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.
Advances in cancer research have led to an improved understanding of the molecular mechanisms underpinning the development of cancer and how the immune system responds to cancer. This influx of research has led to an increasing number and variety of therapies in the drug development pipeline, including targeted therapies and associated biomarker tests that can select which patients are most likely to respond, and immunotherapies that harness the body's immune system to destroy cancer cells. Compared with standard chemotherapies, these new cancer therapies may demonstrate evidence of benefit and clearer distinctions between efficacy and toxicity at an earlier stage of development. However, there is a concern that the traditional processes for cancer drug development, evaluation, and regulatory approval could impede or delay the use of these promising cancer treatments in clinical practice. This has led to a number of effortsâ€"by patient advocates, the pharmaceutical industry, and the Food and Drug Administration (FDA)â€"to accelerate the review of promising new cancer therapies, especially for cancers that currently lack effective treatments. However, generating the necessary data to confirm safety and efficacy during expedited drug development programs can present a unique set of challenges and opportunities. To explore this new landscape in cancer drug development, the National Academies of Sciences, Engineering, and Medicine developed a workshop held in December 2016. This workshop convened cancer researchers, patient advocates, and representatives from industry, academia, and government to discuss challenges with traditional approaches to drug development, opportunities to improve the efficiency of drug development, and strategies to enhance the information available about a cancer therapy throughout its life cycle in order to improve its use in clinical practice. This publication summarizes the presentations and discussions from the workshop.
Though overall cancer incidence and mortality have continued to decline in recent years, cancer continues to devastate the lives of far too many Americans. In 2009 alone, 1.5 million American men, women, and children were diagnosed with cancer, and 562,000 died from the disease. There is a growing body of evidence linking environmental exposures to cancer. The Pres. Cancer Panel dedicated its 2008¿2009 activities to examining the impact of environmental factors on cancer risk. The Panel considered industrial, occupational, and agricultural exposures as well as exposures related to medical practice, military activities, modern lifestyles, and natural sources. This report presents the Panel¿s recommend. to mitigate or eliminate these barriers. Illus.
Genetic alterations in cancer, in addition to being the fundamental drivers of tumorigenesis, can give rise to a variety of metabolic adaptations that allow cancer cells to survive and proliferate in diverse tumor microenvironments. This metabolic flexibility is different from normal cellular metabolic processes and leads to heterogeneity in cancer metabolism within the same cancer type or even within the same tumor. In this book, we delve into the complexity and diversity of cancer metabolism, and highlight how understanding the heterogeneity of cancer metabolism is fundamental to the development of effective metabolism-based therapeutic strategies. Deciphering how cancer cells utilize various nutrient resources will enable clinicians and researchers to pair specific chemotherapeutic agents with patients who are most likely to respond with positive outcomes, allowing for more cost-effective and personalized cancer therapeutic strategies.
Though cancer was once considered to be a problem primarily in wealthy nations, low- and middle-income countries now bear a majority share of the global cancer burden, and cancer often surpasses the burden of infectious diseases in these countries. Effective low-cost cancer control options are available for some malignancies, with the World Health Organization estimating that these interventions could facilitate the prevention of approximately one-third of cancer deaths worldwide. Effective cancer treatment approaches are also available and can reduce the morbidity and mortality due to cancer in low-resource areas. But these interventions remain inaccessible for many people in the world, especially those residing in low-resource communities that are characterized by a lack of fundsâ€"on an individual or a societal basisâ€"to cover health infrastructure and care costs. As a result, worse outcomes for patients with cancer are more common in low- and middle-income countries compared with high-income countries. Few guidelines and strategies for cancer control consider the appropriateness and feasibility of interventions in low-resource settings, and this may undermine the effectiveness of care. Recognizing the challenges of providing cancer care in resource constrained settings, the National Academies of Sciences, Engineering, and Medicine developed a two- workshop series examining cancer care in low-resource communities, building on prior work of the National Academies. The first workshop, held in October 2015, focused on cancer prevention and early detection. The second workshop was held in November 2016, and focused on cancer treatment, palliative care, and survivorship care in low-resource areas. This publication summarizes the presentations and discussions of this workshop.
In our society's aggressive pursuit of cures for cancer, we have neglected symptom control and comfort care. Less than one percent of the National Cancer Institute's budget is spent on any aspect of palliative care research or education, despite the half million people who die of cancer each year and the larger number living with cancer and its symptoms. Improving Palliative Care for Cancer examines the barriersâ€"scientific, policy, and socialâ€"that keep those in need from getting good palliative care. It goes on to recommend public- and private-sector actions that would lead to the development of more effective palliative interventions; better information about currently used interventions; and greater knowledge about, and access to, palliative care for all those with cancer who would benefit from it.
