would make lifestyle changes such as quitting smoking, maintaining a healthy weight, and staying out of the sun. Education is crucial as most people don't realize the power they possess to markedly alter the course of their health. Screening was another hotly debated topic. Early detection saves lives so why do several effective screening guidelines have yet to be adopted as the standard of care? Panelists blamed the media and agreed that when debates over screening recommendations are hashed out in public, the science is often lost, which gives the public the option of doing nothing. Let's face it... many screenings aren't all that much fun. If no one can agree as to whether getting one actually saves lives, the easiest choice is to postpone the test until a consensus is reached. Not good. To me, the most interesting topic of the evening addressed the needs of patients once they're diagnosed. How are they being supported throughout their treatment? In many cases the answer is, they're not. Not only do patients need specialists on hand to explain treatment options and next steps, in many cases they need financial counselors, nutritionists, and social workers to help them navigate the journey. "If it's pouring outside, and I have to take two buses to get to my chemotherapy appointment, there's a good chance that I might pull the covers over my head and go back to sleep." said Kim Thiboldeaux, president and chief executive officer of Cancer Support Community. She added that a psychosocial evaluation should be done at the beginning of treatment with checkups along the way to determine how to best meet the needs of patients and their families. This seems simple enough to implement, right? Well, the notion has been met with raised eyebrows because once problems such as depression, financial strain and the like are uncovered, the healthcare provider becomes responsible for getting the patient help for that particular problem,which, as I said early on, they don't have time for!That leads me to the topic of survivorship. There are 12.5 million of us in the U.S. alone. How are patients supposed to effectively manage the many possible long term and late effects of treatment without having access to specialists whose jobs are to keep their eyes out for warning signs that could lead to recurrence? Ideally, we will be given a survivorship care plan on a pin drive that we'll take with us to our follow up exams. I don't know about you, but I always feel a little guilty taking 15 minutes of my oncologist's time for my annual appointment. I'm 13 years out now, and I know he's busy trying to save the lives of his many patients who are still fighting the good fight. I definitely still go but I rush through the appointment, telling him I'm fine while apologizing for keeping him from more important things. So, here's my idea... what if the government offered incentives to primary care physicians to specialize in cancer survivorship? They would take those calls regarding side aches, depression, and fear of recurrence. They would encourage lifestyle changes and point us to area programs that would support those changes. They'd also take care of all of those screenings we're supposed to get but sometimes avoid.The Breakaway from Cancer team has some great ideas too. They have developed a nine-step action plan that will soon be made public. Stuart Arbuckle, vice president and general manager of Amgen Oncology, said "We look forward to continuing to work with the Breakaway from Cancer team on initiatives that will continue to drive this dialog, and inspire action in order to provide patients and their families with the best possible care."