Improving Cancer Diagnosis and Care


Book Description

Rapid advances in cancer research, the development of new and more sophisticated approaches to diagnostic testing, and the growth in targeted cancer therapies are transforming the landscape of cancer diagnosis and care. These innovations have contributed to improved outcomes for patients with cancer, but they have also increased the complexity involved in diagnosis and subsequent care decisions. To examine opportunities to improve cancer diagnosis and care, the National Academies of Sciences, Engineering, and Medicine developed a two-workshop series. The first workshop, held on February 12â€"13, 2018, in Washington, DC, focused on potential strategies to ensure that patients have access to appropriate expertise and technologies in oncologic pathology and imaging to inform their cancer diagnosis and treatment planning, as well as assessment of treatment response and surveillance. This publication chronicles the presentations and discussions at the workshop.




Improving Cancer Diagnosis and Care


Book Description

A hallmark of high-quality cancer care is the delivery of the right treatment to the right patient at the right time. Precision oncology therapies, which target specific genetic changes in a patient's cancer, are changing the nature of cancer treatment by allowing clinicians to select therapies that are most likely to benefit individual patients. In current clinical practice, oncologists are increasingly formulating cancer treatment plans using results from complex laboratory and imaging tests that characterize the molecular underpinnings of an individual patient's cancer. These molecular fingerprints can be quite complex and heterogeneous, even within a single patient. To enable these molecular tumor characterizations to effectively and safely inform cancer care, the cancer community is working to develop and validate multiparameter omics tests and imaging tests as well as software and computational methods for interpretation of the resulting datasets. To examine opportunities to improve cancer diagnosis and care in the new precision oncology era, the National Cancer Policy Forum developed a two-workshop series. The first workshop focused on patient access to expertise and technologies in oncologic imaging and pathology and was held in February 2018. The second workshop, conducted in collaboration with the Board on Mathematical Sciences and Analytics, was held in October 2018 to examine the use of multidimensional data derived from patients with cancer, and the computational methods that analyze these data to inform cancer treatment decisions. This publication summarizes the presentations and discussions from the second workshop.




Oncologic Imaging


Book Description

Completely updated to reflect the latest developments in science and technology, the second edition of this reference presents the diagnostic imaging tools essential to the detection, diagnosis, staging, treatment planning, and post-treatment management of cancer in both adults and children. Organized by major organs and body systems, the text offers comprehensive, abundantly illustrated guidance to enable both the radiologist and clinical oncologist to better appreciate and overcome the challenges of tumor imaging. Features 12 brand-new chapters that examine new imaging techniques, molecular imaging, minimally invasive approaches, 3D and conformal treatment planning, interventional techniques in radiation oncology, interventional breast techniques, and more. Emphasizes practical interactions between oncologists and radiologists. Includes expanded coverage of paediatric tumours as well as thorax, gastrointestinal tract, genitourinary, and musculoskeletal cancers. Offers reorganized and increased content on the brain and spinal cord. Nearly 1,400 illustrations enable both the radiologist and clinical oncologist to better appreciate and overcome the challenges of tumour imaging. - Outstanding Features! Presents internationally renowned authors' insights on recent technological breakthroughs in imaging for each anatomical region, and offers their views on future advances in the field. Discusses the latest advances in treatment planning. Devotes four chapters to the critical role of imaging in radiation treatment planning and delivery. Makes reference easy with a body-system organisation.




