American Society of Clinical Oncology educational book
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Am Soc Clin Oncol Educ Book · Jan 2014
Review Historical Article50 Years of progress in the systemic therapy of non-small cell lung cancer.
Non-small cell lung cancer constitutes 85% to 90% of lung cancer and is the most common cause of cancer death. Over the past 50 years, substantial progress has been made in all aspects of lung cancer including screening, diagnostic evaluation, surgery, radiation therapy, and chemotherapy. This review focuses on the advances in systemic therapy during this half century.
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Am Soc Clin Oncol Educ Book · Jan 2014
ReviewShould triple-negative breast cancer (TNBC) subtype affect local-regional therapy decision making?
The more aggressive biologic characteristics and the current lack of targeted therapy for triple-negative breast cancer (TNBC) make local-regional management decisions challenging for physicians. TNBC is associated with patients of younger age, black race and BRCA1 mutation carriers. Distinctions between BRCA1-associated and sporadic TNBC include increased lifetime risk of ipsilateral and contralateral breast cancer after breast cancer therapy (BCT) for BRCA carriers, which is not shared by sporadic TNBC. ⋯ TNBC should be treated with APBI only on clinical trials. Although hWBRT may be considered in TNBC, its association with younger age, advanced disease and use of systemic chemotherapy often precludes its use for this subtype. Until definitive treatment strategies are validated in large datasets and confirmed in randomized trials, TNBC subtype, in and of itself, should not direct local-regional management treatment decisions.
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Am Soc Clin Oncol Educ Book · Jan 2014
ReviewNovel approaches to improve the treatment of rare gynecologic cancers: research opportunities and challenges.
More than 50% of all gynecologic cancers can be classified as rare tumors (defined as an incidence of fewer than six per 100,000). Improved understanding of the molecular pathogenesis of tumors increases the proportion of rare tumors and creates challenges in optimizing the design of clinical trials. ⋯ Although randomized trials can be done in many tumor types, there are some for which conducting even single-arm studies may be challenging. For these tumors, robust collection of data through national and/or international registries could lead through audit to improvements in the treatment of rare tumors.
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Am Soc Clin Oncol Educ Book · Jan 2014
ReviewAchieving a deeper understanding of the implemented provisions of the Affordable Care Act.
The Patient Protection and Affordable Care Act (ACA) was signed into law by President Barack Obama on March 23, 2010. Since that time, numerous regulations have been promulgated, legal battles continue to be fought and the major provisions of the law are being implemented. In the following article, we outline components of the ACA that are relevant to cancer health care, review current implementation of the new health care reform law, and identify challenges that may lie ahead in the post-ACA era. Specifically, among the things we explore are Medicaid expansion, health insurance exchanges, essential health benefits and preventive services, subsidies, access to clinical trials, the Medicare Part D donut hole, and physician quality payment reform.
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Am Soc Clin Oncol Educ Book · Jan 2014
ReviewCompassion, compassion fatigue, and burnout: key insights for oncology professionals.
When cancer care clinicians become stressed, sad, isolated--and unaware of this--they are placing themselves at risk for burnout and their patients at risk for suboptimal care. Despite their best intentions, clinicians can sink from a healthy work state of compassion, empathy, and well-being into compassion fatigue and burnout. ⋯ The recognition of these issues as a threat to clinician performance has outstripped the development of evidence-based interventions, but interventions tested to date are effective, feasible, and scalable. These interventions could be incorporated systematically into cancer care.