Addressing the Unique Needs of our Nation’s Veterans Diagnosed with Cancer

By Lucio N. Gordan, MD | President & Managing Physician, Florida Cancer Specialists & Research Institute

Ensuring that all patients with cancer have convenient access to high-quality, affordable cancer care is the essence of community oncology.

For U.S. military veterans, many of whom live in rural areas and struggle with injuries or other illnesses, accessing the comprehensive care they need close to home can be a challenge.

As Florida’s largest community-based oncology provider, we are working in partnership with the U.S. Department of Veterans Affairs to close that gap and address the unique needs among the 1.4 million veterans who live in Florida, which has the country’s third-highest veteran population.

Nearly one-half of all veterans in Florida who were referred for treatment outside of the VHA system in 2023 received care from one of nearly 100 FCS clinics across the state. Already this year, more than 3,000 veterans have been referred to FCS.

Our ability to provide easy access to the most advanced and personalized treatment, typically within 72 hours of referral, supports the VA’s efforts to support the often complex needs of veterans and their families from screening through survivorship.

I was honored to serve recently on a panel at the Conquering Veteran Cancer, Together event during the 2024 American Society of Clinical Oncology (ASCO) annual meeting. This initiative, sponsored by 百时美施贵宝 aims to improve the continuity of cancer care for veterans by fostering engagement between the VA, community and academic providers, and patient caregivers.

The event was beyond inspiring. And it helped to broaden my appreciation of the veteran experience and the specialized services required to consistently deliver the best-in-class cancer care these women and men and their families need and deserve.

We know, for example, that more than one-third of veterans suffer from mental health issues that can include depression, anxiety and post-traumatic stress disorder.

At FCS, the framework of our holistic model of care (HMoC) transcends traditional oncology care and recognizes the importance of emotional well-being. Our approach goes beyond treating the initial condition that brought these patients to FCS and enables us to nurture the whole person at each step of their cancer journey.

Of the FCS patients referred from the VA already in 2024, nearly 94% have been screened using the Patient Health Questiionaire-9 (PHQ-9), a clinically validated tool that helps identify and assess depression. Patients whose PHQ-9 scores indicate elevated depression levels are offered comprehensive care coordination support based on their individual needs.

Beyond behavioral health, our established teams are at the ready to provide nurse navigation, clinical nutrition counseling, palliative care, caregiver support and 24/7 triaging. This is becoming our standard of care and we continue to track our progress through precise quality measures.

As proud as I am of our efforts, we know that we must do better and do more, especially as we expect the number of veteran referrals to FCS will continue to grow.

My distinguished panel colleagues included Michael Kelley , MD, national program director for oncology for the Department of Veterans Affairs, and Manali Patel, MD, MPH, MS, associate professor, Stanford University School of Medicine and staff oncologist with the VA Palo Alto Health Care System.

Each spoke passionately about their respective efforts to prioritize health equity for the estimated 56,000 veterans diagnosed with cancer within the VA system each year, where nearly 500 cancer specialists provide a comprehensive continuum of high-quality care and treatment to ensure superior outcomes. Their commitment and priorities mirror many of ours.

The VA’s teleoncology program has greatly expanded options for veterans to access cancer care virtually, no matter where they are located. The National Precision Oncology Program ensures that all veterans have access to next-generation molecular testing that identifies specific gene mutations and helps to direct treatment decisions with great precision. Veterans are able to access the most advanced treatments through participation in ongoing research trials led by VA researchers who are continuously advancing the science of cancer.

As a part of the Biden Cancer Moonshot, the VA recently announced several critical new initiatives. Key among these are expanding access to genetic, lung and colorectal cancer screening, enhancing preventive services such as smoking cessation, and prioritizing claims processing.

My panel colleagues also issued a call to action for their fellow oncology professionals to join them in further enhancing and evolving specialized care initiatives.

As I have witnessed throughout my career, innovation and collaboration are key to conquering cancer. This remains true as we strive to bring care closer to where veterans live and address their unique needs.

I have since initiated an internal work force to move us forward. My FCS physician and leadership colleagues and I will build up our connections with the VA, payors and other partners. Already we have a hearty list of action items, which include:

• Further streamlining the referral process to get the fastest care possible engagement and coordination of care and involve family caregivers from the start.
• Exploring new avenues to connect veterans to the more than 180 early and late-phase clinical trials offered through our nationally recognized research program.
• Contracting to get swift payment approvals for all required treatments.

As always, our ultimate goal remains to bring hope, healing and the best possible outcomes to each person we serve. I look forward to updating you on our progress.