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Showing 601 - 650A Conversation with Samuel Silver, MD, PhD
Over the past 2 decades, significant therapeutic advances have led to greater survival rates and quality of life for patients with cancer. During the same period there has been a transformation in the way oncology services are both perceived and delivered. In a recent conversation with The ASCO...
Increased Use of Hospital Services Boosts Oncology Spending
For our ongoing series on the rising costs of cancer care, The ASCO Post spoke with Lee N. Newcomer, MD, Senior Vice President of Oncology for UnitedHealthcare. Dr. Newcomer is responsible for improving cost-effective cancer care at the nation’s largest health insurer. He shed light on areas of...
Treating Cancer in Japan: A Conversation with Kensei Tobinai, MD
In this installment of Oncology Worldwide, internationally regarded lymphoma expert and cancer survivor, Kensei Tobinai, MD, Chief, National Cancer Center Hospital, Tokyo, sheds light on the Japanese oncology experience. Medical Education What was the medical school experience in Japan like? When...
Integrative Oncology Modalities Supported by Varying Levels of Evidence, but More Research Needed Overall
Over the past couple of decades, unregulated nonstandard oncology approaches have gained growing popularity among cancer patients. The relatively new field of integrative oncology was established to promote a more holistic and multidisciplinary approach to cancer care and to encourage scientific...
Oncology Drug Shortage: An Unintended Consequence of the Medicare Modernization Act and Free-market Forces?
Oncology has a drug shortage problem, and the FDA says that it is getting worse. Drug shortages are not a new phenomenon, but over the past few years we have seen a rapidly growing number of shortfalls that are limiting providers’ ability to care for their patients. In 2004, the FDA reported 58...
A Conversation with Monica Morrow, MD, FACS
Over the past 15 years, practice guidelines have become an accepted tool to help physicians optimize patient care by offering informed assessment of the benefits and potential harms associated with various care options. However, a plethora of new guidelines have entered the market, many of which...
Palliative Care, Quality of Life, and Cost
More than half of our nation’s patients with cancer are Medicare beneficiaries, making the entitlement program ground zero in the heated debate on health-care spending. Total Medicare expenditures attributable to beneficiaries in their last year of life runs upward of 30%; this statistic serves as...
SIDEBAR: Letter to President Obama
Excerpt from a letter signed by ASCO and other leading cancer organizations to President Barack Obama (July 13, 2011) urging him to resist proposed cuts to Medicare reimbursement for oncology drugs: “Due to financial and administrative burdens that currently exist, community oncology practices...
SIDEBAR: Customary Prompt Pay
In the 2006 Physician Fee Schedule, the Centers for Medicare & Medicaid Services (CMS) interpreted the Medicare Modernization Act definition of average sales price to include “prompt pay” in its calculation. CMS maintains that since the statute includes the words “prompt pay discount,” it must...
Oncology Community Faces Complex Challenges in Evolving Policy Arena
As the political environment heats up in advance of the upcoming presidential campaign season, many issues crucial to the oncology community are being placed on the political chopping block as policymakers seek ways to reduce the mounting debt and soaring health-care spending. To help clarify some...
SIDEBAR: A Snapshot of I-SPY 2
With principal investigator Laura Esserman, MD, MBA, of the University of California, San Francisco, and co–principal investigator Donald Berry, PhD, of MD Anderson Cancer Center, I-SPY 2 will screen up to 12 different drugs in neoadjuvant therapy for breast cancer over the course of the trial. In...
Can Bayesian Design Streamline Our Sluggish Clinical Trial System?
The randomized controlled clinical trial has long been the gold standard for new cancer drugs to demonstrate worthiness of FDA approval; however, many experts contend that that our method of bringing drugs to the market is plagued by undue costs, long delays, and overregulation. According to Donald ...
New Technologies Are Driving Up Costs: Are They Worth the Price?
Expensive new cancer therapies and technologies are alluring for both physicians and their patients. Prostate cancer, because of the sheer volume of cases and the variability of treatment options, serves as a dynamic disease model in the ongoing debate over how to curb spending and maintain...
