scout

All News

Palliative care differs from other oncology care settings because it involves end-of-life discussions. This article is intended to help oncology nurses who deliver news that involves palliative care by describing components of breaking bad news, providing an example for how to break bad news, and suggesting methods for evaluating a nurse-patient interaction. One possible scenario for achieving a positive outcome after delivering unwelcome information will also be described. Applying the methods described in this article can help to promote a positive outcome when a nurse delivers bad news to a patient.

Oncology is undergoing a sea change. Because of sophisticated cancer screening, combined with increasingly effective treatments, the majority of cancer patients are surviving beyond the period of active treatment. As a consequence, cancer care teams are striving to confront the new—and very welcome—challenge of caring for long-term cancer survivors.

In this edition, we offer an example of how clinicians and patients can be fooled and/or injured by fraudulent healthcare practitioners and their services. The clinical care team must be sure that the references it provides to patients are safe and reliable. Keep a list of reliable references and a list of those practitioners and services/treatments that should be avoided. Maintain an open door policy with your patients designed to encourage questions and exchange such information.

A newly released ASCO study, titled "Future Supply and Demand for Oncologists: Challenges to Assuring Access to Oncology Services," projects a potential shortfall of medical oncologists in the United States, which could severely compromise access to quality care. Cancer Care & Economics (CC&E) recently spoke with Michael Goldstein, MD, an oncologist at Beth Israel Deaconess Medical Center, Boston. Dr. Goldstein, chair of the ASCO Workforce in Oncology Task Force, contributed to the development and analysis of this important study.

On June 29, 2005, President Bush signed into law the Patient Navigator Outreach and Chronic Disease Prevention Act of 2005 (H.R. 1812). This legislation authorized the National Cancer Institute (NCI) to oversee the distribution of $25 million in competitive 5-year grants to help underserved communities access health care services.

Despite significant improvements in the treatment of Hodgkin's lymphoma over the past 2 decades, physicians continue to face dilemmas in therapy for the disease, and many cured patients live with complications of treatment. Newer therapeutic options are still needed for the disease, to minimize complications and to improve the treatment of patients in relapse. This review considers the treatment of Hodgkin's lymphoma in younger patients, addressing such issues as which patients with early-stage disease may require radiotherapy, what prognostic factors provide information that can affect treatment choices in patients with advanced disease, and what we have learned about treatment complications in this setting.

Despite significant improvements in the treatment of Hodgkin's lymphoma over the past 2 decades, physicians continue to face dilemmas in therapy for the disease, and many cured patients live with complications of treatment. Newer therapeutic options are still needed for the disease, to minimize complications and to improve the treatment of patients in relapse. This review considers the treatment of Hodgkin's lymphoma in younger patients, addressing such issues as which patients with early-stage disease may require radiotherapy, what prognostic factors provide information that can affect treatment choices in patients with advanced disease, and what we have learned about treatment complications in this setting.

Despite significant improvements in the treatment of Hodgkin's lymphoma over the past 2 decades, physicians continue to face dilemmas in therapy for the disease, and many cured patients live with complications of treatment. Newer therapeutic options are still needed for the disease, to minimize complications and to improve the treatment of patients in relapse. This review considers the treatment of Hodgkin's lymphoma in younger patients, addressing such issues as which patients with early-stage disease may require radiotherapy, what prognostic factors provide information that can affect treatment choices in patients with advanced disease, and what we have learned about treatment complications in this setting.

Three cancer organizations have joined in supporting FDA in an appeal to the District of Columbia Circuit Court of Appeals to overturn a decision that terminally ill patients have a fundamental right of access to experimental drugs.

Ultrasound-guided placement of a balloon catheter for partial breast brachytherapy can be safely delayed until after the final pathology report has confirmed that the patient is a candidate for the procedure, according to a new study.

Congress finally resolved the current federal budget in mid-February, 4 months after fiscal year (FY) 2007 began, and raised the National Institutes of Health's funding to $28.9 billion, an increase of $619.5 million (2%) over its FY2006 appropriations.

A mature 70-patient report by Chau T. Dang, MD, et al, on cardiac safetyof dose-dense AC (doxorubicin and cyclophosphamide, 60/600 mg/m2 X4) followed by Taxol with Herceptinfor 52 weeks in HER2-positivepatients, has concluded that theregimen is feasible; 3 of 70 patients (4%) had cessation oftrastuzumab because of asymptomaticLVEF decline, about 6 monthsinto the treatment period.

A second interimefficacy analysis of BCIRG 006 indicatessimilar survival benefit but significantlyless toxicity with a regimen oftrastuzumab (Herceptin) plus docetaxel(Taxotere), compared with trastuzumabplus doxorubicin.

As oncology professionals, we all look forward to seeing our successfully treated patients come in for their follow-up visits. In a busy day filled with making complex medical decisions, delivering bad news, managing symptoms, and dealing with insurance companies, it is a real highlight. These individuals are among the over 10 million cancer survivors in the United States and represent 3.5% of the population. However, along with these optimistic results come new challenges for survivors that require ongoing medical care and psychosocial support. Survivors face lifetime health risks that are dependent on the cancer, treatment exposures, genetic predispositions, comorbid health conditions, and lifestyle behaviors.

The risk of cancer increases with age, and as the US population rapidly ages, the number of older adults seeking treatment for cancer is also increasing dramatically. However, this growing population of older adults has been underrepresented in clinical trials that set the standards for oncology care. In addition, most clinical trials conducted to date have not addressed the problems that accompany aging, including reduced physiologic reserve, changes in drug pharmacokinetics, and the impact of comorbid medical conditions and polypharmacy on treatment tolerance. As a result, there are variations in treatment patterns between older and younger adults and few evidence-based guidelines accounting for the changes in physiology or pharmacokinetics that occur with aging. This article examines the demographics of cancer and aging, the barriers to enrollment of older adults on clinical trials, and approaches for future trials to address the needs of the older patient.

The risk of cancer increases with age, and as the US population rapidly ages, the number of older adults seeking treatment for cancer is also increasing dramatically. However, this growing population of older adults has been underrepresented in clinical trials that set the standards for oncology care. In addition, most clinical trials conducted to date have not addressed the problems that accompany aging, including reduced physiologic reserve, changes in drug pharmacokinetics, and the impact of comorbid medical conditions and polypharmacy on treatment tolerance. As a result, there are variations in treatment patterns between older and younger adults and few evidence-based guidelines accounting for the changes in physiology or pharmacokinetics that occur with aging. This article examines the demographics of cancer and aging, the barriers to enrollment of older adults on clinical trials, and approaches for future trials to address the needs of the older patient.