Cancer patients are sending a powerful message: who delivers their care matters just as much as the treatment itself.
Andreas Charalambous, who leads the Department of Nursing at the Cyprus University of Technology and serves on the MASCC Executive Board, recently highlighted a new publication examining how people with cancer actually prefer their care to be organized and by whom it should be delivered. The study focuses on something many healthcare systems overlook: patients’ real-world preferences for cancer nurses compared with doctors and other professionals.
What the new study is about
The publication is titled “Patient Preferences for Cancer Nurses as Care Providers: A Systematic Review of Discrete Choice Experiments.” In simple terms, a “discrete choice experiment” is a research method where patients are shown different care scenarios and asked to choose which one they prefer, allowing researchers to understand which aspects of care matter most to them.
Researchers screened 461 studies but only 11 met the quality and relevance criteria to be included in the final analysis. These 11 studies were conducted in Australia (3 studies), the United Kingdom (3 studies), and China (5 studies), and involved people with several cancer types, including breast, gastric, prostate, and mixed cancer populations.
Who was included in the research
Across these 11 studies, participants represented a range of diagnoses: four studies involved people with breast cancer, four focused on gastric cancer, one on prostate cancer, and two included mixed cancer groups. This mix helps show whether preferences for cancer nurses are consistent across different cancer types or if they vary depending on diagnosis and context.
The inclusion of participants from three different countries also introduces cultural and system-level differences in how cancer care is organized, which can influence how patients view nurses, doctors, and other professionals. That raises an important question: are we designing cancer services around historical habits, or around what patients in different health systems actually want today?
Follow-up care: who do patients prefer?
In six of the studies that focused on follow-up care—often called survivorship or surveillance care after initial treatment—cancer medical specialists (such as oncologists) were the top choice for providing this ongoing care. Cancer nurses came second, followed by general practitioners, suggesting that patients still strongly associate follow-up cancer care with specialist expertise.
But here’s where it gets controversial: if specialists are the preferred option yet are already overloaded in many systems, should health services continue to prioritize specialist-led follow-up at all costs, or should they reshape services so cancer nurse specialists can take on more of this role without patients feeling they are getting “second best”?
Supportive care: nurses move to the front
When the focus shifts to supportive care—things like diet and exercise guidance, screening for anxiety and depression, and other quality-of-life support—the picture changes noticeably. In four out of five supportive-care studies, cancer nurses were the preferred care providers, ahead of allied health professionals and then cancer medical specialists.
And this is the part most people miss: patients may trust doctors most for follow-up and surveillance, but they often see nurses as the go-to professionals for holistic, practical, day-to-day support that affects how they actually live with and beyond cancer. This suggests that policies which underuse cancer nurses in supportive care might be out of step with what patients actually value.
What patients are willing to pay (WTP)
The study also reports “willingness-to-pay” (WTP) estimates, which reflect how much patients would theoretically pay for certain types of care from specific providers. For follow-up care, the highest WTP estimate was $US226.15 for having a medical specialist oversee this stage of care, highlighting just how highly patients rate specialist-led follow-up.
For supportive care, the highest WTP was $US137.52 for a cancer nurse to provide diet-focused lifestyle advice after treatment for breast cancer. That is a striking signal: patients not only value nurse-led supportive care, they value it enough that, in economic terms, they see it as a service worth paying significantly for.
Why cancer nurses matter so much
Overall, the evidence shows that people with cancer place a very high value on cancer nurses, particularly in the realm of supportive care. Nurses are seen as key providers for areas like lifestyle advice, emotional support, and psychosocial screening, where continuous, person-centered interaction really matters.
This creates a strong argument for expanding the number of cancer nurse specialists and broadening their scope of practice. With the right training and authority, these nurses could deliver more elements of both follow-up and supportive care, matching patient preferences while easing pressure on overburdened cancer specialists.
A potential shift in cancer care models
The study suggests there is a clear opportunity to redesign cancer follow-up pathways so that expert care is shared more deliberately between cancer medical specialists and cancer nurse specialists. For example, routine surveillance visits could alternate between a specialist and a nurse specialist, while supportive care is primarily nurse-led, with clear referral pathways back to the specialist for medical issues.
However, this raises a provocative question: if the data show nurses are preferred for supportive care, should they be given more authority in areas that have traditionally been considered the domain of doctors, such as initiating certain interventions or leading survivorship programs? Some clinicians may worry this blurs professional boundaries, while others may see it as an essential evolution of modern, team-based cancer care.
Who wrote the paper?
The article “Patient Preferences for Cancer Nurses as Care Providers: A Systematic Review of Discrete Choice Experiments” is authored by a large international team. The authors include Elise Button, Carla Thamm, Megan Crichton, Rachel Milte, Andreas Charalambous, Juliana Christina, Murray R. Turner, Jane Mahony, Fiona Crawford-Williams, Olivia Cook, Natasha Doherty, Kerry Patford, Catherine Paterson, and Raymond J. Chan.
Their combined expertise spans nursing, supportive care, health economics, and survivorship research, which helps explain the strong focus on understanding not only what care patients prefer, but what they are willing to pay and how systems might be redesigned. Readers who want to explore the full methodology and detailed results can access the complete article through the journal’s website, as well as additional posts related to Andreas Charalambous’s work on OncoDaily.
Your turn: what do you think?
Here’s a bold point that could easily spark debate: if patients clearly value cancer nurses for supportive care and are willing to pay for their expertise, is it time to publicly recognize nurse-led services as a core pillar—not a “support act”—in cancer care models? Or should follow-up and supportive care remain primarily specialist-led, even if that does not fully reflect what patients say they prefer?
Do you agree that cancer nurse specialists should have an expanded, more autonomous role in follow-up and supportive care, or do you worry that shifting too much responsibility away from doctors could compromise care quality? Share your thoughts: should future cancer services be designed explicitly around these patient preference findings, or are there other factors—like workforce constraints, training, or safety concerns—that you think should carry more weight?
