Did you know 85% of cancer patients are treated in the community setting? The phrase “community hospital” typically refers to your local hospital, the same one that is ready to set a child’s broken arm, remove a gallbladder, provide lab services and treat accident victims brought in by local paramedics. In other words, community hospitals treat the public’s various ailments, and that includes cancer. Community medicine is vital to our public health because it delivers quality, affordable and accessible health services.

Unlike a broken leg or appendectomy, cancer is ever evolving and so are the research and treatment protocols. A community hospital sees a lot of patients. For an early-stage cancer, they may be great places to be seen because you may know the care team and they are easy to access. By nature and mission, community oncologists are fully dedicated to treating patients, rather than researching, publishing or teaching. They keep up with their respective fields by certifications through continuing education, but the steady volume of information that comes through the cancer research fire hose cannot be practically absorbed by the community oncologist in his/her spare time, of which they usually have very little. To address this situation treatment guidelines have been established.

If the nature/business of community hospitals is to treat “all comers,” then the nature/business of accredited cancer centers is to research, develop, and publish new clinical findings. This begins with a specific theory about a specific protocol or drug for a specific patient population and the hopes for a specific outcome. It is wonderful that groups of experienced professionals are dedicated to doing this life-saving research, but it is not without significant costs and failures. There’s also the potential for big profit. Somebody has to manufacture and deliver the goods and that’s what the pharmaceutical industry does. These companies invest in much of the research and development (R&D) that lead to clinical trials conducted at these accredited cancer centers with the hope of receiving FDA approval to market the product more broadly.

While my late husband’s cancer journey uprooted our entire lives, compared to so many other people in our situation, it was typical. We visited our local hospital when we suspected he’d had a stroke. Many scans & tests later, we were seen by a community oncologist affiliated with the same hospital. Then came the avalanche of information,vocabulary completely unknown to us about melanoma and its treatment. I’m sure many other patients and advocates can relate to frantically Googling new words after the oncologist left the room, feeling compelled — as we were— to make a quick decision because it seemed time was of the essence.

I have had the time and distance to reflect and study the path Robert and I stumbled along. With this look back I can see how scattered, fragmented and camouflaged the direction and sources of information were. Was it possible for me to become a knowledgeable and effective advocate in the time and situation given? It was maybe not impossible but probably unrealistic. Ultimately, in the case of adults it is the patient who decides but it is the advocate who helps frame and inform the decisions to be made.

Where does a rookie advocate go for learning, training and Q&A? How about the community oncologist who has their hands full every day, how do they absorb the latest trial info and availability that could be so important to a patient under their care? Where do the clinical trials go to find matching patients who could possibly benefit from the drug or procedure being tested?

I wonder how many drugs, therapies and procedures never make it to market or much later than it should have because trials failed to meet the patient enrollment requirements. If technology can match people for a vacation rental, mortgages, dates, and car insurance, surely we can develop a tool to assist matching people to the info and resources in the cancer trial ecosystem.

1104Health and the cheryl app empowers patients and their advocates and caregivers to find the best options out there and take control of their treatment journey. Sign up to see if there is a clinical trial applicable to you.