More than half of cancer patients diagnosed at ACS Commission on Cancer (CoC)-accredited hospitals undergo surgery as part of their treatment.1
While surgeons play a significant role in the treatment of cancer patients, collaboration with oncologists, nurse practitioners, physical therapists, and other specialists remains a critical component to care.
Organized under the theme “Harnessing the Power of Collaboration,” the 2025 ACS Cancer Conference, held in Phoenix, Arizona, March 12–14, explored the meaning of collaboration and how teams can work together to address the evolving needs of cancer patients, survivors, and their caregivers. The conference drew nearly 500 attendees, including surgeons, cancer registrars, and other cancer specialists.
“Taking care of cancer patients requires multidisciplinary care,” said Ronald J. Weigel, MD, PhD, MBA, FACS, Medical Director for ACS Cancer Programs, during his opening remarks. “We want to highlight collaboration between hospitals, particularly as it relates to taking care of patients in underserved areas, one of them being rural.”
Throughout more than 25 sessions divided into four tracks (clinical, quality improvement, accreditation, and research), attendees filled sessions with meaningful discussions on the quality of cancer care in an age when treatments are not a one-size-fits-all approach.
Five key takeaways from the cancer conference are:
1. Collaboration Requires Strategic Planning
In the keynote panel session, representatives from multiple societies that collaborate with the ACS CoC—American Cancer Society, American Society of Clinical Oncology, American Society for Radiation Oncology (ASTRO), National Comprehensive Center Network (NCCN), Society for Immunotherapy of Cancer, and Society of Surgical Oncology—presided over a panel discussion on ways national organizations can work together to not only improve cancer care but also develop pathways that foster innovation.
“There’s this overarching need for us to not be so siloed,” said Laurie J. Kirstein, MD, FACS, a breast surgical oncologist from Memorial Sloan Kettering Cancer Center in Middletown, New Jersey, and Chair of the CoC. Dr. Kirstein called for organizations to meet more formally and more frequently. “We all care about improving the quality of patient care and making sure that quality doesn’t decrease in any way.”
The panel focused on two specific areas where more collaboration likely can make the most impact in cancer care: streamlining the development of uniform guidelines and standards, as well as uniting on legislative priorities, such as reducing the burden of insurance pre-authorizations and advocating for increased funding of cancer research.
“We are all much better off when we work together,” said ASTRO CEO Vivek S. Kavadi, MD, MBA, FASTRO. “We work together across the House of Medicine, specifically with various cancer organizations and coalitions, to advocate for cancer care in the multiple venues where it’s necessary.”
Panelists also emphasized that guidelines are more effective when they are cross-referenced by other organizations and developed with input from multiple stakeholders.
“There should be a consistent way for each of our organizations to amplify the collective voice of all guidelines and organizations,” said Wui-Jin Koh, MD, NCCN senior vice president and chief medical officer.
Dr. Koh noted that 97% of NCCN guidelines panels include a patient advocate, which they define as someone who is a cancer survivor or caregiver to a patient with cancer. These viewpoints are fundamental to driving change and highlighting multiple perspectives that otherwise go unheard, Dr. Koh said.
Collaboration also fosters unity in the wake of natural disasters and other disruptive events. Leticia Nogueira, PhD, MPH, scientific director of health services research at the American Cancer Society, recalled that the COVID-19 pandemic was a notable period that called for uniform clinical guidance in an unprecedented time.
“Nowadays, we think of the LA wildfires or Hurricane Helene as disasters, but COVID was also a disaster,” she said, explaining that several medical organizations came together to develop guidelines related to the care of cancer patients during the pandemic. “I think that collaboration was key. None of these organizations could have figured out everything alone.”
2. Rural Cancer Patients Require Innovative Solutions
Despite evidence demonstrating that CoC accreditation increases high-quality care and outcomes for cancer patients, not all rural settings have the resources to apply for and maintain accreditation, and some CoC standards may not be achievable for smaller hospital groups. Recognizing the distinct needs of rural patients, who compose about 15%-20% of the US population,2 the CoC will be launching a new accreditation track for hospitals located in rural counties.
