Pharmacists have a vital role in shining a brighter light on blood cancer

More than three quarters of patients with blood cancer consider their illness to be a “hidden cancer” because of a lack of public understanding — pharmacists can help to change that.
Illustration of a torch shining through a series of blood vials, revealing a cancer on the illuminated spotlight behind them.

Blood cancer is the fifth most common cancer and the third leading cause of cancer-related deaths in the UK but awareness of it is overshadowed by more widely recognised cancers​[1]​.

According to the charity Blood Cancer UK, despite contributing to more deaths than breast cancer and prostate cancer, 78% of individuals grappling with blood cancer classify it as a hidden illness owing to a “lack of political focus”​[2]​.

A report published by the charity attributes this to the fact that leukaemia, lymphoma, myeloma, myeloproliferative neoplasms and myelodysplastic syndromes “are often seen as separate diseases”, meaning “the real impact of blood cancer is hidden in the way the statistics are reported”.

This has also led to a lack of patient and public knowledge regarding specific blood cancer diagnoses, with approximately 76% of patients expressing a pronounced lack of understanding that their condition is a type of blood cancer at the time of diagnosis​[3]​.

One of the significant challenges stemming from limited awareness is the prolonged diagnostic journey experienced by affected individuals.

Research reveals that 31% of patients afflicted with blood cancer visit their GP three or more times before being diagnosed​[2]​. This protracted period not only intensifies patient suffering but also impedes timely access to appropriate therapeutic interventions.

Optimising treatment outcomes

In light of this, healthcare professionals — notably, cancer pharmacists — possess a pivotal responsibility to bridge this knowledge gap by offering our patients clear and thorough information, allowing them to actively engage in their care.

In community pharmacy, our specialised skills in medication management, coupled with the acumen to identify early warning signs, position us to expedite symptom recognition and facilitate timely referrals for thorough investigations​[4]​.

Research has shown that patients with blood cancer, who are monitored by pharmacists, are more likely to experience a lower number of symptoms or complaints during treatment periods

Furthermore, as cancer pharmacists, we play an important role in the holistic treatment of people affected by blood cancer. Our knowledge of treatment regimens and understanding of potential drug interactions, as well as our expertise in the safe and effective use of medications, is crucial in optimising therapy outcomes and minimising adverse effects.

In hospitals, pharmacists work in partnership with the multidisciplinary team to ensure that the patient receives the most effective and appropriate medication, and that the patient is given the necessary support so that they can safely take their medication. Research has shown that patients with blood cancer, who are monitored by pharmacists, are more likely to experience a lower number of symptoms or complaints during treatment periods and are more likely to adhere to their treatment regimens​[5]​.

Managing side effects

Pharmacists, as easily available healthcare resources, also play an important role in assisting patients in navigating the often complex landscape of cancer treatment side effects. We empower patients to successfully manage and limit the impact of side effects by giving specific information on likely reactions, proposing techniques for symptom reduction and controlling side effects.

This symbiotic interaction between the patient and the pharmacist ensures a strengthened therapeutic partnership, enhancing the patient’s journey towards optimal health outcomes.

These insights are supported by research in the broader field of oncology, such as a study published in the Journal of Oncology Pharmacy Practice, which demonstrated that pharmacist-led interventions significantly improved chemotherapy-induced nausea and vomiting management​[6]​.

Additionally, research published in the Journal of Clinical Oncology found that pharmacist interventions improved adherence to oral chemotherapy regimens and helped patients manage associated side effects more effectively​[7]​. These examples illustrate how pharmacists contribute to mitigating side effects and improve treatment outcomes in cancer care, emphasising the importance of their role in blood cancer treatment.

Navigating support

An often underemphasised facet of the blood cancer landscape lies in the provision of comprehensive support services. Some 58% of individuals diagnosed with blood cancer continue to be unaware of the existence of support structures that could potentially improve their journey. Additionally, nearly half (47%) of patients with blood cancer confess to a lack of connection with supportive networks, despite recognising their importance​[2]​.

As cancer pharmacists, we can go beyond our responsibilities as drug experts to play an important role in signposting patients to a variety of resources

As cancer pharmacists, we can go beyond our responsibilities as drug experts to play an important role in signposting patients to a variety of resources, such as patient education materials, counselling resources and assistance programmes, thereby strengthening a holistic approach to patient care.

While following the strict standards related to research, pharmacists can also provide information about taking part in clinical trials, and support patients and healthcare professionals through the study stages.

Blood Cancer UK plays an important role in this area as it assists healthcare professionals and patients as they manage the hurdles associated with this disease. The organisation provides a variety of services and efforts to increase awareness and knowledge among healthcare professionals, including access to the most recent research, clinical recommendations and teaching materials.

Furthermore, Blood Cancer UK provides vital patient support services, including information, emotional support and practical guidance throughout a patient’s journey. This collaboration between patients, healthcare professionals and the charity can increase awareness of blood cancer and will undoubtedly catalyse early diagnosis, decreasing patient distress and improving treatment outcomes.

