Highlights from the President’s Cancer Panel: Building on a Strong Legacy

The National Cancer Institute (NCI) was established by the National Cancer Act of 1971, which President Richard Nixon signed into law. This legislation was an amendment to the Public Health Service Act of 1944 and represented the commitment of the United States government to what President Nixon described as the “war on cancer,” for the disease had become the nation’s second leading cause of death by 1970. In 1986, the Association of Community Cancer Centers (ACCC) awarded President Nixon with its Annual Achievement Award and the signing of this seminal law was memorialized on the cover of the Association’s inaugural issue of its journal, Oncology Issues (known then as The Journal of Cancer Program Management).

More than 50 years later, that mission is stronger than it is has ever been. The White House Cancer Moonshot initiative has reiterated the federal government’s commitment to “end cancer as we know it.” The science of oncology is rapidly evolving, as cancer programs and practices around the US continue to make cutting-edge discoveries in the diagnosis and treatment of cancer. In addition, there is an increased spotlight on the effects social drivers of health have on cancer care delivery, as health equity initiatives continue to permeate the oncology landscape.

Building on these successes, NCI released the National Cancer Plan on April 3, 2023. The plan outlines goals designed to support the objectives of Cancer Moonshot. “The National Cancer Plan represents a commitment to achieving a society where most cancers are prevented and where every person diagnosed with cancer lives a full and active life,” said Monica Bertagnolli, MD, NCI director.

In support of this effort, the President’s Cancer Panel featuring Elizabeth Jaffee, MD, deputy director at The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins; Carol Brown, MD, senior vice president and chief health equity officer at Memorial Sloan Kettering Cancer Center; and Mitchell Berger, MD, director, Brain Tumor Center at University of California San Francisco, held their first National Cancer Plan Stakeholder meeting on Thursday, September 7, 2023. As the leading education and advocacy organization for the cancer care community, ACCC was invited to share the association’s key priorities for impacting cancer care in the US. ACCC president Olalekan Ajayi, PharmD, MBA, and chief operating officer at Highlands Oncology Group, PA, discussed these initiatives in a 30-minute session that included a robust question and answer period.     

The Oncology Workforce

“As the president of ACCC, I have the privilege of focusing our efforts on building our oncology workforce, and to ensure its readiness to deal with the complexities of delivering cancer care to our patients,” Dr. Ajayi said to begin his session. “This is important as we all know the toll the pandemic has had on the physical, mental, and psychological health of our oncology workforce.”

According to Dr. Ajayi, combatting the effects of the COVID-19 pandemic, as well the increasing complexities that accompany cancer care treatment and delivery in recent years has been challenging for both patients and providers. Thus, ACCC is working with its interdisciplinary partners to ensure that its members and the greater cancer community have adequate support and resources while navigating specific workforce challenges, for example, developing partnerships with high schools, colleges, and medical schools to build an oncology pipeline. “Another way ACCC uniquely pursues this goal is through the oncology state societies that are affiliated with the Association all throughout the United States. This affiliation allows us to tackle regional as well as local workforce issues.”

Financial Advocacy

Dr. Ajayi went on to discuss the patient-centered approach that is at the core of the Association’s agenda. “At ACCC, we believe that treating cancer is not just about treating a disease, but treating the patient, and all the facets of their care,” he said. “For every patient that presents at a cancer program or practice, their provider must consider the psychological and practical aspects of their care.” The Financial Advocacy Network is one resource the multidisciplinary cancer care team can use to meet these care needs.

“At ACCC we are known for our Financial Advocacy Network, and we are the only organization in the oncology space that has developed guidelines to help prevent our patients from experiencing financial toxicity”, Dr. Ajayi shared with the panel. “We have had robust success and are extremely proud of the benefits this resource has provided cancer programs and practices around the country.”

The Importance of Screening

In discussing the importance of screening with the panel, Dr. Ajayi highlighted the Appalachian Community Cancer Alliance, an initiative ACCC created alongside 6 oncology state societies from throughout the region (Kentucky, North Carolina, South Carolina, Tennessee, Virginia, and West Virginia). This alliance seeks to provide residents of the Appalachian Region and beyond with interdisciplinary, patient-centered approaches to cancer care from prevention through survivorship, with an emphasis on enhanced quality of life.  

“As a part of this alliance, we are focused on building a screening program that is sustainable,” Dr. Ajayi said. “In underserved communities that lack resources for treatment, screening is our best weapon.” According to Dr. Ajayi, ACCC has been a pioneer in developing groundbreaking screening initiatives, and has built programs, tools, and resources that cancer programs and practices can leverage to improve their lung cancer screening rates. “At Highlands Oncology Group, we have data that show us screening works. For 1 in every 40 patients we screen, we detect some form of cancer early—which means the patient has a greater chance of living longer.”

Diving Deep in the Q&A

Dr. Berger: Supportive services seem to be a fundamental pillar of your organization, and I want to understand how to advocate for your efforts. What are the main barriers we can advocate for and how would you propose we advocate to the President to support your mission?

Dr. Ajayi: When it comes to supportive care services, one of the major challenges is enabling cancer care organizations to provide these services in a sustainable manner. It takes a fair amount of man and brain power to deliver these services. We need to create policies that provide reimbursement for many of these services and give cancer programs and practices an incentive to deliver these crucial services.

Dr. Jaffee: Given the issues you have raised [regarding sustainability]; do you have any other suggestions we could bring up to the President? You must also have workforce challenges within these [underserved communities] to be able to provide these services. Can you speak to that?

Dr. Ajayi: Empowering cancer programs and practices to foster community resources is probably the best solution for creating sustainability. As a cancer program or practice, when you are dealing with reimbursement issues, you don’t have a lot of wiggle room when it comes to providing ancillary services that are equally rewarding for patients. We also need to understand that cancer programs and practices are best placed to develop innovative strategies to deliver these services. Any initiative that is launched solely from a national standpoint will likely create a one-size-fits-all model that will not be applicable to everyone.

When it comes to the workforce, we need to provide the resources for our workforce, so they know where to get the information and training they need to provide these services. We also need to identify new professions within the cancer care team who will facilitate this goal. For example, I believe that community health workers are an underutilized resource by larger cancer programs, so developing partnerships with these professionals would be beneficial.

Dr. Brown: Thank you, Dr. Ajayi—excellent presentation. Can you speak about the Appalachian initiative, are you partnering with governmental agencies to implement these amazing initiatives?

Dr. Ajayi: One of our core values at ACCC is collaboration. LUNGevity is one of our major partners with the Appalachian Community Cancer Alliance. We have also partnered with many other organizations as well with the multiple initiatives we have. Our efforts on reducing mortality of lung cancer in Rural Appalachia has been recognized by Cancer Moonshot, and moving forward, we hope this platform provides the foundation for more partnerships with government agencies.