Short of specialists and cancer care

By Dr. Ananya Mandal, MDMar 23 2010

Consider this

• A study by the Medical Oncology Group of Australia found that Australia needs at least 100 more oncologists.
• 51% cancer sufferers need chemotherapy for their treatment.
• Only 19% patients who are eligible for chemotherapy are actually getting it

Research findings

Associate Professor Bogda Koczwara, from the Medical Oncology Group of Australia, conducted the survey which found just 19 per cent of all those diagnosed with cancer were receiving chemotherapy.

"Of all the cancer diagnosed in Australia, roughly half would derive a benefit from chemotherapy," Dr Koczwara said.

"What we've seen in our survey is less than half of those patients receive chemotherapy, so rather than one in two patients we're seeing about one in five patients."

Dr Koczwara said that there is scarcity of oncology services and specialists that has made the chemotherapy utilization rate in Australia “too low”.

Lack of adequate specialists has also translated into lack of availability of appropriate therapy for many patients especially those from rural areas who need long drives each time they need to see an oncologist. Lack of awareness in the part of healthcare providers regarding usefulness of chemotherapy is also responsible for low chemotherapy utilization rates.

"I don't think cost is a factor ... it may be a factor of access or awareness, or both," Dr Koczwara said.

"It means there are patients in Australia today who could benefit from cancer treatment and they're not getting it."

She surveyed 80% oncologists in Australia and has reported a shortage of nearly 157 full time oncologists and predicted a further deterioration of the situation with rising number of cancer patients. By 2014 Australia's medical oncologist shortfall would increase to between 126 to 198 doctors. NSW has the second biggest shortfall of all the states, mainly due to the large population particularly in regional and rural areas, she said. An estimated 38% rise in medical oncologists in urgently needed.

Experts speak

The chief executive officer of the Cancer Council Australia, Ian Olver, said the gap between demand and supply is so huge that providing only oncologists will not be enough.

''We are going to have to be clever about what we call a workforce of medical oncologists,'' he said. ''We may well have to use nurse practitioners [and other health professionals] for some of the things that medical oncologists do.''

Sally Crossing, the chairwoman of advocacy group Cancer Voices NSW, said she was ''very surprised and even more worried'' by the shortage.

''We need to make sure that people with cancer have access to treatment that will help them, and it needs to be treatment that is not too hard to get,'' she said.

She expressed concern over shortage of oncologists especially in rural and regional areas as well as metropolitan areas.

Ms Crossing said Cancer Voices had approached the Medical Oncology Group of Australia to undertake the study after a number of cancer patients reported having trouble accessing a medical oncologist and the group discovered that there was a dearth of research about the medical oncology workforce.

''With all this talk of health reform, we need to get an idea of how many more [health professionals] we need,'' she said.

This report has followed the federal government’s announcement last week for an additional $632 million in funding, over 10 years, to recruit medical trainees, including 680 medical specialists.