A Conversation with Richard J. Gilbertson, MD, PhD
St. Jude Children’s Research Hospital, Memphis, the country’s first and only NCI-designated Comprehensive Cancer Center devoted solely to children, recently appointed internationally regarded pediatric brain tumor researcher, Richard J. Gilbertson, MD, PhD, as its new Cancer Center Director. In a...
AACR Issues Landmark Report on Cancer Progress
At a recent press conference in Washington, DC, the American Association for Cancer Research (AACR) assembled luminaries from the cancer research and care communities to discuss the salient points of the association’s newly released progress report on the current and future state of cancer research ...
Geriatric Oncology, a Much Needed Discipline for Future Cancer Care
The U.S. health-care system, with its rapidly aging population, faces a multitude of difficult clinical and financial challenges in caring for its burgeoning population of older patients with cancer. Moreover, age-related social and medical issues among older patients need to be addressed by a...
Important Lessons for Oncology from the Front Lines of the AIDS Pandemic
On June 5, 1981, the CDC issued a warning about a rare type of pneumonia discovered among a small group of young gay men in Los Angeles, later determined to be AIDS-related, ushering in the HIV/AIDS epidemic. Early on, AIDS-related malignancies brought the oncology community into this formidable...
Oncologists Need Hands-on Approach in Developing Next Generation of EHRs
The electronic health record system offered by vendors is more like a filing cabinet, not the sophisticated, interactive database needed by busy oncologists, according to Kevin S. Hughes, MD, FACS, Co-Director, Avon Comprehensive Breast Evaluation Center, Massachusetts General Hospital, who...
Improving Quality and Safety with Health Information Technology
A well-documented flaw in paper-based health care is the propensity for medical errors. According to Blackford Middleton, MD, MPH, MSc, implementing clinical decision support software can decrease medical error, improve outcomes, and lower the costs of care. Presenting a session titled “Improving...
Lessons from a Northern Neighbor: A Conversation with Joseph M. Connors, MD
Policy analysts searching for a better understanding of health-care models often compare the cancer delivery systems of Canada and the United States. The ASCO Post recently spoke with Joseph M. Connors, MD, Clinical Professor and Director of the BC Cancer Agency’s Centre for Lymphoid Cancer,...
MD Anderson Cancer Center’s New President Has a Bold Vision
On September 1, 2011, Ronald A. DePinho, MD, became only the fourth President in the 70-year history of The University of Texas MD Anderson Cancer Center in Houston. Dr. DePinho spent the previous 14 years as head of Dana-Farber’s Belfer Institute for Applied Cancer Science. In a recent interview...
Shortening the Learning Curve of the U.S. Health-care System
If we are able to harness the full potential of digital technologies, computerized registries, databases, and the Web, could we solve many of the current woes of our sluggish and costly health-care system? Yes, according to Lynn Etheredge, a consultant with the Rapid Learning Project at the George...
Advances in Gynecologic Cancer Surgery Continue to Improve Outcomes
Over the past several decades, advances in chemotherapy and surgery have begun to translate into improved survival in gynecologic malignancies. The ASCO Post recently spoke with Ginger Gardner, MD, a surgical oncologist at Memorial Sloan-Kettering Cancer Center, who specializes in the management...
SIDEBAR: Bevacizumab in Breast Cancer: Additional Perspective
A recent poll by MDoutlook1 concluded that payer coverage would have a significant role in bevacizumab’s use in metastatic breast cancer. Usage of the drug could be cut by two-thirds in the United States and by one-third outside the United States. The NCCN has kept its recommendation of bevacizumab ...
Bevacizumab Breast Cancer Indication Rescinded: What Are the Downstream Implications?
Leading up to FDA’s resolution to revoke the breast cancer indication for bevacizumab (Avastin), the debate over the drug’s clinical value was imbued with contentious ideologic overtones, which culminated in a 2-day public hearing that exposed deep divisions not only in the scientific community,...
