Cancer isn’t just one disease, but many — each with its own challenges, characteristics, risks and treatments. As we have worked tirelessly to understand this group of diseases, I’ve witnessed a profound shift in how we approach cancer treatment.
When I began treating advanced melanoma, patients had few treatment options outside of chemotherapy, surgery and radiation. Early novel therapeutics often required long hospital stays and carried significant toxicities. With the advent of immune and cell-based therapies, we’re now treating cancer in a very different landscape.
Many of my advanced melanoma patients would succumb to their disease within a year or two but are now living long, full lives, 10-15 years beyond their diagnosis. Not only do these therapies extend survival for patients who had little hope, their administration no longer confines patients to the walls of a hospital.
This paradigm shift is improving the patient experience — reshaping cancer care in a way that challenges healthcare leaders to rethink how and where treatment takes place.
New therapies, new possibilities
With scientific advances, we can now deliver once-novel cancer treatments outside of the inpatient setting. From targeted therapies to immunotherapies, many advanced cancer treatments are moving toward administration in the outpatient setting thanks to better monitoring, lower toxicity and better management of toxicities.
For patients and their caregivers, this means less time spent in a hospital bed and more time at home with their families. Less time away from work, school and everyday life, leading to better quality of life during treatment. For hospitals and providers, it means a new model that reduces the need for inpatient resources while still providing high-quality cancer care to our patients.
Healthcare leaders must rethink the future
Historically, comprehensive academic cancer centers were the only places equipped to administer advanced cancer therapies. Many were developed or studied at places like Moffitt Cancer Center, where specialized expertise drives the best patient outcomes. Community hospitals have played a key role in referring patients to these centers in their search for the best care.
However, as treatments like chimeric antigen receptor T-cell therapy, immune checkpoint inhibitors and bispecific T-cell engagers become standard treatment, that model is not sustainable — and we need everyone to lean in. To make these life-saving cancer treatments more accessible and improve outcomes, community hospitals must start preparing for a future where they can safely administer them, manage side effects and provide follow-up care.
If your hospital or health system is not already preparing for this shift, now is the time. The future of cancer care is happening, and not just at major academic centers. Here’s how community hospitals can lean in to scale these therapies:
- Expand outpatient infusion capabilities. Many immunotherapies and cell therapies can now be safely given outside the inpatient setting, requiring leaders to rethink facilities, staffing and space planning.
- Train staff to manage unique toxicities. Immunotherapy side effects differ from chemo or radiation. Community hospitals need specialized teams equipped to recognize and manage adverse effects quickly.
- Partner with cancer centers. Follow-up care is crucial for patients receiving advanced therapies. Even if your hospital is not ready to administer them, you can play an important role in post-treatment monitoring, reducing unnecessary travel and hospital stays for patients treated outside their local community.
Cancer care is not what it was 10 or even five years ago. Hospital leaders should not question if outpatient cancer treatment with immune and cell-based therapies will become standard in your system, but when. Outpatient is not just in; it is the future. Hospitals that invest in proper infrastructure and team training now will help lead the future of cancer care, scaling these therapies and saving more lives.
Dr. Patrick Hwu is CEO at Moffitt Cancer Center, a leading cancer hospital based in Tampa, Fla.