Call to action: Pharmacists needed for cancer care

Cancer care is advancing faster than ever, bringing both new hope and new complexity. As I travel across the United States, I hear from health system leaders that they need more pharmacists trained in oncology. There are many reasons for this demand.

I want to outline how and why a pharmacist who is already in practice and considering a career path change should consider oncology. And even if you aren’t interested in becoming an oncology specialist, consider how your patients’ diagnoses of cancer impacts their overall medication regimen. There is a rapidly growing need for every pharmacist to have clarity of the impact of cancer agents on other existing conditions (e.g., diabetes, hypertension, renal disorders, etc.) and therapy goals.

Consider the fact that, in 2024, FDA approved 50 novel agents. Of those, 15 (30%) were for cancer care and treatment, and 18 were novel, first-in-class therapies (many for rare cancers). As of late September 2025, FDA had approved 35 novel therapies, 13 (37%) of which were for cancer care and treatment. One does not have to spend long on any pharmaceutical manufacturer’s website to see that the pipeline of development for cancer treatments is significant compared with other therapeutic areas.

Advances in cancer treatments have brought incredible progress—but also high costs. In addition, our understanding of the genetic markers for tumor response to therapy has dramatically improved, allowing clinicians to better target therapies in those who are most likely to benefit. This precision approach to cancer treatment, coupled with the need to ensure patients are achieving the appropriate drug therapy outcomes, truly necessitates the full engagement of pharmacists.

Across the country, pharmacists are increasingly stepping into specialized roles in cancer care—not just through traditional residency programs, but also by navigating alternative career paths. Many begin their careers as generalists in community or hospital pharmacies, and gradually transition into oncology by re-skilling through self-directed learning, cross-training across service lines, and gaining support from leadership within their organizations.

For example, just this year, Veterans Affairs (VA) published a manuscript describing the utilization of Oncology Clinical Pathways in a bootcamp-style to prepare 40 VA pharmacists working in other areas of the VA to take on greater roles in oncology care and ultimately lead to board certification in oncology.

In conversations with colleagues at City of Hope Cancer Centers (headquartered in Duarte, CA), we have embraced a similar internal program to train pharmacists who are generalists to migrate to oncology through an integrated two-year training program. This allows the pharmacist to remain in their primary role of service and re-skill into an oncology-specific role over time.

Cancer therapies are complicated and highly specialized. Each case involves layers of complexity—from tumor-specific guidelines and patient factors to institutional, supply chain, and insurance challenges. Board-Certified Oncology Pharmacist (BCOP) certification is more than just a title—it’s a signal of clinical expertise and commitment to excellence in cancer care. Today, there are just over 4,000 U.S. pharmacists who hold this certification, yet the need is likely far greater—perhaps double that number—as cancer therapies continue to expand and evolve. While some hospitals require certification for advanced clinical roles, others strongly encourage it, recognizing the value it brings to both patients and health care teams.

There are three clear pathways to becoming board certified in oncology. The most common routes include completion of a PGY2 residency in oncology pharmacy or a PGY1 residency plus an additional 2 years of practice after pharmacist licensure with ≥50% of the time spent engaging in oncology pharmacy activities. No residency, no problem! Pharmacists are eligible for the BCOP exam with at least 4 years of practice experience, after pharmacist licensure with ≥50% of the time spent engaging in oncology pharmacy activities.

Preparing for the exam itself deepens clinical knowledge and boosts confidence. Maintaining that certification requires ongoing professional development and education—keeping pharmacists at the forefront of cancer treatment advancements. While becoming certified and maintaining certification is not easy, pharmacists who earn board certification often find new doors open in leadership, academic appointments, and broader professional recognition.

As our profession gains success in achieving payment for our services, we believe that many payers will likely require specialist payment for those who have achieved the appropriate credential (i.e., BCOP) given that this is the approach insurers take with physicians. In short, board certification isn’t just a credential—it’s a catalyst for growth, innovation, and better patient care in oncology pharmacy.

We are so blessed in our profession to have a versatile degree which provides the foundation as a generalist which can be adapted over time to highly specialized roles. Given the aging population in America, the incidence and prevalence of cancers, and the hope that current and emerging therapies can provide, there is a deepening and renewed need for more pharmacists in our profession to pursue oncology specialization.

APhA is pleased to help you explore career pathways that interest you. Members can join APhA’s Board Certified Pharmacists Community to network with others who share this passion and find a mentor.

The next decade in oncology will be defined not just by new therapies, but by the pharmacists who help their patients make the most of them. At APhA, we’re ready to help you take that step.

For every pharmacist. For all of pharmacy.