To explore the role of the National Institutes of Health (NIH) in innovative drug development and its impact on patient access, the Board on Health Care Services and the Board on Health Sciences Policy of the National Academies jointly hosted a public workshop on July 24â€"25, 2019, in Washington, DC. Workshop speakers and participants discussed the ways in which federal investments in biomedical research are translated into innovative therapies and considered approaches to ensure that the public has affordable access to the resulting new drugs. This publication summarizes the presentations and discussions from the workshop.
Descriptions of summer research programs: The AIM REU: Individual projects with a common theme by D. W. Farmer The Applied Mathematical Sciences Summer Institute by E. T. Camacho and S. A. Wirkus Promoting research and minority participantion via undergraduate research in the mathematical sciences. MTBI/SUMS-Arizona State University by C. Castillo-Chavez, C. Castillo-Garsow, G. Chowell, D. Murillo, and M. Pshaenich Summer mathematics research experience for undergraduates (REU) at Brigham Young University by M. Dorff Introducing undergraduates for underrepresented minorities to mathematical research: The CSU Channel Islands/California Lutheran University REU, 2004-2006 by C. Wyels The REUT and NREUP programs at California State University, Chico by C. M. Gallagher and T. W. Mattman Undergraduate research at Canisius. Geometry and physics on graphs, summer 2006 by S. Prassidis The NSF REU at Central Michigan University by S. Narayan and K. Smith Claremont Colleges REU, 2005-07 by J. Hoste The first summer undergraduate research program at Clayton State University by A. Lanz Clemson REU in computational number theory and combinatorics by N. Calkin and K. James Research with pre-mathematicians by C. R. Johnson Traditional roots, new beginnings: Transitions in undergraduate research in mathematics at ETSU by A. P. Godbole Undergraduate research in mathematics at Grand Valley State University by S. Schlicker The Hope College REU program by T. Pennings The REU experience at Iowa State University by L. Hogben Lafayette College's REU by G. Gordon LSU REU: Graphs, knots, & Dessins in topology, number theory & geometry by N. W. Stoltzfus, R. V. Perlis, and J. W. Hoffman Mount Holyoke College mathematics summer research institute by M. M. Robinson The director's summer program at the NSA by T. White REU in mathematical biology at Penn State Erie, The Behrend College by J. P. Previte, M. A. Rutter, and S. A. Stevens The Rice University Summer Institute of Statistics (RUSIS) by J. Rojo The Rose-Hulman REU in mathematics by K. Bryan The REU program at DIMACS/Rutgers University by B. J. Latka and F. S. Roberts The SUNY Potsdam-Clarkson University REU program by J. Foisy The Trinity University research experiences for undergraduates in mathematics program by S. Chapman Undergraduate research in mathematics at the University of Akron by J. D. Adler The Duluth undergraduate research program 1977-2006 by J. A. Gallian Promoting undergraduate research in mathematics at the University of Nebraska-Lincoln by J. L. Walker, W. Ledder, R. Rebarber, and G. Woodward REU site: Algorithmic combinatorics on words by F. Blanchet-Sadri Promoting undergraduate research by T. Aktosun Research experiences for undergraduates inverse problems for electrical networks by J. A. Morrow Valparaiso experiences in research for undergraduates in mathematics by R. Gillman and Z. Szaniszlo Wabash Summer Institute in Algebra (WSIA) by M. Axtell, J. D. Phillips, and W. Turner THe SMALL program at Williams College by C. E. Silva and F. Morgan Industrial mathematics and statistics research for undergraduates at WPI by A. C. Heinricher and S. L. Weekes Descriptions of summer enrichment programs: Twelve years of summer program for women in mathematics-What works and why? by M. M. Gupta Research experience for undergraduates in numerical analysis and scientific computing: An international program by G. Fairweather and B. M. Moskal Articles: The Long-Term Undergraduate Research (LURE) model by S. S. Adams, J. A. Davis, N. Eugene, K. Hoke, S. Narayan, and K. Smith Research with students from underrepresented groups by R. Ashley, A. Ayela-Uwangue, F. Cabrera, C. Callesano, and D. A. Narayan Research classes at Gettysburg College by B. Bajnok Research in industrial projects for students: A unique undergraduate experience by S. Beggs What students say about their REU experience by F. Connolly and J. A. Gallian Diversity issues in undergraduate research by R. Cortez, D. Davenport, H
