National PA Week: Mark Honor on the Growth of APPs in Oncology Care

In observation of National Physician Assistant (PA) Week, healthcare organizations across the nation are highlighting the expanding contributions of Advanced Practice Providers (APPs) in cancer care delivery.

In an interview with Oncology Nursing News, Mark Honor, PA, a medical oncology physician assistant at Moffitt Cancer Center, reflected on two decades of practice expansion and the central role PAs play alongside oncology nurses in managing high-volume cancer care.

Two Decades of Growth at Moffitt Cancer Center

When Honor joined Moffitt Cancer Center in 2006, the institution employed 53 APPs, then commonly referred to as "mid-level providers." Over the past 20 years, Moffitt’s APP workforce has expanded to more than 600 professionals. This institutional growth reflects broader national trends in oncology care, where APPs have transitioned from initial supportive roles into integrated clinical leaders.

Moffitt Cancer Center manages the third-highest patient volume among cancer centers in the United States. Honor noted that the institution's 600-plus APPs directly manage a substantial portion of this patient population, ensuring clinical continuity across active treatment, symptom management, and post-treatment surveillance.

Expanding Leadership and Academic Contributions

The integration of PAs into multidisciplinary oncology care has extended beyond direct outpatient visits. Over the past two decades, APP roles at major cancer institutions have evolved to encompass formal governance and research responsibilities.

At Moffitt, APPs now participate in institutional committees, author clinical pathways, contribute to National Comprehensive Cancer Network (NCCN) clinical practice guidelines, publish peer-reviewed manuscripts, and lead formal APP fellowship training programs. These academic and operational contributions have established APPs as vital leaders in health system processes and clinical quality initiatives.

Key Takeaways for Oncology Nurses: Collaborative Care and Practice Evolution

• Substantial APP Workforce Expansion: Moffitt's APP workforce grew from 53 to over 600 providers over 20 years, reflecting the indispensable role of PAs in handling top-tier national patient volumes.
• Multidisciplinary Workflow Integration: PAs work in direct partnership with primary physicians, oncology nurses, and care teams to deliver continuous, evidence-based care across active treatment and surveillance.
• Guideline and Pathway Development: APPs actively author institutional clinical pathways and contribute to NCCN guidelines, aligning daily nursing workflows with standard-of-care updates.
• Shared Educational and Training Leadership: PAs lead APP fellowship programs and specialized training, creating opportunities for interprofessional education with oncology nursing staff.

Optimizing Nursing and APP Collaboration

To maintain efficient patient workflows, close collaboration between oncology nurses and PAs remains essential. PAs assist with complex symptom management, educate patients navigating care plans, and ensure continuity of care during transitions between active systemic therapy and survivorship.

Establishing structured communication channels between nurses, PAs, and supervising physicians optimizes clinical efficiency, reduces administrative delays, and enhances patient satisfaction.