Presenters described the unique challenges of rural areas, where maintaining surgeons and linking care can be a struggle, noted Neal W. Wilkinson, MD, FACS, a general surgeon in Kalispell, Montana, and an ACS Governor. Each rural state ideally should have access to multidisciplinary and regional hospital units/teams, he said, and the CoC-accreditation process should entice and encourage participation by considering the distinct needs of this population.
It also is important to recognize that one approach to improving rural cancer care won’t work everywhere, noted Waddah B. Al-Refaie, MD, FACS, chair of surgery at Creighton University School of Medicine in Omaha, Nebraska. He described the potential of artificial intelligence (AI) to track patient well-being and recovery beyond the use of standard clinical measures.
One of his team’s projects with Georgetown University in Washington, DC—Remote Symptom Collection to Improve Postoperative Care (RECOVER)—is evaluating the potential of a voice-assisted remote symptom monitoring system to improve patient-clinician communication and treatment adherence. The tool, which alerts care teams if a patient experiences a concerning health issue postoperatively, is being assessed in rural and suburban patient populations.
“The digital divide is a real problem in rural America. AI can offer plausible solutions,” said Dr. Al-Refaie. “To our surprise, there was a higher retention rate found in the rural populations to stay in those studies.”
While barriers to care in rural regions are significant, panelists also offered strategic solutions to support hospitals of all sizes in achieving accreditation.
“In our region, going through the CoC-accreditation process has been what I call the great equalizer,” said Charles H. Shelton, MD, medical director of Outer Banks Health in Nags Head, North Carolina, and a member of the CoC Quality Improvement Committee. Outer Banks Health, a 19-bed hospital situated in the Barrier Islands, received CoC accreditation in 2016 and National Accreditation Program for Breast Centers (NAPBC) accreditation in 2022.
Dr. Shelton estimated that before receiving CoC accreditation, approximately 85% of patients in the county traveled to urban areas, sometimes as far as 40-80 miles, to receive their cancer care.
After implementing the CoC and NAPBC standards, which provided the hospital with guidance to leverage their existing community relationships and strategically invest in cancer care, that model has flipped: patient volumes for cancer have increased nearly five-fold, and the region’s cancer mortality rates, once the worst in the state, are now on par with state averages. Access to comparative data on patient retention, shifts in cancer stage, and timeliness metrics has especially helped fuel improvements for patient-centered outcomes, Dr. Shelton added.
Building a network also can help rural providers and hospitals, which often struggle with access to clinical trials and face financial constraints from operating in low-volume, high-fixed cost settings, said Mary Charlton, PhD, a professor of epidemiology at the University of Iowa in Iowa City. A multidisciplinary team at the University of Iowa is collaborating with the University of Kentucky in Lexington to translate lessons learned from the Markey Cancer Center Affiliate Network (MCCAN) model to Iowa. The MCCAN network assists hospitals in achieving the CoC standards through tailored programs and resources, taking into account smaller staff sizes and helping centers gradually increase accreditation efforts.
“It helps to have other people to bounce ideas off of. If you’re a lone person at a rural hospital with a full caseload, that’s a really hard model to follow,” Dr. Charlton said.
3. Care Plans Should Consider Quality of Life and Survivorship
The number of cancer survivors is expected to grow from 8 million to nearly 26 million in 2040.3 To prioritize resources for patients both during and after their cancer treatment, survivorship standards remain an important component of the CoC and NAPBC.
Several presentations at the conference described opportunities to pivot guidelines and support patients with evidence-based practices focused on nutrition, exercise oncology programs, and comprehensive pre- and post-rehabilitation efforts.
