Cancer and the family physician

The American Cancer Society estimates that several hundred thousand lives could be saved per year if the current knowledge about the early treatment and prevention of cancer could be applied to all of the individuals in this country without new cancer "breakthroughs." The family physician has a unique opportunity, by virtue of his accessibility to a large segment of the patient population, to deliver patient education information as well as perform most of the procedures that are necessary to effect an early diagnosis. The family physician must develop a "preventive attitude" in himself, his office support staff, and the cadre of the consultants frequently used. He must be willing to assume the position of being a leader of the cancer team in all phases, which includes prevention, early diagnosis, definitive diagnosis, initial treatment, adjunctive treatment, reconstruction, continued surveillance for the lifetime of the patient, and finally, supportive care for the terminally ill. Care coordinator and primary communicator are positions he assumes on a continuing basis while acting as the patient advocate within the existing structure of the healthcare system. He must assume the role as financial advisor for the patient and his family with recommendations that are individualized, considering the patient's financial circumstance, age, general physical condition, support mechanisms, community resources available, family attitude, available consultation, and stage of disease. Ideally, we should strive to develop many thousands of cancer centers in individual family physicians, as well as other primary care physicians' offices across the country where correct information about cancer and proper diagnostic and therapeutic procedures can be obtained in that office or through proper consultation, with the alternatives in such procedures clearly provided to the patient and his family. These centers would provide an effective means of reducing morbidity and mortality of cancer within the existing structure of healthcare in this country and, if it were coordinated with episodic care, it could be done in the most effective manner.