Surgical Oncology: Advances and Challenges in Breast Cancer Surgery
Mortality rates for breast cancer have declined steadily in the United States since 1990, resulting in an improvement in survival. Multiple factors have contributed to this positive trend, one of which is the combination of earlier detection and more sophisticated surgical techniques. The ASCO Post ...
Drug Shortages Hit Oncology Hard: Experts Weigh in on Challenges and Solutions
Periodic drug shortages are an unavoidable reality in our complicated pharmaceutical supply chain; however, over the past several years, drug shortages have expanded to crisis levels, putting vulnerable patients at risk. In 2010, there were 178 drug shortages reported to the FDA, 132 of which were...
A Patient with Cancer Saw a Need and Left a Living Legacy
It is well documented that the rigors of delivering cancer care can unintentionally supersede valuable doctor-patient communication. Before he died in 1995, Kenneth B. Schwartz, a patient with cancer at Massachusetts General Hospital, recognized this phenomenon and founded the Kenneth B. Schwartz...
Challenges, Progress, and Future Directions in Head and Neck Cancer
Although head and neck cancer remains a major therapeutic challenge, significant advances have been made over the past few decades. The ASCO Post recently spoke with Marshall R. Posner, MD, Medical Director of the Head and Neck Oncology Program, Mount Sinai Medical Center, New York, about the...
A Dose of Destruction and Tough Love for Health Care
Title: The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care Author: Eric Topol, MD Publisher: Basic Books Publication date: February 1, 2012 Price: $27.99 / $31.00 (CAN), Hardcover, 320 pages More information: http://creativedestructionofmedicine.com/...
A Visionary Call for the ‘Creative Destruction’ of Medicine
According to nationally regarded cardiologist and geneticist Eric Topol, MD, Chief Academic Officer of Scripps Health, the next frontier of the digital revolution can create exponentially better health care. Dr. Topol, who is also Director of the Scripps Translational Science Institute and...
Research Funding Key to Continued Progress in Cancer Care
American Association for Cancer Research (AACR) President and ASCO member Judy Garber, MD, MPH, recently spoke with The ASCO Post about the findings of AACR’s landmark Cancer Progress Report,1 In addition, she offered her perspective on the current and future state of cancer research. Project...
Rising Costs in Radiation Oncology Linked to Medicare Coverage
In the ongoing debate over how to control rising cancer care costs, it is vital to identify usage patterns of expensive new technologies. A recent study examined the relationship between Medicare reimbursement and the increasing use of intensity-modulated radiation therapy (IMRT).1 The ASCO Post...
Searching for Quality in an Increasingly Complex Health-care Environment
With the Presidential election just around the corner, the health-care debate will undoubtedly heat up. The ASCO Post spoke with Sean R. Tunis, MD, MSc, Founder and Director, Center for Medical Technology Policy, and former Chief Medical Officer for the Centers for Medicare & Medicaid Services, ...
Summary of ASCO Provisional Clinical Opinion on Palliative Care
The ASCO provisional clinical opinion on palliative care recently published1 was based largely on data from seven published randomized controlled trials, including a phase III lung cancer trial by Temel and colleagues, which was the trigger for the new recommendations.2 The trial’s principal...
An Expert Shares Insight into the Future of Lung Cancer Treatment
Despite growing national focus on early detection, prevention, and new molecular-based treatments, lung cancer persistently remains the number 1 cause of cancer death for men and women in the United States. The ASCO Post spoke to lung cancer specialist Paul A. Bunn, Jr, MD, Executive Director,...
SIDEBAR: ASCO PCO Expert Panel
Members of the Ad hoc Expert Panel included co-chairs Jamie H. Von Roenn, MD, Northwestern University, and Thomas J. Smith, MD, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Medicine, in addition to: Amy P. Abernethy, MD, Erin R. Alesi, MD, Tracy A. Balboni, MD, MPH, Ethan M. Basch,...
ASCO Releases Palliative Care Provisional Clinical Opinion
ASCO has released a provisional clinical opinion (PCO) addressing the integration of palliative care services into standard oncology care.1 The ASCO Post recently spoke with one of the PCO’s lead authors, Thomas J. Smith, MD, Director of Palliative Care for Johns Hopkins Medicine and the Johns...
