Ronald Piana

How will Obama foot the bill for his proposed health-care reform initiative, which is projected to cost at least $1 trillion? Cancer care could suffer more cuts.

Researchers at the University of Michigan discovered a gene that over expresses in about 20% of breast cancers. In order to protect their promising find, they quickly filed for a patent.

Newly appointed FDA commissioner, Margaret A. Hamburg, MD, has created a task force to study how to make the agency's processes more transparent. When it comes to cancer drugs, she's got a tough road ahead.

President Obama wants to push forward his health-care reform initiative this year. Republicans have expressed strong reservations about the plan and its express-train timetable, but they do not enough clout on the Hill to stop it.

A psychoanalyst describes her intimate psychosocial care with a dying patient. But her musings on caring for the terminally ill leave out one crucial thing--pain relief.

The recent decision by CMS to deny coverage for CT colonography in colorectal cancer screening has been seen by some as a favorable trend toward using evidence-based medicine to make more cost-effective coverage decisions. With the Medicare hospital insurance trust fund projected to become insolvent by 2017, perhaps the agency is responding to the impending fiscal realities.

Highly expensive imaging technologies are a lightning rod in today’s contentious healthcare landscape. Critics contend that imaging services are grossly overused, while supporters argue that proper use of imaging saves lives and reduces downstream cancer costs.

As comparative effectiveness research matures from a political buzz phrase to a decision-making process, leaders in the oncology community are concerned about the effect this latest government initiative might have on community practices that already feel overregulated.

One of the most discussed elements of President Obama's health-care reform is the the initiative to launch comparative effectiveness research. The administration contends that CER is about enhancing the quality of care by choosing more effective clinical options. Pharma is worried that comparative effectiveness code for cost-effectiveness, and oncologists are concerned that CER could effect the autonomy of their clinical decision making.

Is the era of PSA screening coming to an end? Proponents say the test saves lives, but a growing number of critics contend that widespread screening does more harm than good. The ongoing controversy over the clinical value of PSA screening has long been perpetuated by a lack of persuasive data, leaving doctors and their patients with difficult conversations and a host of perplexing decisions.

Oncologists who treat head and neck cancer face a double-edged sword-life-saving procedures often leave patients disfigured or unable to speak. For Waun Ki Hong, MD, it simply wasn’t enough to offer a cure that was saddled with too many severe consequence

Recently released, the 2009 Medicare Trustees report projected that Medicare, the primary insurance carrier for much of the nation's cancer population, is in deep fiscal trouble. Amidst the clamor on Capitol Hill for revamping our health-care system, the daunting challenge of Medicare's dilemma is largely left off the table. Silence on this issue threatens our ability to deliver high-quality cancer care to our aging population.

Common logic among the public dictates that it is grossly unfair to deny a person dying of cancer access to an experimental therapy that might be the person's last hope. The blame usually falls on FDA and Pharma; politics and greed are the common back-stories behind this very real , and largely misunderstood issue.

The right to patent human genes has long been a subject of intense debate. Critics contend that this practice infringes on human privacy and stifles scientific progress. The ACLU has finally got a case it can sink its legal teeth into: a woman who tested positive for gene predisposing her to ovarian cancer was denied access to a second opinion because of current patent law.

A mobile MRI unit recently pulled up to the steps of Capitol Hill, launching the Brain Tumor Foundation's national campaign for early detection. Led by the Foundation's president and founder, Patrick J. Kelly, MD, free brain scans were offered to members of Congress and their staff, along with government officials. Good intentions aside, the effort was derided as doing more harm than good by many leading cancer experts.

In a decision that many in the oncology community view as penny-wise, dollar-foolish, CMS reversed its decision to cover CT colonograhpy as a screening tool in colorectal cancer. Proponents of CT colonography contend that the less invasive nature promotes adherence to regular screening; critics say CT colonography's inability to remove polyps creates unnecessary redundancy; if polys are detcted the gold standard optical method is then needed. Why not just do it the first time?

