Expert Editorials

Shared Benefits of Clinical Research Should Come with Shared Responsibility

One of the most frustrating aspects of clinical research is when you learn that your patient, who is both interested and eligible for a study, doesn’t “have coverage for clinical trials.” It is difficult to understand what incentive insurance companies have for including such a clause, since the investigational agent is typically provided by the sponsor, and “routine” costs will accumulate even if the patient isn’t on study. Read Full Article

Expert Editorial: The Current State of Cancer Care in Ghana:Geography Should Not Hinder Patient Care

In Ghana, cancer care has been greatly revolutionized over the past decade. Previously, solid tumors were managed solely by surgeons. If resectable, tumors were treated with surgery followed by some form of chemotherapy—mostly extrapolated from breast cancer regimens— or chemotherapy only. However, patients with metastases received no additional care. Read Full Article

ASCO-Sponsored Oncology REMS Workshop Proposes Way Forward

Risk assessment and risk management, as part of the U.S. drug safety system, is a multidisciplinary stakeholder priority. In the oncology setting, patients, physicians, nonphysician providers, nurses, pharmacists, pharmacies, patient advocacy organizations, industry, and government interface in a complex health care landscape aligned ideally for the delivery of patientcentered, quality care. Read Full Article

Fellowship Programs Benefit from QOPI® Participation

Despite the Accreditation Council for Graduate Medical Education (ACGME) competencies (e.g., systems-based practice, practicebased learning) having been infused into internal medicine residencies for several years now, the average fellow remains ill informed about how health care programs measure and ensure quality. Read Full Article

Overcoming Challenges in Puerto Rico: QOPI Certifies First International Practice

In 2002, after having spent 28 years at M. D. Anderson Cancer Center in Houston, Texas, I decided to move back to my homeland, Puerto Rico. There, I started a small cancer center within Auxilio Mutuo Hospital, with a focus on delivery of high-quality cancer care. Everyone involved soon realized, however, that we were going to encounter huge challenges in accomplishing this goal in Puerto Rico. Read Full Article

HVO/ICC Vietnam: Volunteers Discuss Personal Experiences, National Need

Volunteers Overseas (HVO) and ASCO’s International Cancer Corps (ICC) are excited to report on the development of a new oncology program in Hue, Vietnam. A private, nonprofit organization, HVO was founded in 1986 to improve global health through education of local health care providers. Read Full Article

Reducing Cost, Improving Quality Care through Individual Choices: Taking a Place at the Table

Cancer and general care costs are rising unsustainably and without associated improvements in care quality. These escalating costs impose unbearable burdens on our increasingly vulnerable Medicare and Medicaid systems, positioning the growing "health care bubble" in queue as our nation’s next major financial implosion. Read Full Story

Prescribing Oral Anticancer Agents: Food-induced Injury Is Preventable

The traditional ritual of ending a patient visit with a prescription is unfamiliar to many oncologists, who are often more habituated to sending the patient to the clinic’s infusion unit. However, anticancer drugs are increasingly self-administered as daily oral therapy, resulting in a number of complexities that might not be familiar to many practicing oncologists. Read Full Story

Disparities in Cancer Care: Another Inconvenient Truth

It is no secret that despite major advances in cancer research, screening, and treatment, not all Americans with cancer have benefited equally. Although there has been a 14% decrease in the rate of cancer-related death between the years 1991 and 2004, racial and ethnic minority patients continue to disproportionately die more from cancer compared with their white counterparts, even after adjusting for insurance status and income. Read Full Story

The Importance of Obtaining Family History, Providing Genetic Testing and Counseling in Oncology

Family history is an important but often neglected part of clinical care of the patient with cancer. Information from the family history can potentially influence a person’s choice for initial surgical management, as well as infl uence cancer screening and prevention options for cancer survivors and their relatives. Read Full Story

Changes Afoot for ASCO’s Clinical Practice Committee and State Affiliate Societies: Doing Two Things at Once

My father would occasionally remind my two brothers and me that "One boy is worth one boy, two boys are worth half a boy, and three boys are worth no boy at all." A year ago, the idea of taking on the chairmanship of ASCO’s Clinical Practice Committee (CPC) reminded me of my father’s attempts to keep the three of us on task. Read Full Story

