Delivering High-Quality Cancer Care

Delivering High-Quality Cancer Care

Author: Committee on Improving the Quality of Cancer Care: Addressing the Challenges of an Aging Population

Publisher: National Academies Press

Published: 2014-01-10

Total Pages: 0

ISBN-13: 9780309286602

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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.


Transforming Clinical Research in the United States

Transforming Clinical Research in the United States

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2010-10-22

Total Pages: 151

ISBN-13: 0309163358

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An ideal health care system relies on efficiently generating timely, accurate evidence to deliver on its promise of diminishing the divide between clinical practice and research. There are growing indications, however, that the current health care system and the clinical research that guides medical decisions in the United States falls far short of this vision. The process of generating medical evidence through clinical trials in the United States is expensive and lengthy, includes a number of regulatory hurdles, and is based on a limited infrastructure. The link between clinical research and medical progress is also frequently misunderstood or unsupported by both patients and providers. The focus of clinical research changes as diseases emerge and new treatments create cures for old conditions. As diseases evolve, the ultimate goal remains to speed new and improved medical treatments to patients throughout the world. To keep pace with rapidly changing health care demands, clinical research resources need to be organized and on hand to address the numerous health care questions that continually emerge. Improving the overall capacity of the clinical research enterprise will depend on ensuring that there is an adequate infrastructure in place to support the investigators who conduct research, the patients with real diseases who volunteer to participate in experimental research, and the institutions that organize and carry out the trials. To address these issues and better understand the current state of clinical research in the United States, the Institute of Medicine's (IOM) Forum on Drug Discovery, Development, and Translation held a 2-day workshop entitled Transforming Clinical Research in the United States. The workshop, summarized in this volume, laid the foundation for a broader initiative of the Forum addressing different aspects of clinical research. Future Forum plans include further examining regulatory, administrative, and structural barriers to the effective conduct of clinical research; developing a vision for a stable, continuously funded clinical research infrastructure in the United States; and considering strategies and collaborative activities to facilitate more robust public engagement in the clinical research enterprise.


A National Cancer Clinical Trials System for the 21st Century

A National Cancer Clinical Trials System for the 21st Century

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2010-07-08

Total Pages: 317

ISBN-13: 0309157870

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The National Cancer Institute's (NCI) Clinical Trials Cooperative Group Program has played a key role in developing new and improved cancer therapies. However, the program is falling short of its potential, and the IOM recommends changes that aim to transform the Cooperative Group Program into a dynamic system that efficiently responds to emerging scientific knowledge; involves broad cooperation of stakeholders; and leverages evolving technologies to provide high-quality, practice-changing research.


Cancer

Cancer

Author: Craig A. Almeida

Publisher: John Wiley & Sons

Published: 2011-08-26

Total Pages: 364

ISBN-13: 1444357395

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“... Useful background information is displayed in blue boxes, and good use is made of numerous tables and diagrams... a useful book for the undergraduate medical or allied health professional...” –Oncology News, May/June 2010 This forward looking cancer biology book appeals to a wide ranging audience. Introductory chapters that provide the molecular, cellular, and genetic information needed to comprehend the material of the subsequent chapters bring unprepared students up to speed for the rest of the book and serve as a useful refresher for those with previous biology background. The second set of chapters focuses on the main cancers in terms of risk factors, diagnostic and treatment methods and relevant current research. The final section encompasses the immune system’s role in the prevention and development of cancer and the impact that the Human Genome Project will have on future approaches to cancer care. While best suited to non-majors cancer biology courses, the depth provided satisfies courses that combine both majors and non-majors. Also, and deliberately, the authors have incorporated relevant information on diagnosis and treatment options that lend appeal to the lay reader.


The Prevention and Treatment of Missing Data in Clinical Trials

The Prevention and Treatment of Missing Data in Clinical Trials

Author: National Research Council

Publisher: National Academies Press

Published: 2010-12-21

Total Pages: 163

ISBN-13: 030918651X

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Randomized clinical trials are the primary tool for evaluating new medical interventions. Randomization provides for a fair comparison between treatment and control groups, balancing out, on average, distributions of known and unknown factors among the participants. Unfortunately, these studies often lack a substantial percentage of data. This missing data reduces the benefit provided by the randomization and introduces potential biases in the comparison of the treatment groups. Missing data can arise for a variety of reasons, including the inability or unwillingness of participants to meet appointments for evaluation. And in some studies, some or all of data collection ceases when participants discontinue study treatment. Existing guidelines for the design and conduct of clinical trials, and the analysis of the resulting data, provide only limited advice on how to handle missing data. Thus, approaches to the analysis of data with an appreciable amount of missing values tend to be ad hoc and variable. The Prevention and Treatment of Missing Data in Clinical Trials concludes that a more principled approach to design and analysis in the presence of missing data is both needed and possible. Such an approach needs to focus on two critical elements: (1) careful design and conduct to limit the amount and impact of missing data and (2) analysis that makes full use of information on all randomized participants and is based on careful attention to the assumptions about the nature of the missing data underlying estimates of treatment effects. In addition to the highest priority recommendations, the book offers more detailed recommendations on the conduct of clinical trials and techniques for analysis of trial data.