“If I find out about a patient who has lost 40 pounds and they are about to undergo a Whipple procedure, I am going to play investigator: Why did they lose the weight? What happened? It’s often very surprising what the issue is,” said Renee E. Stubbins, PhD, RD, a clinical oncology dietitian educator at Houston Methodist Neal Cancer Center in Texas.
Specifically, transportation issues, lack of access to healthy food, or emotional distress might contribute to lower nutritional status.
“It’s my job to figure out why, and it’s often not what you think it is—sometimes it is related to the cancer, but sometimes it’s not,” Dr. Stubbins said.
4. Accreditation Adds Value to Hospitals
A growing body of research demonstrates the value of accreditation,4,5 and national quality improvement (QI) projects have allowed teams across the country to focus on specific care gaps such as smoking assessments and missed radiation appointments. However, each hospital faces unique challenges and barriers to improving quality.
Daniel J. Boffa, MD, MBA, FACS, division chief of thoracic surgery at Yale Medicine in New Haven, Connecticut, and Vice Chair of the CoC, facilitated a discussion on ways multiple programs can be managed more efficiently within hospitals without putting undue strain on them. While there may be some general overlap between the accreditation programs, each program guides the hospitals in distinct ways to look at specific aspects of care. Opportunities exist to streamline the accreditation process for hospitals managing multiple programs, as well as to explain the value of accreditation better to the public and providers outside of cancer care, especially among primary care physicians who may be making patient referrals.
“There is brand recognition to being in an accreditation program; it is not a trivial thing,” Dr. Boffa said. “There is a real opportunity to let many more people know what is behind the accreditation process.”
Some changes are in progress to streamline the accreditation process for hospitals with multiple programs. A unification project between the CoC and NAPBC also is underway to reduce redundancy and allow for more meaningful collaboration on quality collaboratives and projects. To help accomplish this goal, NAPBC programs applying for an initial site visit in 2026 or beyond must be CoC accredited.
5. Data for Quality Projects and Research Must Be Leveraged Smartly
The need for smarter and faster access to data was at the forefront of several presentations, spanning discussions on AI as well as how to leverage data more efficiently for projects. There are several upcoming components to help streamline access to real-time data, including new data query and visualization techniques within the Rapid Cancer Reporting System of the National Cancer Database.
AI also has the possibility of transforming cancer care, but only when integrated properly.
Taryne A. Imai, MD, FACS, chief of the Division of Thoracic Surgery at Queen’s Medical Center in Honolulu, Hawaii, and Vice Chair of the CoC Education Committee, described the potential of a “virtual nodule clinic” to automatically identify patients at risk of lung cancer who might otherwise miss screening.
By developing an AI software that screens all radiology reports with natural language processing, the team has been able to apply risk calculators to assess the patient’s risk for lung cancer. The project has the potential to close critical lung cancer care gaps in Hawaii, which has the sixth highest incidence of lung cancer in the country and ranks last in the country for early detection of lung cancer.6
However, for AI to provide the most impact, especially for diagnostic and predictive analyses purposes, the AI program should be fully integrated within a medical record system, and clinician involvement is also key.
“The idea is for AI to enhance the work of healthcare providers and not necessarily replace their decision-making or the human workforce,” Dr. Imai said. “AI needs to be able to adapt to new data and an expansive healthcare environment. We need to regularly evaluate AI performance.”
Other news presented at the conference:
- New operative standards grant: Assessing the Effectiveness and Significance of the Operative Standards Program will be one of the first large-scale projects aimed at evaluating operative standards across cancers and hospital types and assessing the main barriers faced when implementing the standards.
- American Joint Committee on Cancer (AJCC) Version 9 Protocols: The AJCC team is transitioning from editions to versions and is refining the Version 9 protocol production process. Four protocols were released in 2025—thymus, lung, diffuse pleural mesothelioma, and nasopharynx—and several other protocols are in the pipeline, including HPV-associated oropharyngeal cancer and conjunctival carcinoma.
- The 2026 Cancer Conference will be combined with the Quality & Safety Conference. More details on this new format will be announced in the coming months.