New Trends in Oncology Clinical Decision Support Systems

Clinical decision support systems (CDSS) in oncology have evolved over the past 25 years to support the continuum of cancer care. Mia A. Levy, MD, PhD The focus in the past few years has been the adoption of basic electronic health record systems in the setting of high-tech and meaningful use. Read Full Story

Multidisciplinary Cancer Management Courses Inspiring Care Providers in Paraguay

The International Multidisciplinary Cancer Management Course (MCMC) is a major educational effort by ASCO to establish multidisciplinary care of patients with cancer as the standard of care. ASCO partners with local oncology societies to hold MCMCs in low-to-middle income countries as defined by the World Bank. Read Full Story

Resolving the Oncology Drug Shortage Crisis

The research presented at this year’s Annual Meeting represents the latest advances in cancer treatment. Although some of the new agents being discussed today will become the standard of care tomorrow, we must also realize that these novel therapeutics might one day be in short supply, forcing oncology practices to scramble to meet the needs of their patients. Read Full Story

The Rising Cost of Cancer Care: Physicians Take Charge

The rising cost of health care has become the focus of a national conversation. Although costs associated with prevention, therapy, and surveillance in patients with cancer after completion of treatment are a relatively small fraction of the total cost of the entire U.S. health care system, the increasing incidence of cancer in the population and greater expense associated with new therapies pose a direct challenge. The effects of physicians’ decisions are demonstrated by the substantial regional variations in health care costs that have been documented. Read Full Article

The Promise and Pitfalls of Early Detection

The logic of cancer screening is particularly strong: detection at an early stage must surely lead to a reduction in death or serious morbidity. Given the right circumstances, early detection can improve the health of the population. However, there are important challenges that are counterintuitive and often underappreciated. Read Full Story

Cancer: A “Slow Motion” International Crisis

Today, cancer is truly a global problem. Each year, according to the World Health Organization, an estimated 7.6 million people around the world die of cancer, which is more than HIV/AIDS, malaria, and tuberculosis combined. Indeed, the number of people diagnosed with cancer every year worldwide is expected to nearly double in the coming decades, with a majority of these patients being from low- and middleincome countries. Read Full Article

ASCO Blueprint Reimagines Clinical Research for Molecular Era

Rapid advances in the understanding of cancer biology, coincident with technologic progress, are leading to identification of new targets for prevention and treatment. In addition, improvements in drug development enable us to cultivate new agents that directly affect these molecular targets. Similarly, we are experiencing a revolution in the ability to manage and rapidly analyze large quantities of data, both biologic and clinical. Read Full Article

IOM Recommendations Seek to Ensure Evidence-Based, Unbiased Guidelines

Clinical practice guidelines (CPGs) are a ubiquitous part of health care. As of February 2012, the United States National Guidelines Clearinghouse (NGC) had 532 guidelines listed under the disease heading of neoplasm, 16 of which were developed by the American Society of Clinical Oncology (ASCO). Read Full Article

ASCO’s Newest Committee Dedicated to Promoting Quality Survivorship Care

Remarkable progress in the field of oncology has produced a growing population of cancer survivors in the United States that exceeded 12 million in 2010. With almost 65% of individuals living 5 or more years from diagnosis, this number will undoubtedly continue to increase, underscoring the importance of optimizing health outcomes of long-term cancer survivors who experience increased risks for morbidity and premature mortality associated with their malignancies and with cancer treatments. Read Full Article

Committing to Excellence through Constructive Feedback: Quality is a Mirror

Who wants to be mediocre? Certainly none of us went through college and into medical school or medical training to be below average. Yet, when it comes to the way we practice our specialty of medical oncology, there are many ways that we slip from superior to merely adequate. Read Full Article

Doctor–Patient Communications Key to Individualized Care

Good communication between patients and clinicians is a fundamental component of quality cancer care. Advocates, patients, and clinicians agree that productive dialogues result in treatment plans that are tailored to meet individual needs. Research has finally closed the loop by proving that effective clinician–patient communication is associated with better outcomes. Read Full Article