The Basics of Cancer Immunotherapy

The Basics of Cancer Immunotherapy

Author: Haidong Dong

Publisher: Springer

Published: 2018-01-05

Total Pages: 164

ISBN-13: 3319706225

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This book provides patients and their physicians (especially “non-oncologist” health care providers) with a clear and concise introduction to cancer immunotherapy, which, unlike traditional forms of cancer therapy, acts by boosting the patient’s own immune system to fight cancer. The unique features of cancer immunotherapy make its management, monitoring and side-effects different from those of traditional cancer therapy. Especially novel are the side effects of cancer immunotherapy, necessitating greater awareness for both patients and physicians in order to minimize complications of therapy. The patient-friendly, concise, easy-to-understand, and up-to-date knowledge presented in this book will inform patients about the benefits and risks of cancer immunotherapy, and help them and their care providers to understand how immunotherapy would control their unique disease. Researchers and academic professionals in the field of cancer immunotherapy will also find clear and useful information to help them communicate with patients or address unresolved problems. Some key features of the book are: Expertise. All editors and authors are scientists and oncologists specializing in cancer immunotherapy, and are involved in scientific discovery from the early stage of immune-checkpoint inhibitors to today’s daily patient care. Their insights, expertise and experience guarantee the high quality and authority in the science, medicine and practice of cancer immunotherapy. Patient-friendly. This book is written for cancer patients in order to meet their needs when considering immunotherapy. As an educational tool, this book will help the reader balance the risks and benefits based on both science and clinical facts, and therefore to make the best choice in receiving or withdrawing from immunotherapy. Disease Specificity. Cancer is a complicated disease involving multiple stages and pathology. Its response to immunotherapy is individualized and varies depending on cancer types. The authors’ expertise in treating different types of cancers, including melanoma, lung, kidney, bladder, and lymphoma, provides disease-specific insights in applying immunotherapy to each disease.


Cancer Management With Chinese Medicine

Cancer Management With Chinese Medicine

Author: Hai Hong

Publisher: World Scientific

Published: 2012-02-29

Total Pages: 223

ISBN-13: 9814458007

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Significant advances made by Western medicine in the treatment of cancer are well-documented, but little has been written in English on complementary holistic treatment with Chinese medical methods that manage its symptoms and ameliorate the side effects of surgery, chemotherapy or radiotherapy. This book explains the complementary approach using cases from the medical files of Professor Rencun Yu, who was trained in Western medical oncology but also practices Chinese medicine. In addition, introductory chapters explain the basic principles of Chinese medicine, while other chapters cover the prevention of cancers through appropriate nutrition and living habits. The book should command the attention of medical professionals as well as the layperson interested in preventing and understanding the illness.There is no equivalent book in English that so skillfully combines an introduction to Chinese medical principles and cancer management for the general reader with detailed clinical studies of the crucial complementary role played by Chinese medicine in Western treatments for cancer patients./a


Clinical Gynecologic Oncology E-Book

Clinical Gynecologic Oncology E-Book

Author: Philip J. DiSaia

Publisher: Elsevier Health Sciences

Published: 2017-02-04

Total Pages: 893

ISBN-13: 0323443168

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The most readable, most comprehensive book in its field, Clinical Gynecologic Oncology, 9th Edition is the leading reference for diagnosis and treatment of gynecologic cancers – a must-have reference for improving outcomes and providing effective care. A "who’s who" list of contributing authors, under the editorial direction of Drs. Philip DiSaia and William Creasman, provides expert guidance on clinical presentations and management, now fully up to date with a brand-new design for faster, easier reference. Contains useful appendices covering staging, screening, nutritional therapy, toxicity criteria, blood component therapy, and radiation therapy. Covers hot topics such as multi-panel genetic testing, target therapies, sentinel node concept in endometrial cancer and vulvar cancer, and robotic surgery. Updates include new quick-reference features such as key point boxes with bulleted lists, highlighted key text, enhanced chapter outlines, and a brand-new design throughout. Includes up-to-date references and algorithms, making this text a comprehensive resource for clinical practice, personal study, and exam review. Helps you take advantage of the latest advances in early detection and improved treatment options for gynecologic cancers, especially uterine and cervical cancers.


Cancer Consult

Cancer Consult

Author: Syed A. Abutalib

Publisher: John Wiley & Sons

Published: 2014-06-16

Total Pages: 984

ISBN-13: 1118589173

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The field of oncology benefits from several large-scale reference books and a host of monographs dedicated to specific cancers. However, truly excellent practice and review books are, surprisingly, quite scarce. Outside of a scant handful of books and online reference tools that offer clinical response practice and board review in a basic question and answer format, there are no resources that offer a robust, engaging, fully referenced tool for these vital activities in every oncologist’s and oncology trainee’s work. This print and electronic book seeks to fill that void, offering comprehensive question-and-answer style content that covers the entire specialty of oncology and provides practicing oncologists with a fascinating and immediately applicable compendium of vital information dealing with a well-balanced selection of common and uncommon cancers. At the heart of this book is the editor’s and authors’ desire to overcome the controversies and barriers to practice that usually emerge following the appearance of new data. In every section, the user is guided toward collaboration in ongoing clinical research – for example, via discussions of well-designed ongoing clinical trials in each specific area. Developed with both the teacher and learner in mind, this book also offers trainees and fellows an excellent opportunity to enhance their preparation for the ABIM oncology fellowship exam as well as for the oncology boards. It will also be an extremely useful tool for oncologists working toward the recertification exam. This comprehensive, beefy book includes hundreds of painstakingly developed multiple-choice and mini-case-based questions covering the principles of medical oncology, malignant hematology, surgical oncology, and radiation oncology. It also contains mini-cases and questions dealing with the biology, diagnosis, classification, staging, and multidisciplinary treatment of cancers at every anatomic site. The very latest topics are included, such as molecular techniques, targeted therapies, and translational cancer research. Concise but detailed answers are referenced to key journals and books, and evidence-based wherever possible. NCCN guidelines are also referenced as appropriate. With its powerful focus on take-home messages from and for actual clinical work, this book will help keep oncologists up to date, bridging the gaps between journal and reference literature, conferences, and their existing knowledge base.