Most of a cancer patient's experience with treatment happens outside the clinic, at home and in the weeks between scans. Clinical teams know this, but short appointments and stretched capacity mean that the support patients need between visits is rarely built into the system.
This is what happens when that support is missing: patients feel well looked after during active treatment, then describe falling off a cliff once they move past the most intensive phase of care.¹ Unmet needs of that kind travel with measurably higher distress and anxiety, across every domain researchers have measured.²
Unmet needs are the challenge
Patients carry small, practical questions into consultations that often never get asked, even though the answers frequently have clinical relevance. Unmet needs are also more common than they appear, with close to three quarters of patients reporting at least one unmet supportive care need.³
Fatigue represents the most significant gap. It affects close to 4 in 10 patients at moderate or severe intensity, and around 7 in 10 once mild cases are counted.⁴ Even so, only 32% of the physicians surveyed were aware of fatigue-specific guidelines, and 91% said the topic was hardly covered in their medical studies.⁵
Much of what patients need is practical as much as clinical: what a side effect means, or whether a dose was taken correctly. That contributes to a broader picture, in which health system and information needs form the largest category of unmet needs in cancer care, affecting more than half of patients.³
In the field: Dawn Health’s Cora BC
Cora BC, Dawn Health's Therapy Companion for breast cancer, built with Novartis, gives patients and their loved ones a digital companion through every stage of treatment.
With a 35% 30-day retention (since launch in December 2024) against a 3% industry average for digital health, Cora BC is now live in Germany, the UK, Canada and Australia (dawnhealth.com/cora-bc).
Cora BC is built for breast cancer. The gap it addresses accumulates between appointments across solid tumors, and the evidence for that wider population is set out below. Within its own indication, Cora BC maps onto the gap through:
- Health tracking and progress visualization: patients complete regular check-ins and see their health trends over time.
- Personalized reminders: medication and appointment reminders tailored to each patient, helping them stay organized and develop the routines that consistent treatment depends on.
- Tailored content: information that matches where a patient is in treatment, rather than generic disease education.
- Consultation-ready reports: what patients record between visits reaches their care team, supporting better communication with healthcare professionals.
What the evidence shows
A growing body of real-world data now backs this approach:
- Lower hospitalization: 20% against 32.5% for ePRO users versus matched controls in metastatic cancer (observational real-world data)⁶
- Faster discharge: hospital stays averaged 1.9 days against 3.2 when admission did occur.⁶
- Lower cost of care: $1,146 saved per member per month.⁶
- Slower decline, fewer emergency visits: monitored patients held physical function for 12.6 months against 8.5, and quality of life for 15.6 months against 12.2 (secondary endpoint). Emergency department visits came later and less often.⁷
- Guideline-endorsed at scale: ESMO formally recommended patient-reported outcome monitoring in routine practice in 2022.⁸ Across 33 cancer centers in France and Belgium, 90% of patients reported that monitoring improved their care.⁹
The commercial case for pharma
The evidence points out a particular kind of benefit: digital health solutions protect the patient's ability to keep living their life during treatment. While no difference in overall survival was found, monitored patients held their physical function four months longer and their quality of life three months longer.⁷
On the other end, a patient who reports a symptom early avoids the emergency visit and the admission behind it, which is where the lower hospitalization rates and shorter stays come from.⁶ Those are the figures that carry weight in reimbursement arguments, formulary placement and HTA submissions.
The same holds for the data. Patients record what they experience because it helps them arrive at a consultation prepared, with said record also supporting real-world evidence, although depending on the consent and governance designed into the program from the start.
Dawn Health designs patient support solutions to meet that standard.
References
- Adam R, Duncan L, MacLennan S, et al. Co-design of the Structured Personalised Assessment for Reviews after Cancer (SPARC) intervention. Health Expectations. 2025. doi:10.1111/hex.70174
- Hart NH, Crawford-Williams F, Crichton M, et al. Unmet supportive care needs of people with advanced cancer and their caregivers: a systematic scoping review. Critical Reviews in Oncology/Hematology. 2022;176:103728. doi:10.1016/j.critrevonc.2022.103728
- Springer F, Mehnert-Theuerkauf A, Gebhardt C, et al. Unmet supportive care needs among cancer patients: exploring cancer entity-specific needs and associated factors. Journal of Cancer Research and Clinical Oncology. 2024. doi:10.1007/s00432-024-05715-4
- Kang YE, Yoon JH, Park NH, et al. Prevalence of cancer-related fatigue based on severity: a systematic review and meta-analysis. Scientific Reports. 2023. doi:10.1038/s41598-023-39046-0
- Wagner AS, Wehlen L, Milzer M, et al. Physicians' perspectives on cancer-related fatigue management and their suggestions for improvements in medical training: a cross-sectional survey study in Germany. Supportive Care in Cancer. 2024. doi:10.1007/s00520-024-08978-2
- Patt DA, Bhardwaj A, Patel AM, et al. Impact of remote symptom monitoring with electronic patient-reported outcomes on hospitalization, survival, and cost in community oncology practice: the Texas Two-Step Study. JCO Clinical Cancer Informatics. 2023;7:e2300182. doi:10.1200/CCI.23.00182
- Basch E, Schrag D, Henson S, et al. Symptom monitoring with electronic patient-reported outcomes during cancer treatment: final results of the PRO-TECT cluster-randomized trial. Nature Medicine. 2025. doi:10.1038/s41591-025-03507-y
- Di Maio M, Basch E, Denis F, et al. The role of patient-reported outcome measures in the continuum of cancer clinical care: ESMO Clinical Practice Guideline. Annals of Oncology. 2022. doi:10.1016/j.annonc.2022.04.007
- Franzoi MA, Ferreira AR, Lemaire A, et al. Implementation of a remote symptom monitoring pathway in oncology care: analysis of real-world experience across 33 cancer centres in France and Belgium. The Lancet Regional Health – Europe. 2024. doi:10.1016/j.lanepe.2024.101005
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