Cost savings

Lastly, the pivotal role of pharmacists extends beyond clinical care. The intricate domain of healthcare is tightly interwoven with cost considerations and pharmacists, equipped with their profound understanding of funding streams, medication alternatives and therapeutic equivalences, are uniquely positioned to recommend cost-effective treatment options without compromising efficacy or safety. This judicious approach also contributes to the sustainability of healthcare systems by rationalising drug expenditures.

This role of pharmacists is well documented in the literature. For example, a study published in the American Journal of Health-System Pharmacy highlighted the impact of pharmacist-led medication therapy management on optimising drug regimens in patients with chronic diseases​[8]​. Similarly, research in the Journal of Pharmacy Practice and Research emphasised the positive outcomes of pharmacist interventions in optimising dosages and improving medication adherence​[9]​.

These findings underscore the vital contribution of pharmacists in therapeutic optimisation, ensuring that patients receive the most effective and appropriate drug regimens.

However, several barriers can impede the effectiveness of this crucial role. Time constraints, heavy workloads, and a lack of specialised training in patient education can hinder pharmacists’ ability to dedicate adequate time and resources to providing comprehensive patient information.

The capacity to effect change is rooted in our combined knowledge as pharmacists and healthcare custodians

Interdisciplinary collaboration and effective communication with patients of varying health literacy levels and diverse cultural backgrounds can also pose challenges. Overcoming patient anxiety and advocating for better resource availability are essential tasks.

The capacity to effect change is rooted in our combined knowledge as pharmacists and healthcare custodians. Recognising and addressing these barriers is vital to ensuring that cancer pharmacists can fulfil their mission of empowering patients through knowledge.

We have the power to enter unknown territory through increased awareness campaigns, tenacious advocacy for legislative change, fast diagnoses and strengthened support infrastructures.

Let’s come together under the flag of change, join forces with groups such as Blood Cancer UK, and bring blood cancer’s profile out of the darkness and into the light. By working collectively, we can drive change, secure resources for vital research and strive towards a future where no lives are lost to this devastating disease.

Healthcare professionals have an opportunity to emerge as champions for driving greater recognition and support from politicians. Such coordinated efforts can help direct the required resources towards blood cancer, assuring its prominent inclusion in the scope of public health concern and, eventually, enhancing patient outcomes.

  1. 1
    Facts and information about blood cancer. Blood Cancer UK. 2022. (accessed Oct 2023).
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    Howell DA, Shellens R, Roman E, et al. Haematological malignancy: are patients appropriately referred for specialist palliative and hospice care? A systematic review and meta-analysis of published data. Palliat Med. 2011;25:630–41. doi:10.1177/0269216310391692
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    Kotronoulas G, Kearney N, Maguire R, et al. What Is the Value of the Routine Use of Patient-Reported Outcome Measures Toward Improvement of Patient Outcomes, Processes of Care, and Health Service Outcomes in Cancer Care? A Systematic Review of Controlled Trials. JCO. 2014;32:1480–501. doi:10.1200/jco.2013.53.5948
  5. 5
    Moulin SMM, Eutrópio FJ, Souza J de O, et al. The role of clinical pharmacists in treatment adherence: fast impact in suppression of chronic myeloid leukemia development and symptoms. Support Care Cancer. 2016;25:951–5. doi:10.1007/s00520-016-3486-6
  6. 6
    Quinn CS, Bergsbaken JJ, Blessinger EJ, et al. Implementation of a clinical pharmacist-led service to optimize management of refractory chemotherapy-induced nausea and vomiting in adult hematology/oncology clinic. J Oncol Pharm Pract. 2021;28:1499–507. doi:10.1177/10781552211029702
  7. 7
    Nguyen LMT, Rhondali W, De la Cruz M, et al. Frequency and Predictors of Patient Deviation From Prescribed Opioids and Barriers to Opioid Pain Management in Patients With Advanced Cancer. Journal of Pain and Symptom Management. 2013;45:506–16. doi:10.1016/j.jpainsymman.2012.02.023
  8. 8
    Gillespie U, Alassaad A, Henrohn D, et al. A Comprehensive Pharmacist Intervention to Reduce Morbidity in Patients 80 Years or Older. Arch Intern Med. 2009;169:894. doi:10.1001/archinternmed.2009.71
  9. 9
    Ali S, Ali M, Paudyal V, et al. <p>A Randomized Controlled Trial to Assess the Impact of Clinical Pharmacy Interventions on Treatment Outcomes, Health Related Quality of Life and Medication Adherence Among Hepatitis C Patients</p> PPA. 2019;Volume 13:2089–100. doi:10.2147/ppa.s224937
Last updated
The Pharmaceutical Journal, PJ, October 2023, Vol 311, No 7978;311(7978)::DOI:10.1211/PJ.2023.1.197730

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