Delivering High-Quality Cancer Care


Book Description

In the United States, approximately 14 million people have had cancer and more than 1.6 million new cases are diagnosed each year. However, more than a decade after the Institute of Medicine (IOM) first studied the quality of cancer care, the barriers to achieving excellent care for all cancer patients remain daunting. Care often is not patient-centered, many patients do not receive palliative care to manage their symptoms and side effects from treatment, and decisions about care often are not based on the latest scientific evidence. The cost of cancer care also is rising faster than many sectors of medicine--having increased to $125 billion in 2010 from $72 billion in 2004--and is projected to reach $173 billion by 2020. Rising costs are making cancer care less affordable for patients and their families and are creating disparities in patients' access to high-quality cancer care. There also are growing shortages of health professionals skilled in providing cancer care, and the number of adults age 65 and older--the group most susceptible to cancer--is expected to double by 2030, contributing to a 45 percent increase in the number of people developing cancer. The current care delivery system is poorly prepared to address the care needs of this population, which are complex due to altered physiology, functional and cognitive impairment, multiple coexisting diseases, increased side effects from treatment, and greater need for social support. Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis presents a conceptual framework for improving the quality of cancer care. This study proposes improvements to six interconnected components of care: (1) engaged patients; (2) an adequately staffed, trained, and coordinated workforce; (3) evidence-based care; (4) learning health care information technology (IT); (5) translation of evidence into clinical practice, quality measurement and performance improvement; and (6) accessible and affordable care. This report recommends changes across the board in these areas to improve the quality of care. Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis provides information for cancer care teams, patients and their families, researchers, quality metrics developers, and payers, as well as HHS, other federal agencies, and industry to reevaluate their current roles and responsibilities in cancer care and work together to develop a higher quality care delivery system. By working toward this shared goal, the cancer care community can improve the quality of life and outcomes for people facing a cancer diagnosis.




Quality Cancer Care


Book Description

Maintaining quality and improving cancer care does not occur in a vacuum. It requires a coordinated effort among many team members to whom this book is directed. Cancer care in the United States is in crisis as per a recent National Institute of Health publication. Much of this has to do with the complexity of the cancer care, its delivery systems, the aging population and the diminishing workforce. We need to be smarter and more efficient to de-escalate this crisis and improve the survival and survivorship of our cancer patients. Improved survivorship of families and caregivers will be included as well. The book will follow the continuum of cancer care model as its outline vide infra. It will provide many concrete instances of successful practices and programs which improve survivorship. Initially it will discuss the current crisis on a global and then national platform. There will be a discussion about disability adjusted life years lost, lost productivity, loss of life and its impact upon the nation and communities. The financial impact of cancer on society and government will be included in this. Population health management as regards cancer will then look at communities served, community health needs assessments and social determinants of health. How prevention and screening programs can be formulated from the above will be illustrated. Compliance with treatments as promulgated by the Commission on Cancer’s Cancer Program Practice Performance Reports (CP3R) will be reviewed. The relationship between compliance and improved survival will be highlighted. Navigation and distress management to assure patients complete planned treatments will be included in this section. Quality of survivorship will review the four domains of life- spiritual, social, psychological and physical. How these can be maximized through system improvement and program development will be illustrated. Financial issues and legal protections will also be included in this section. Survivorship care planning i.e. surveillance for recurrent cancer, prevention of related and new cancers will be an integral part of this section. Palliative, end of life care and bereavement care will complete the continuum cycle. Identifying hospitalized patients in need of palliative needs will be refreshed. How to establish an in-patient palliative care team and creating a seamless transition from in-patient to out-patient palliative care will be presented. Intended AudienceAdministrative and clinical staff involved in the delivery of cancer care including: hospital executives, physicians, nurses, radiation therapists, psychology counselors, social workers, physical therapists, occupation therapists, nutritionists, government, healthcare insurance representatives, etc.




Cancer Care for the Whole Patient


Book Description

Cancer care today often provides state-of-the-science biomedical treatment, but fails to address the psychological and social (psychosocial) problems associated with the illness. This failure can compromise the effectiveness of health care and thereby adversely affect the health of cancer patients. Psychological and social problems created or exacerbated by cancer-including depression and other emotional problems; lack of information or skills needed to manage the illness; lack of transportation or other resources; and disruptions in work, school, and family life-cause additional suffering, weaken adherence to prescribed treatments, and threaten patients' return to health. Today, it is not possible to deliver high-quality cancer care without using existing approaches, tools, and resources to address patients' psychosocial health needs. All patients with cancer and their families should expect and receive cancer care that ensures the provision of appropriate psychosocial health services. Cancer Care for the Whole Patient recommends actions that oncology providers, health policy makers, educators, health insurers, health planners, researchers and research sponsors, and consumer advocates should undertake to ensure that this standard is met.