Changing the Course of Human Health through Bold Pursuits in Science
The synergy between industry, academic research, and regulatory bodies will play an increasingly important role in ensuring the future of a robust cancer drug pipeline. To gain insight on oncologic development trends, The ASCO Post recently spoke with Jean Pierre Bizzari, MD, Head of Global...
Defining Meaningful Benefit: The Debate Continues in Bevacizumab’s Wake
The events surrounding the labeling of bevacizumab (Avastin) have been well covered since last November when the FDA withdrew the drug’s accelerated approval as a treatment for metastatic breast cancer. However, the controversy initiated a debate over the value of endpoints in clinical trials in...
Geriatric Oncologists: A Small but Passionate Group
Although age is the major risk factor for developing cancer, geriatric oncology is still a relatively new discipline within the oncology community. To gain insight into this evolving component of cancer care, The ASCO Post recently spoke with a leader in the field, Stuart M. Lichtman, MD, FACP,...
New Research Shows Promise in Cachexia, a Persistent Clinical Challenge
In the late 1980s, researchers led by Alfred L. Goldberg, PhD, first isolated the large protein complexes now called 26S proteasomes, which are the sites where most cellular proteins are degraded back to amino acids. Protein degradation by the proteasome pathway is critical in regulating many...
JAMA Highlights New Comparative Effectiveness Studies
A recent press briefing moderated by Phil B. Fontanarosa, MD, MBA, Executive Editor, JAMA, presented new findings on comparative effectiveness research, and two of the studies discussed focused on cancer. Dr. Fontanarosa started by defining comparative effectiveness research, which gained...
Untreated Cancer Pain Remains a Significant Global Problem
“Physicians are afraid of morphine … Doctors [in Kenya] are so used to patients dying in pain … they think that this is how you must die. They are suspicious if you don’t die this way — [and feel] that you died prematurely.” —Human Rights Watch interview with Dr. John Weru of Nairobi Hospice,...
Cancer Care in India: Complex Challenges in a Populous Nation
With 1.22 billion people, India is the second most populous country in the world. Experts project that cancer incidence in India will increase by more than two-thirds over the next 20 years, to approximately 1.7 million new cases per year. Due to a range of economic and social issues, most of...
Advances in Prostate Cancer Accompanied by Ongoing Debates
Scientific advances have markedly improved prostate cancer survival, but this clinical success story is not without its share of controversy. From screening through treatment, a growing array of options offer an admixture of promise and confusion for clinicians and patients. Moreover, today’s...
When It Comes to Scientific Exploration, Renowned Clinical Investigator Lets the Work Guide His Path
Internationally renowned clinical investigator Daniel D. Von Hoff, MD, FACP, attended grade school in a one-room schoolhouse on the rural outskirts of Oshkosh, Wisconsin. Polio was a scourge at the time, and Dr. Von Hoff recalled lining up with his skittish classmates to get the newly developed...
New ASCO President Reflects on Value of Mentorship and Addressing Health-care Disparities
Sandra M. Swain, MD, Medical Director of the Washington Cancer Institute at the MedStar Washington Hospital Center in Washington, DC, and ASCO President for the 2012 to 2013 term, is a leading authority on breast cancer treatment with a global reputation in cutting-edge clinical research. The...
Dana-Farber Researcher’s Work with Partners in Health Brings Quality Cancer Care to Rwanda
Lawrence N. Shulman, MD, Chief Medical Officer at Dana-Farber Cancer Institute, grew up in New York City. A product of the public school system, Dr. Shulman entered Syracuse University as a history major, only to realize that studying the past, although important, wasn’t for him. “I wanted a field...
Trailblazing Oncologist Had Instrumental Role in France’s War on Cancer
David Khayat, MD, PhD, Chair of the Department of Medical Oncology at the Pitié-Salpêtrière Hospital in Paris, was inspired to become an oncologist by an episode that could have been ripped from the pages of one of his best-selling novels. At the age of 18, Dr. Khayat was the witness at his best...
