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Volume 3, Number 1 (January 2006) | |||||
Letter from the Editor |
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Broadening our reach The West Clinic, Memphis, TN Two-thousand-five was a good year for Community Oncology: we were awarded the Healthcare Publication of the Year and submissions increased so quickly we are going monthly, starting this month. In 2006 we will be sponsoring the first annual Community Oncology Conference, in which key leaders from government and healthcare will focus on the most pressing concerns facing our discipline. In this issue, we think outside the comfort zone where our practices usually reside with a provocative Community Dialogue interview, a cautionary technology tale, and a thoughtful review of colorectal cancer therapy that takes into account patient preference and cost.
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Community Dialogue |
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The patient from hell When Stephen Schneider was diagnosed with rare and deadly mantle cell lymphoma, it was as though the gods of irony had struck: an internationally known research scientist (in climatology), Dr. Schneider was faced with a research disease. But he was able to bring to bear his experience in assessing risk and making decisions in the face of few data. Dr. Schneider has already ruffled feathers with his assertions about the rut of evidence-based medicine; he’s not opposed to clinical trials but wants patients—and their doctors—to fight for individualized treatments. His treatment course took a number of intriguing twists and turns.
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Community Translations |
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Capecitabine versus 5-FU in metastatic colorectal cancer: considerations for treatment decision-making Arizona Oncology Associates (US Oncology), Sedona, AZ Advances in the treatment of metastatic colorectal cancer are expanding the options available for patients who once had limited choices. Some new approaches are minimizing the risk of complications and drug-induced reactions without sacrificing therapeutic benefit. Among these approaches is a return to the oral route of administration for selected antineoplastic agents, such as capecitabine, an oral fluoropyrimidine. The oral approach is preferred by both doctors and patients. This paper provides an overview of colorectal cancer, discusses capecitabine, and proposes a three-part patient management action plan.
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Review Article |
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AIDS-related cancers, part II: systemic and cerebral lymphomas Chelsea and Westminster Hospital, London, UK Cancer remains a common cause of morbidity and mortality in the 60 million people worldwide who have been infected with HIV-1. Part I of this article, which appeared in our November/December 2005 issue, focused on Kaposi’s sarcoma and cervical cancer and discussed the issue of cytotoxic treatment, including the fact that it is complicated by underlying immunoparesis, and options are often limited. Improvement in outcomes was detailed. In Part II, the epidemiology and management of systemic AIDS-related lymphoma and primary cerebral lymphomas are discussed.
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Challenging Cases/Rare Cancers |
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Cystosarcoma phyllodes with lymph node metastasis Department of Radiation Oncology, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India This rare form of breast cancer has a low incidence of metastasis and an even lower incidence of lymph node metastasis. The authors report a case of a 45-year-old woman who presented with a large lump in her left breast and involvement of multiple ipsilateral axillary lymph nodes. Clinical findings and cytologic examination were suggestive of cystosarcoma phyllodes, for which she underwent a radical mastectomy.
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Economics/Practice Management |
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Efficient practice management: a nine-point action plan Cancer Specialists of Tidewater, Ltd., Chesapeake, VA They may seem like simple common sense, but the nine steps outlined in this article are often neglected by physicians, nurses, and their practice managers. In the past, it was easy to become complacent and accept that the amount of money coming into a practice was sufficient. However, in today’s reimbursement climate, oncology practices can no longer afford such a lax attitude. Unless attention is paid to efficient business operations, you simply leave money on the table—money that could be in your pocket and in your practice.
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Book Review |
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The heart and mind of cancer care Reviewed by David M. Mintzer, MD, Pennsylvania Hospital, Philadelphia, PA This book offers guidance, not only on pain and symptom treatment, but on listening and communication skills as well.
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Technology |
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Data mining for quality care When Kaiser Permanente completes its $3 billion electronic medical record (EMR) system, tremors are likely to run through the nation’s small, community-based practices, including those that treat cancer patients.
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Washington Update |
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New CMS demonstration project and significant payment cuts ring in 2006 Community Oncology Alliance, Washington, DC Although the Centers for Medicare & Medicaid Services is launching a new demonstration project in 2006, the agency has grossly underestimated the time needed to document, bill, and administer the data collection effort. The new project limits oncologists’ guideline choices and unnecessarily complicates the collection of staging data.
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© 2006 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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