Not every cancer is curable. The patient, may sometimes need to “live with it’, as is the case with diabetes or heart diseases. Controlling, rather than curing is the best course ahead for certain types of cancers including ovarian, chronic leukemia, some lymphomas, and metastatic breast and prostate cancers. Controlling cancer implies to limit the spreading.  The cancer may shrink, but nevertheless it will be there.

A patient will obviously prefer full eradication, rather than limiting it to a certain magnitude, but in some situations long term control is the best outcome possible. With the availability of new oral options, the advancement in treatment choices is significant, but they do require adherence on the part of patients who require long term treatments. Obviously, patients who are more compliant with cancer treatment, stand to benefit  the better outcomes.

A recent study conducted by the American Society of Clinical Oncology noted that nearly one-third of patients skipped eight or more days of treatment; these patients, not surprisingly, were in the group with worse progression-free survival rates.

There is little doubt that as and when cancer becomes a chronic condition for some patients, medication adherence emerges as a major factor in treatment outcome. As the medication progresses from short-term to chronic, patient adherence faces new challenges.

However, patient behavior may be only one of several factors that determine compliance; other important components may include physician behavior, the patient-physician relationship, and the patient’s support system, including family. Some of these challenges to patient compliance are broadly divided into these categories :

• Patient Demography Factors : age, ethnicity, social and family support, attitudes toward treatment, beliefs, and socioeconomic factors
• Medication factors : cost, route of administration, side effect profile, dose requirements, length of treatment
• Systemic factors : insurance, ease of accessing physician, appointment scheduling

These barriers may differ from individual to individual. Hence, it is of utmost importance, to recognize the individual barrier that a patient may face and then actively addressing it to improve patient adherence and compliance.