The National Cancer Institute (NCI) is about to embark on a series of “quality care” initiatives designed to identify the best medical care approaches for various cancers. The NCI strategy was laid out to the Senate Cancer Coalition by Robert Hiatt, MD, PhD, on September 16. Hiatt, who is the deputy director of the Division of Cancer Control and Population Studies at the NCI, disclosed that the NCI will be issuing a request for applications (RFA) for consortiums of investigators, presumably composed of oncologists, cancer centers, university medical centers, state cancer registries, and medical associations. Each team will be provided with core support to carry out innovative, in-depth analyses consistent with a series of recommendations made in the past year by both the National Cancer Policy Board and the President’s Cancer Panel. These recommendations include: developing a cancer data system that provides quality benchmarks for use by systems of providers; supporting national studies of newly diagnosed cancer patients, which yield data that relate care to outcomes; and trying to find out why some population segments are not receiving quality cancer care.
Hiatt mentioned the American Society of Clinical Oncologists and the American College of Radiology as examples of the professional groups that he hopes will participate. Hiatt also discussed NCI’s “extensive” revamping of its clinical trials program, with an eye toward making it easier for more oncologists to participate. “Efforts to increase participation of physicians have begun with two pilot projects to assess the feasibility of a national network of physicians who will have access to an open menu of studies,” Hiatt explained.
A 70-year-old man with a history of localized prostate cancer treated with whole-pelvis radiation therapy with a boost to the prostate, in conjunction with androgen deprivation therapy 7 years prior, presented with lower back pain. A bone scan revealed an area of activity in the sacrum. What is the most likely diagnosis?
