On Tuesday, March 12, I had the privilege of joining Jennifer Bires, LCSW, OSW-C, CST, FACC, executive director of Life with Cancer and Patient Experience at Inova Schar Cancer Institute and newly elected member of the Board of Trustees for the Association of Cancer Care Centers (ACCC), at a meeting with delegates from the Swedish Ministry of Health and Social Affairs. During the meeting, which took place at Inova’s Life with Cancer clinic in Fairfax, Virginia, I provided an overview of ACCC's efforts to expand access to cancer care and alleviate the financial burdens on patients, highlighting recent advocacy initiatives on Capitol Hill. Bires shared the Cancer Institute's innovative approach to person-centered cancer care, with an emphasis on the invaluable psychosocial support offered by the Life with Cancer program.

One notable topic of discussion centered around the use of advanced practice providers (APPs) to expand the availability of healthcare providers—a practice integral to the multidisciplinary oncology care team in the United States. The absence of APPs in Sweden sparked interest among the delegates, with 1 expressing their admiration for the role of nurse practitioners based on prior experiences in the US and expressed a desire for similar expansion in Sweden.

Both the US and Sweden face challenges in cancer care access, albeit with different underlying causes. Sweden grapples with a shortage of oncologists as does the US, with the latter also confronting challenges rooted in social drivers of health, including financial barriers to the cost of treatment. The role of industry in promoting equitable and accessible care for all was acknowledged by all individuals present. 

A panel consisting of 4 members from Life with Cancer, including 2 nurse navigators, Laura Kaminski, BSN, RN, OCN, and Eva Ruiz Olivares, BSN, RN; an oncology behavioral therapist, Anna Harkins-Joseph, LCSW; and an oncology dietitian, Marion Irvin, RD, CSO, LD, CNSC, elaborated on their pivotal roles in providing continuous support to patients and their families from diagnosis to survivorship. Robust discussions ensued between the Swedish delegates and Inova staff regarding potential research opportunities focusing on the impact of psychosocial care on patient outcomes.

Stephanie Van Bebber, senior director of the Inova Schar Clinical Trials Office within the Inova Health System, provided an insightful overview of the ongoing research endeavors at the program—highlighting the expanding reach of trials into the Northern Virginia community. Van Bebber mentioned the enrollment rate of patients into cancer clinical trials at the cancer program currently stands at between 1% to 5%, but with a concerted effort to raise this figure over the next 3 years. Swedish delegates expressed a desire for all patients with cancer to be enrolled in trials, emphasizing the importance of maximizing participation rates. This aspiration aligns with several initiatives spearheaded by ACCC, such as the Just ASK training program in partnership with the American Society of Clinical Oncology (ASCO), aimed at enhancing clinical trial awareness and diversifying participation. Additionally, the ACCC Community Oncology Research Institute (ACORI)—launched under the tenure of past ACCC president, Randall A. Oyer, MD, FACC, executive medical director, Penn Medicine Lancaster General Health, Ann B. Barshinger Cancer Institute—endeavors to broaden access to clinical trials within community settings and reflects ACCC's commitment to advancing research and improving patient outcomes.

Kathleen Harnden, MD, MBA, director of Breast Medical Oncology at Inova Health System, provided valuable insights into the integration of cancer clinical trials within her program. Notably, she highlighted Inova's significant contribution as one of the leading enrollers in an ongoing clinical trial investigating a promising new approach to hormone therapy for patients with breast cancer. Dr. Harnden emphasized the importance of clinical trials in advancing treatment options and improving outcomes for patients. Further, she discussed how participation in such trials not only offers patients access to cutting-edge therapies but also contributes to the advancement of medical knowledge and the development of more effective treatments.

Jennifer Bires led the Swedish delegation on a tour of Inova Schar Cancer Institute and provided insights into the patient-centric design of Inova Schar Cancer spaces. The delegation then visited the Inova Saville Cancer Screening and Prevention Clinic, where Elizabeth Hatcher, MSN, FNP-BC, outlined the clinic's services and ongoing trials. Finally, the group explored the Radiation department on a tour led by Ann Miner, senior director of Radiation Oncology at Inova Health System, observing cutting-edge technologies, such as a proton beam, and facilities designed to cater to the needs of pediatric and adolescent patients.

As the meeting concluded, members of the Swedish delegation expressed their admiration for witnessing "words put into actions" during their visit. They conveyed their anticipation of bringing back valuable insights and learnings to their country, inspired by the innovative approaches and collaborative efforts witnessed today. This exchange of ideas and experiences serves as a testament to the importance of global cooperation in advancing cancer care and research, which will ultimately benefit patients worldwide.

The Swedish Delegation included members from the Ministry of Health and Social Affairs, Swecare Foundation, A3P Biomedical, AstraZeneca, Elypta, Karolinska Universitetssjukhuset, Micropos Medical, Nollvision Cancer, The Swedish Network against Cancer, Scibase, and Sprint BioScience.

Molly Kisiel, MSN, FNP-BC is director, Clinical Content, Editorial Content and Strategy, Association of Cancer Care Centers, Rockville, Maryland. Prior to this position, she spent 14 years working as a registered nurse, oncology nurse navigator, and nurse practitioner at the Inova Health System. 

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