Journal of the National Comprehensive Cancer Network : JNCCN
-
J Natl Compr Canc Netw · Jul 2009
Practice patterns and guideline adherence of medical oncologists in managing patients with early breast cancer.
Studies of adherence to breast cancer guidelines have often focused on primary therapies, but concordance with other guideline recommendations has not been examined as extensively. This study assesses the knowledge and practice patterns of medical oncologists in the United States to inform education and quality improvement initiatives that can improve breast cancer care. ⋯ Oncologists often make guideline-consistent choices, but discordant clinical decisions may occur in important aspects of care for early breast cancer. Broadening the diffusion and adoption of guideline recommendations is an important mechanism for addressing these gaps and may substantially improve the quality of breast cancer care.
-
J Natl Compr Canc Netw · Jul 2009
Role of interventional radiology in the treatment of patients with neuroendocrine metastases in the liver.
Management of liver metastasis from neuroendocrine tumors routinely includes an interventional radiologist. Hepatic artery embolization, either bland (transarterial embolization) or with chemotherapy (transarterial chemoembolization), has been shown to improve response rates in neuroendocrine metastases to the liver. Radiofrequency ablation, cryotherapy, and percutaneous alcohol ablation are important adjuncts or alternative treatments to surgical debulking. In this article, the authors examine important techniques in the armamentarium of the interventional radiologist.
-
J Natl Compr Canc Netw · Apr 2009
ReviewA communication approach for oncologists: understanding patient coping and communicating about bad news, palliative care, and hospice.
Oncologists frequently approach patients to discuss difficult topics, such as bad news about cancer progression and referrals to palliative care and hospice. To communicate effectively in these difficult situations, it is helpful to assess what the patient knows and wants to know about their disease in general and, specifically, their prognosis. ⋯ Although this coping is normal, it is difficult for most clinicians to interpret. This article presents a framework for understanding normal patient coping and gives specific examples of how to talk with these patients during difficult transitions, such as times of disease progression, and about referral to hospice and palliative care.