Volume 4, Number 4 (April 2007)

Letter from the Editor

179

Many viewpoints, one view: improving outcomes

Linda D. Bosserman, MD, FACP, Editor

Wilshire Oncology Medical Group, Inc., La Verne, CA

In this month’s issue we focus on breast cancer and gather the points of view of a number of different voices: community oncologists, oncology nurses and pharmacists, and specialists with a long involvement in research on this disease.

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Challenging Cases/Rare Cancers

197

Differentiated thyroid cancer

Matt Freeby, MD, and Robert J. McConnell, MD

Division of Endocrinology, Columbia University, and The Thyroid Center, New York Presbyterian Hospital, New York, NY

Differentiated thyroid cancer is an uncommon disorder that is being diagnosed with increasing frequency. A typical case is presented, followed by a review of the pertinent literature, steps in clinical assessment, prognosis, treatment, and follow-up.

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Community Translations

207

Long-term follow-up of a nonanthracycline regimen as adjuvant therapy for operable breast cancer

Four cycles of docetaxel (Taxotere) with cyclophosphamide (TC) is a viable, and possibly superior, alternative to the AC regimen (four cycles of doxorubicin plus cyclophosphamide). A review of the literature and commentaries from several clinicians.

FROM THE COMMUNITY ONCOLOGIST'S PERSPECTIVE
Are anthracyclines still necessary in adjuvant therapy of early breast cancer?

Alida Podrumar, MD,

Western Maryland Health System, Cumberland, MD

FROM THE RESEARCHER'S PERSPECTIVE
The AC vs TC trial: a personal perspective

Stephen E. Jones, MD

US Oncology Research, Houston, TX

FROM THE NURSE'S PERSPECTIVE
Which treatment is the best?

Patti House, RN, OCN

Western Maryland Health System, Cumberland, MD

FROM THE ADMINISTRATOR'S PERSPECTIVE
Less toxicity, but just as good

Sandra J. Crabtree, RPh, BCOP

Western Maryland Health System, Cumberland, MD

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Controversies in Patient Care

220

Update on fulvestrant for hormone receptor–positive advanced breast cancer

William J. Gradishar, MD, FACP

Division of Hematology-Oncology, Department of Medicine, Feinberg School of Medicine, The Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL

With its unique mechanism of action and lack of estrogen agonist activity, fulvestrant (Faslodex) offers an attractive treatment option for tamoxifen-resistant patients.

COMMENTARY
Fulvestrant offers an attractive treatment option for postmenopausal breast cancer

Ronald J. Scheff, MD

Weill Cornell Breast Center, Weill Medical College of Cornell University, New York, NY

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Original Contribution

235

Conformal proton beam radiation therapy for prostate cancer: concepts and clinical results

Carl J. Rossi, Jr., MD

Loma Linda University Medical Center, Loma Linda, CA

Protons are ideal for treating localized cancers in areas surrounded by dose-limiting normal structures. Long-term treatment results from nonrandomized trials also demonstrate biochemical disease-free rates equivalent to other forms of therapy with minimal morbidity.

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Managing Side Effects

245

Clinical evaluation and treatment of insomnia in patients with cancer

Edward J. Stepanski, PhD

Accelerated Community Oncology Research Network, Memphis, TN

Insomnia is a common symptom among patients treated for cancer. Chronic insomnia has been linked to increased levels of pain, depression, and fatigue and is therefore an appropriate target for evaluation and treatment. In this article, the author discusses how to assess insomnia, as well as the treatment options.

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Implementing Clinical Trials

254

Recruiting and enrolling minority patients to cancer clinical trials

Elyse R. Park, PhD, Elisa S. Weiss, PhD, and Beverly Moy, MD, MPH

Massachusetts General Hospital/Harvard Medical School, Boston, MA, and Memorial Sloan-Kettering Cancer Center, New York, NY

Despite government efforts to correct the problem, minority participation in cancer clinical trials remains low. This article reviews the problem and the reasons why it is important, and offers a number of specific solutions. Say the authors, community oncologists are in an excellent position to recruit minority patients and stand to benefit from doing so.

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Economics/Practice Management

259

Financial benchmarking: results from a survey of office-based oncology practices, part 2

John Akscin, Thomas R. Barr, MBA, and Elaine L. Towle, CMPE

OTN, South San Francisco, CA, and Oncology Metrics, llc, Fort Worth, TX

Reimbursement changes have made it essential to evaluate and monitor practice finances. The authors designed a user-friendly survey tool to collect data on business operations and report on their survey results.

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Meetings Highlights

FROM THE SECOND ANNUAL COMMUNITY ONCOLOGY CONFERENCE

187

Performance reporting can pay off

While oncologists have come under increasing pressure to curb the use of expensive new drugs, many have seen how working with payers can benefit practices and patients.

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188

Investing in mid-level providers pays dividends

Physician assistants, nurse practitioners, and other mid-level providers can improve patient access, expand service capacity, increase revenue for services, and enhance the reputation of a practice in the community.

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Washington Update

265

Community Cancer Care Preservation Act of 2007 introduced in House

Steven M. Coplon, MHA

Community Oncology Alliance, Memphis, TN

A bipartisan bill seeks to achieve the promise of balanced reform for cancer as pledged by Medicare legislation in 2003. The salient points of the bill and how readers can contact their members of Congress to ensure passage of the new proposed law.

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265

Helping patients navigate the Part D labyrinth

Joel B. Finkelstein

The Medicare drug benefit has created new obstacles for patients who need oral chemotherapy or treatment for nausea and pain. Steps you can take.

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© 2007 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.

The opinions expressed herein are those of the authors or advertisers. The authors, editors, and publishers make every effort to ensure that no inaccurate or misleading data, opinion, or statement is published in this journal and that drug names, dosages, and recommendations are accurate. However, readers should confirm all dosage schedules against the manufacturer’s package information data. The Publisher, Editorial Board, and their employees accept no liability whatsoever for the consequences of any inaccurate or misleading data, opinion, or statement.