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When you start seeing a patient for the first time who has been treated elsewhere and the previous oncologist has not followed standard protocol, how do you present this new way of doing things without alienating the patient or sounding critical of the previous doctor?

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My practice has been concerned that we physicians were not maximizing our “coding potential”; that is, we were not receiving as much remuneration for each cancer patient visit as Medicare permits under its guidelines. Therefore, the practice hired a company that specializes in teaching physicians how to get more. This company is part of a newly minted industry that does nothing else.

Job Description This is a new position, created as the result of the organization’s strategy to become the regional market leader in cancer services in central Pennsylvania. The Medical Director will be responsible for directing physician clinical services as well as developing services and recruiting clinical professionals. This position will also maintain a clinical practice to complement their leadership duties.

We are recruiting board-certified oncologists for full and part time positions. Responsibilities include leading teams of health professionals, peer-to-peer discussions with physicians, collaborating with clinical content specialists; and opportunity for health services research. This position is for the individual seeking a change in career direction that is both dynamic and challenging.

This review covers symptoms and complications in patients with late-stage pancreatic cancer, including venous thromboembolism, anorexia-cachexia, pain, and depression.

If MGTs could predict which patients were most prone to late recurrence and thus might benefit from extended adjuvant endocrine therapy, it would be a huge advancement in the care and survivorship of our patients. More studies of MGTs are required to clarify their role in evaluating prognosis and predicting response to therapy in breast cancer.

Cancer Network brings exclusive coverage of content and expert perspectives from the 38th annual Oncology Nursing Society Congress, held April 25–28, 2013 at the Walter E. Washington Convention Center in Washington, DC. Through educational sessions and symposia, podium and poster presentations, workshops, and special interest group (SIG) meetings, ONS Congress provides myriad opportunities to learn about innovations in cancer treatment and supportive care; ways to integrate and promote evidence-based practice to improve patient outcomes and quality of life; strategies for nursing self-care; and approaches to support professional growth.

One way of framing the ethical question in this case might be: “What are my ethical obligations to provide an anticancer therapy when I think it is unlikely to benefit the patient?” The broader clinical questions involved in this case are fundamentally the same in most patients.

Most Americans are aware that technical experts from Consumer Reports magazine consistently rank televisions and automobiles manufactured by Japanese companies higher than their US counterparts, but I believe that neither Consumer Reports nor US physicians understand how much better lung cancer treatment results are in Japan.

In this interview we discuss the dissemination of research results, clinical trials, and other oncology news using social media, as well as what type of media oncologists use, and how useful and relevant this type of information is for most oncologists.

Along with chemotherapy and surgery, radiation therapy remains one of the three main treatments for cancer. A new article in Science Translational Medicine reviews the recent advances and current challenges in radiation oncology today.

Cancer Network presents exclusive coverage of the 30th Annual Miami Breast Cancer Conference. We speak with nationally recognized breast cancer specialists and bring you their insights into the optimal multidisciplinary management of patients with breast cancer and the application of innovative approaches to practice. As always, we encourage feedback and suggestions on how we can better serve your clinical cancer information needs. Please check your inbox for reports from the 30th Annual Miami Breast Cancer Conference, and watch here for our editorial staff’s coverage during the meeting.

Results from a retrospective analysis indicate that the use of the antiangiogenic, VEGF inhibitor sorafenib for the treatment of advanced renal cell carcinoma was well tolerated in patients aged 65 years or older.

To place responsibility for rationing chemotherapeutics on the oncologist not only increases his or her emotional burden, but it also strains the doctor-patient relationship. We should not allow oncologists to become bedside healthcare rationers simply because no one else wants to do the job.

Oncologists would be well advised to consider their obligations to the patient, as well as other stakeholders, and be prepared to resolve potential conflicts that go beyond the focus of their clinical training.

Further prospective clinical trials in very elderly patients with DLBCL are clearly needed. Complementing the growing need for such trials, an evolving clinical trial infrastructure, geriatric oncology support, and novel therapeutics are making such studies feasible in the current era.

Elderly patients may have several such comorbidities, but their impact on normal life is minimal-and so most of these patients may receive a curative treatment such as R-CHOP. Very elderly patients have more comorbidities with greater impact, with the result that some of their vital organs exhibit functional deficiency.

In this review, we critically analyze clinical trials that were specifically designed for the very elderly, and we discuss the challenges encountered by investigators who are conducting studies in this patient population. We conclude by proposing an algorithm to help clinicians determine the optimal therapeutic strategy for treatment of DLBCL in very elderly patients.

It is hard to realize that an elderly patient's visit to you is likely the only trip outside his or her apartment for the week and the only contact with someone other than family or an aide. Doctor visits sometimes become the elderly's primary contact with the larger world.

Costs of care continue to rise; new cancer drugs are more expensive than ever before, and more patients are being treated with these drugs. While patients and claims datasets consistently report an association between financial burden and quality of care, the impact on traditional disease-related outcomes-survival, for example-have not been assessed.

In this article, we have chosen to focus on three ethical challenges that we believe practicing oncologists might commonly encounter with their patients. The ethical dilemmas are presented in a case-based approach in the hope of better joining the ethical theory to clinical practice.

Cancer Network presents exclusive coverage from the American Society of Clinical Oncology (ASCO) Gastrointestinal Cancers Symposium. Check out the stories below for write-ups of the most important information to come out of this year's event.

New data suggest that surveillance of patients with small kidney tumors may be a safe alternative to surgery, especially in older patients or those with comorbid conditions.

As often as not, the decision whether to treat or deny treatment to any elderly patient with cancer is a result of an oncologist’s impression of the individual person’s ability to benefit from and withstand the side effects of therapy. And that decision is usually based on a clinical assessment that is far more intuitive than it is scientific.

Localized prostate cancer treatment with surgery or radiation results in similar long-term side effects, such as erectile dysfunction and urinary incontinence.

My suggestion, as unrealistic as it is, would be to encourage the creation and maintenance of parallel groups of quality measures: one set to satisfy the reportable measures of quality that affect reimbursements and pay for performance, and a second set that would be developed by and adapted to each institution to measure and drive improvements in those things we felt were true measures of high quality care.

The reality is that new biological agents are often priced like a Ferrari, and patients who are covered under a pharmacy benefit are required to fork over not a fixed copay but a percentage of the pill’s cost, each and every month ‘til eternity or death, whichever comes first.

The same week that bevacizumab (Avastin) received a new indication for the treatment of metastatic colorectal cancer, results from two phase III trials involving the drug were presented at the American Society of Clinical Oncology 2013 Gastrointestinal Cancers Symposium (ASCO GI) held January 24–26 in San Francisco.