National cancer advocacy groups leveled harsh criticism at Senate negotiators from both parties for their failure to include any significant enhancements of beneficiary entitlements in a pending Medicare legislative package. Ellen Stovall, president of the National Coalition for Cancer Survivorship and a convener of the Cancer Leadership Council, said, "Once the cancer community understands that the Senate leadership is prepared to offer more than $40 billion in so-called provider givebacks and nothing for people with cancer, they will be very angry."
Among the provisions being considered by the Senate was the Access to Cancer Therapies Act (S. 913), which would extend Medicare coverage to all oral anticancer drugs, including new targeted therapies like imatinib(Drug information on imatinib) (Gleevec) and widely prescribed agents like tamoxifen(Drug information on tamoxifen). Patient advocates strongly support the legislation as a means of providing cancer patients immediate access to life-extending drugs that are available only in oral form and thus not currently covered by Medicare. The bill has enjoyed broad bipartisan support from members of Congress, with more than half of all senators signed on as cosponsors and more than three-quarters of all House members cosponsoring the House counterpart, H.R. 1624.
Given that level of support and the relatively modest cost associated with the legislation, advocates for cancer patients had hoped the provision would be a high priority for Senate negotiators. According to Ms. Stovall, "We were particularly hopeful that the leadership of the Finance Committee, mostly coming from rural states, would appreciate the distinct advantages of oral cancer medications to their constituents, who might not have ready access to a local oncologist. Failure to address this clear need is a great disappointment."
Cancer groups also consistently supported a comprehensive benefit under Medicare, but realized that projected expense and ideologic differences made that unlikely in this Congress. "The Senate negotiators could have made a significant downpayment on an eventual comprehensive benefit by including S. 913, but chose not to do so," Ms. Stovall said. "Cancer patients will feel betrayed by that unfortunate decision."
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?
