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VA's Oncology Services and Tools

VA's National Oncology Program is comprised of state-of-the-art services and tools for diagnosing and treating Veterans with cancer.

Precision Oncology

VA's National Precision Oncology Program (NPOP) was launched in 2016 as part of the White House's Cancer Moonshot Initiative to eliminate cancer. Using precision oncology enables VA physicians to better select cancer treatment strategies for each individual Veteran. Oncologists at VA use molecular testing - which analyzes a patient's genomic profile - to more accurately determine a Veteran's cancer prognosis and the best course of treatment. Genetic testing does not impact service-connected benefits.

TeleOncology

National TeleOncology service is expanding TeleOncology access to Veterans across the nation with the National TeleOncology service (NTO). NTO oncologists specialize in the type of oncology they treat and most are affiliated with NCI Designated Cancer Centers. TeleOncology provides cancer care virtually through telecommunication technology, connecting patient and provider across great distances. NTO delivers cancer diagnostics and treatments for Veterans via telemedicine.

VA uses a “hub-and-spoke” model for TeleOncology, with the main hub based in the Durham VA Medical Center. VA cancer specialists around the country work through NTO from their local VA Medical Center office, providing care virtually to a selected spoke site. Patients can connect with providers two different ways - they can either travel to a spoke site to connect with clinical video telehealth (CVT) or connect from their home using an internet-connected device with VA Video Connect (VVC).

Clinical Trials

Cancer clinical trials enable testing of novel treatments to establish the evidence for oncology care thereby, speeding the delivery of new treatments to the clinic to help cancer patients. These research studies not only explore new ways to treat cancer but also have the potential to improve quality of life for patients. Many of today's successful cancer treatments are the result of past clinical trials. Through clinical trials, doctors determine which new treatments are safe, effective, and better than current treatment options.

When diagnosed with cancer, patients are presented with a variety of treatment options. Clinical trials are one important treatment option that patients should consider with their provider. During a clinical trial, you give approval to add information about your cancer, the treatment and cancer related genomic and molecular biology information to VA's Cancer Registry. The information gained through clinical trials expands our understanding of different cancers and improves the quality of care our Veterans receive.

Pharmacogenomics

In 2019, the Imagenetics program at Sanford Health and VA teamed up to offer pharmacogenomic (PGx) testing to current VA patients at no cost. PGx testing analyzes genes to learn how you may respond to commonly prescribed medications used to treat pain, mental health, selected cancers and infections, cardiovascular, neurologic, and inflammatory disorders. This information helps your doctors and pharmacists decide the best treatment options for you.

Any Veteran patient (with few exceptions) is eligible to receive PGx testing through this program which is available at select VA medical centers.

PGx testing helps reduce the trial-and-error process of trying different drugs in varying doses. Side effects can be reduced when PGx testing is used because VA providers are alerted of a potential “drug-gene” interaction when ordering medications.

Clinical Cancer Research Service

In 2023, VA established the Clinical Cancer Research Service (CCRS) to increase access to cancer clinical trials for Veterans. Cancer clinical trials advance knowledge and provide high-quality medical care.

CCRS uses a two-pronged approach to bring the option of cancer clinical trials to Veterans. First, the Cancer Clinical Trials Navigation (CTN) service assists VA providers in identifying clinical trials and gives Veterans education and information about clinical trials. Second, the Decentralized Clinical Trials (DCT) service offers clinical trials that don’t require Veterans to travel to the specific VA facility offering the trial. This model allows for therapies to be delivered at a VA facility closest to the Veteran, making it easier for the Veteran to participate and improving study enrollment.

CCRS has key partnerships with other VA research consortia, National Cancer Institute, and non-profit organizations and is committed to ensuring that VA oncologists and Veterans have access to the best possible cancer care through these initiatives.

Play button for "Cancer Code | Cancer Surveillance Informed by Genetic Testing" video

Comprehensive Genetics Service

VA’s Comprehensive Genetics Service (CGS) offers Veterans and their providers a comprehensive understanding of their genetic predispositions to cancer, empowering them to make informed treatment decisions. Through genetic counseling and testing, CGS identifies potential inherited cancer risks and offers individualized preventive and surveillance options with the goal of early detection and intervention. Moreover, CGS assists patients in navigating the emotional and logistical implications of their genetic information.

Clinical Cancer Genetics Service (CCGS)

The educational programs offered through CGS not only benefit the Veterans they serve but also contribute to a broader understanding of cancer genetics. The knowledge gained through our collaborative education advances care not just within VA but across the entire medical community. For example, VA has partnered with City of Hope in a new, cutting-edge, centrally funded and managed cancer genetics training program for oncology providers.

The services provided by CGS embody VA’s dedication to providing exceptional care and support to Veterans predisposed to cancer. By delivering personalized, high-quality care, VA equips Veterans with the tools needed and empowers them to take charge of their health.

Genetic testing does not impact current or future consideration of service-connected benefits.

Medical Genetics Service (MGS)

In addition to its cancer-related services, VA’s Comprehensive Genetics Service also includes the Medical Genetics Service (MGS), which focuses on hereditary conditions unrelated to cancer. MGS provides testing and counseling for genetic conditions such as inherited heart diseases, metabolic disorders, and other health issues that may impact Veterans and their families. Through MGS, Veterans can receive personalized genetic information that guides prevention, early diagnosis, and treatment tailored to their specific needs. MGS ensures that Veterans have access to comprehensive genetic care that goes beyond cancer, empowering them to manage their health more effectively.

Close to Me Care Delivery Models

Bringing Cancer Care to Veterans

VA’s Close to Me Care Delivery Models are a visionary initiative designed to bridge the gap between Veterans and accessible health care. Close to Me deploys innovative solutions that bring anti-cancer therapy services closer to Veterans’ homes, ensuring that Veterans have easy access to the care they need, where they need it.

These new clinic options have revolutionized VA cancer care delivery by establishing a network of community-based outpatient clinics that are serviced by either traveling, or stationary, nurse and provider care teams.

This expansion means that Veterans can access more than just primary care at their local clinics, including cancer care treatments, provider visits, and specialist consultations via telehealth, further optimizing VA clinics. Initially launched in 2021, Close to Me has expanded to treat over 1,500 Veterans at 29 VA locations, with more slated to open in 2024 and 2025.

Impacting Veterans for the Better

Close to Me often reduces the need for lengthy travel to distant VA facilities, so Veterans and caregivers are afforded more time to go about their daily lives and focus on healing. Since 2021, the program has saved Veterans undergoing cancer treatment, and their caregivers, over 300,000 traveled miles.

By decentralizing care and promoting convenient access, Close to Me not only boasts high patient satisfaction but has also recorded a 99% treatment adherence rate with its patients, and zero medical emergencies.

Additionally, the program has saved VA over $3.2 million in Medication Cost Avoidance as of FY2024. Close to Me embodies VA’s mission to provide accessible, personalized, and high-quality health care for Veterans.

Learn more about VA's other cancer-related services and technologies:

VA's National Radiation Oncology ProgramVA Office of Research and DevelopmentVA's Cancer Registry