Delivering Affordable Cancer Care in the 21st Century


Book Description

Rising health care costs are a central fiscal challenge confronting the United States. National spending on health care currently accounts for 18 percent of gross domestic product (GDP), but is anticipated to increase to 25 percent of GDP by 2037. The Bipartisan Policy Center argues that "this rapid growth in health expenditures creates an unsustainable burden on America's economy, with far-reaching consequences". These consequences include crowding out many national priorities, including investments in education, infrastructure, and research; stagnation of employee wages; and decreased international competitiveness.In spite of health care costs that far exceed those of other countries, health outcomes in the United States are not considerably better. With the goal of ensuring that patients have access to high-quality, affordable cancer care, the Institute of Medicine's (IOM's) National Cancer Policy Forum convened a public workshop, Delivering Affordable Cancer Care in the 21st Century, October 8-9, 2012, in Washington, DC. Delivering Affordable Cancer Care in the 21st Century summarizes the workshop.




Fulfilling the Potential of Cancer Prevention and Early Detection


Book Description

Cancer ranks second only to heart disease as a leading cause of death in the United States, making it a tremendous burden in years of life lost, patient suffering, and economic costs. Fulfilling the Potential for Cancer Prevention and Early Detection reviews the proof that we can dramatically reduce cancer rates. The National Cancer Policy Board, part of the Institute of Medicine, outlines a national strategy to realize the promise of cancer prevention and early detection, including specific and wide-ranging recommendations. Offering a wealth of information and directly addressing major controversies, the book includes: A detailed look at how significantly cancer could be reduced through lifestyle changes, evaluating approaches used to alter eating, smoking, and exercise habits. An analysis of the intuitive notion that screening for cancer leads to improved health outcomes, including a discussion of screening methods, potential risks, and current recommendations. An examination of cancer prevention and control opportunities in primary health care delivery settings, including a review of interventions aimed at improving provider performance. Reviews of professional education and training programs, research trends and opportunities, and federal programs that support cancer prevention and early detection. This in-depth volume will be of interest to policy analysts, cancer and public health specialists, health care administrators and providers, researchers, insurers, medical journalists, and patient advocates.




Patient-Centered Cancer Treatment Planning


Book Description

Each year approximately 1.5 million people are diagnosed with cancer in the United States, most of whom inevitably face difficult decisions concerning their course of care. Recognizing challenges associated with cancer treatment, the National Coalition for Cancer Survivorship (NCCS) and the National Cancer Policy Forum (NCPF) of the Institute of Medicine (IOM) hosted a public workshop in Washington, DC on February 28 and March 1, 2011, entitled Patient-Centered Cancer Treatment Planning: Improving the Quality of Oncology Care. This workshop summary includes an overview of patient-centered care and cancer treatment planning, as well as subject areas on shared decision making, communication in the cancer care setting, and patient experiences with cancer treatment. Best practices, models of treatment planning, and tools to facilitate their use are also discussed, along with policy changes that may promote patient-centeredness by enhancing patient's understanding of and commitment to the goals of treatment through shared decision-making process with their healthcare team from the moment of diagnosis onward. Moreover, Patient-Centered Cancer Treatment Planning emphasizes treatment planning for patients with cancer at the time diagnosis.




The Unequal Burden of Cancer


Book Description

We know more about cancer prevention, detection, and treatment than ever beforeâ€"yet not all segments of the U.S. population have benefited to the fullest extent possible from these advances. Some ethnic minorities experience more cancer than the majority population, and poor peopleâ€"no matter what their ethnicityâ€"often lack access to adequate cancer care. This book provides an authoritative view of cancer as it is experienced by ethnic minorities and the medically underserved. It offers conclusions and recommendations in these areas: Defining and understanding special populations, and improving the collection of cancer-related data. Setting appropriate priorities for and increasing the effectiveness of specific National Institutes of Health (NIH) research programs, to ensure that special populations are represented in clinical trials. Disseminating research results to health professionals serving these populations, with sensitivity to the issues of cancer survivorship. The book provides background data on the nation's struggle against cancer, activities and expenditures of the NIH, and other relevant topics.