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Volume 2, Number 4 (July/August 2005) | |||||
Letter from the Editor |
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289 |
Proving the quality of our care The West Clinic, Memphis, TN The concept of quality oncology care isn’t new; we all aspire to and usually deliver it. What we haven’t done is prove the cost effectiveness of our cancer treatment to payers, patients, and even to ourselves. It’s time for oncologists to lead this discussion and direct the process, rather than have it handed to us by middlemen with their own agenda.
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Original Research |
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293 |
Uncompensated costs associated with the outpatient management of cancer chemotherapy–associated febrile neutropenia University of Illinois, Chicago, Northwestern University Medical School, Chicago, and Ingalls Hospital and Monroe Medical Associates, Harvey, IL For a small community oncology practice, the costs of managing chemotherapy-related neutropenia can be considerable. The findings of this report raise concerns about Medicare reimbursement changes. The changes could lead to clinically important decrements in cancer care, possibly with poorer outcomes for patients.
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Community Translations |
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299 |
Defining targets and protecting normal tissues in inverse-planned IMRT for prostate, head and neck, and gynecologic cancers: a comparative review Hollings Cancer Center, Charleston, SC The rise of interest in intensity-modulated radiation therapy has been astronomical. It’s no surprise: IMRT spares normal tissues surrounded by targets and allows for a higher tumor radiation dose. The resulting dose distributions are almost always superior to those achieved with traditional radiation planning approaches, particularly in patients with complex and concave targets.
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Community Dialogue |
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314 |
Are Americans ready for cancer prevention in a pill? Preventing cancer should be an easy sell. But for a variety of reasons, Americans have not yet embraced the concept, despite years of highly publicized research at NCI for ways to prevent breast, prostate, and colon cancers. It’s not like cardiology, where doctors treat a problem such as high blood pressure to reduce stroke risk. Patients accept that, but there’s no analog in oncology.
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Controversies in Patient Management |
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331 |
Adjuvant therapy for colon cancer in the elderly: treat or don’t treat? North Shore University Hospital, Manhasset, and Memorial Sloan-Kettering Cancer Center at Suffolk, Commack, NY Elderly patients receive the same benefits from adjuvant therapy as do younger patients—and have about the same level of risk.
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Challenging Cases/Rare Cancers |
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339 |
Occult systemic malignancy masquerading as thrombotic thrombocytopenic purpura–hemolytic uremic syndrome The University of Oklahoma Health Sciences Center, Oklahoma City, OK In retrospect, a bone marrow biopsy might have documented the presence of metastatic cancer in the patient whose case is reported here. But plasma exchange for TTP-HUS was initiated; it was the right treatment for the wrong disease.
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Quality Care |
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351 |
A call for action: leadership is needed now on quality, safety, and pay for performance in community oncology Wilshire Medical Oncology Group, Inc., La Verne, CA We have elevated the quality of cancer care in this country. But now we must communicate that success and more fully articulate its value. Because of changes in Medicare, the need to lead the quality care movement is urgent.
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Economics/Practice Management |
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357 |
The new language of cancer care: contribution to working capital, human resource costs, practice efficiency, and opportunity costs Baptist Centers for Cancer Care and Supportive Oncology Services, Inc., Memphis, TN To stay economically viable, community oncology clinics must increase the efficiency of patient visits without compromising patient care.
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Practice Survival |
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318 |
Unmet expectations Huntington Beach, CA All oncologists have seen patients undergo a crisis of faith. But it came as a shock when this patient–a priest–shook his fist at God.
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Brief Communications |
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324 |
A case of breast cancer detected by a pet dog UW Cancer Center/Wausau Hospital, Wausau WI A dachshund puppy sniffed and poked at its owner’s left axilla. The dog’s diagnosis: infiltrating ductal carcinoma.
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324 |
Hypersensitivity reaction to carboplatin followed by reaction to cisplatin Naples Community Hospital, Naples, FL Although physicians have successfully administered cisplatin to carboplatin-allergic patients, these authors detail a case of hypersensitivity to both drugs.
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Legal Matters |
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345 |
Ask your lawyer Philadelphia, PA A practice wants to take on a new doctor. How can it protect itself if things go sour?
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Washington Update |
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365 |
President Bush asked to extend Medicare demonstration project Community Oncology Alliance, Memphis, TN Politicians from both sides of the aisle are coming together on this issue.
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366 |
Consequences of the Medicare Modernization Act A report on the anxious discussion at the 10th annual NCCN conference.
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© 2005 by Elsevier Inc. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without permission in writing from the publisher. |
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