Although significant questions remain, the recently released IMPACT study is a major victory for Dendreon's prostate cancer vaccine, Provenge. Two years ago, Provenge was denied FDA approval causing a wave of public outcry. Now, all eyes are on FDA as Dendreon gears up to once again tackle the approval process.

Candida and Aspergillus are the most common causes of invasive fungal infections in immunocompromised patients. Over the past two decades, there has been a substantial rise among cancer patients in the incidence of life-threatening invasive fungal infections that pose significant clinical challenges for the oncology community (N Engl J Med 348:1546-1554, 2003).

Prostate-specific antigen testing, the most widely used screening tool in prostate cancer, has long had both critics and supporters. Two studies published in the New England Journal of Medicine continue to generate debate over the value of PSA screening. The papers have two major points in common: They are large-scale studies, and they leave more questions than answers.

George Bernard Shaw once said “Youth is wasted on the young.” But for Sharon Murphy, MD, youth is in the hands of exactly the right people. As a medical student, Dr. Murphy was considering a career in internal medicine; doing rounds on the adult wards changed her mind.

Jimmie C. Holland, MD, widely recognized as the founder of “psychooncology,” grew up in a rural part of Texas with fertile black soil, known as the Blackland Bible Belt. It was a time when cotton was king and little girls were named Bobbi and Jimmie. Back then, the gender line was clearly demarcated; girls became teachers and nurses and homemakers. Interested in medicine as a youngster, Jimmie thought about nursing, but decided instead to buck the old-boy tradition and become a doctor. Her family and teachers supported her dream, and she never looked back.

In the first of what will become an annual review process, the nation’s largest cancer-care payer has added three new formularies to its drug coverage policy, giving oncologists even greater ability to prescribe off -label cancer drugs.

The new year has begun, but controversy over erythropoiesis-stimulating agents for chemotherapy-induced anemia continues. Restrictive FDA revisions to ESA labeling have had a profound effect on the management of patients with anemia as well as on the practice of oncology itself.

Oncologists face special patient communication challenges, as cancer treatments are highly complex and prognosis is often grim. For various reasons, important information is often avoided or communicated poorly, leaving cancer patients in emotional limbo.

Growing up in Canton, Ohio, Fred Appelbaum, MD, dreamt of cowboys, cattle rustling, and a career in medicine- of sorts. “It wasn’t until I was an undergrad at Dartmouth College that I thought seriously about medicine. But I didn’t think about academic medicine or research. I thought I’d end up a small-town doc like in Gunsmoke,” explained Dr. Appelbaum, referring to the popular TV series from the 1950s.

As a preschooler, Clara D. Bloomfield, MD, had visions of Florence Nightingale in her head. At the age of four, she informed her mother that she wanted to become a nurse. “My mother said, ‘Well dear, that’s very nice. But if you want to become a nurse, you might as well become a doctor’,” Dr. Bloomfield told Oncology News International.

The ever-growing complexity of chemotherapy coding is so onerous that office managers sometimes lose track of their non-drug billing items. Here are four questions that oft en pop up about nondrug billing and coding.

Today’s shrinking drug reimbursements are forcing community oncologists to adopt more creative business models to shore up their bottom line, such as hiring full-time pharmacists.

The modest, utilitarian office of Elaine S. Jaffe, MD, is dominated by a large microscope, stacks of pathology slides, and a view of the sprawling, 350-acre campus of the National Institutes of Health.

Here are some simple things that can be done to keep the billing related to skilled nursing facilities in order. Here’s a scenario that most likely plays out in oncology practices on a routine basis: A Medicare beneficiary arrives at a community offi ce for treatment. She has a blood draw followed by a 2-hour chemotherapy infusion. Th e oncology practice’s offi ce submits a reimbursement claim through Medicare Part B. Two weeks later a notice from Medicare arrives-claim denied!