The VA is expanding its precision cancer treatment program to reach veterans in rural towns who struggle with access to care.

The VA’s National Precision Oncology Program began as a research pilot focusing on veterans with lung cancer and has expanded to 126 VA facilities where doctors match treatment to a veteran’s type of cancer. The VA continues to grow the program by offering TeleOncology so veterans in rural areas lacking cancer specialists can get guidance virtually.

“By telehealth, I can now deliver every specialist, every place in the country,” said Michael Kelley, Chief of Hematology and Oncology at the Durham VA Medical Center in North Carolina and VA’s National Program Director for Oncology.

Patients can access TeleOncology by using VA Video Connect through an internet-connected device at home or by using clinical video telehealth at a VA Medical Center.

“It’s important to understand first that veterans enrolled in the Veterans Health Administration systems are 2½ times more likely to live in rural areas,” Kelley said. “The National TeleOncology Program leverages telehealth to provide world-class specialty and subspeciality oncology care and services to veterans, regardless of where they live.”

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More than 3,000 veterans used the National TeleOncology Program in 2019, Kelley said.

The National Oncology Program Office takes a rigorous approach to cancer treatment. The program’s researchers use next generation sequencing to break down tumors’ unique genetic characteristics, then use that information to advise doctors on targeted treatments, therapies, or clinical trials.

About 50,000 veterans had their tumors tested for genetic variation to target cancer treatment, Kelley said. Genetic sequencing was used to guide treatment for about 1,000 veterans diagnosed with metastatic prostate cancer, he said.

The program also maintains a cancer registry, molecular oncology tumor board, research, and clinical trials to further personalized care.

The most rewarding part of the program is witnessing the patients fight, Kelley said. He’s a thoracic oncologist and has watched as his patients respond to precise treatment plans, even in TeleOncology appointments.

“I think it’s always very heartening when you’re able to provide something that the patient needs but may not have had previously,” he said. “I was seeing patients who really needed me, and what was most heartening was it was clear that they could tell there was a difference in the type of care that was being provided, the sophistication, and just the expertise in my little area of oncology. So that was very heartening, and I really enjoy interacting with the patients – and I can beam in anytime they need me.”