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Nora Janjan, MD, MPSA, MBA

Nora Janjan, MD, MPSA, MBA

Senior Fellow for Healthcare Policy, National Center for Policy Analysis
Editor-in-Chief, ONCOLOGY

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Most patients with advanced cancer, and up to 60% of patients with any stage of the disease, experience significant pain. The WHO estimates that 25% of all cancer patients die with unrelieved pain.

American medicine is poised for an expanded conflict over the assumption and consequences of risk in medical care.

The Hippocratic Oath underscores that harm to patients can result either from acts of commission or omission. Decisions about the use of diagnostic imaging are now under great scrutiny.

Only the possibility of increasing survival with better tumor localization and staging is probable with multiparametric MRI—and improved survival with MR imaging in prostate cancer has not been shown in a clinical trial or meta-analysis to date.

To insure standardization of all aspects of care during the conduct of a clinical trial, clinical trials should include guideline-based criteria for the management of all symptoms of cancer and its treatment, and failure to adhere to any of the standards for symptom management during the conduct of the trial should result in an equal level of protocol violation.

This will have a significant impact on medicine and on the care we will be able to deliver. It has life and death implications. The patients of America, who have enjoyed the best healthcare in the world, have lost.

While ONCOLOGY has continued to evolve along with the field of oncology—for example, it now addresses critical issues of science and socioeconomics—it has remained true to the founding principles. Perhaps largely for this reason, the journal continues to be widely read across the entire oncology community.

Palliative care addresses the symptoms of cancer throughout the course of the disease. Moreover, rather than just improving end-of-life care, palliative care also improves survival.

The practice of radiation oncology has been transformed over the past quarter-century in three significant aspects.

The continuing challenge for every specialty in oncology is to improve the therapeutic ratio, which is the balance of the biological effectiveness of the treatment and the severity of treatment-related side effects.


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