Oncology

Cancer patients relieved that they can get insurance coverage because of the new health care law may be disappointed to learn that some the nation's best cancer hospitals are off-limits.

Dramatic progress has been made in reducing colon cancer incidence and death rates in the U.S., but concerns remain about striking racial and socio-economic disparities, according to new national statistics on colorectal cancer.

U.S. patients not only are spending too much on medical treatments, there are still too many ways dollar-driven health care causes harm, according to a top official with the American Cancer Society.

A more individualized view of what drives the onset of non-small cell lung cancer is raising treatment hopes as new therapies emerge and are under development, said Leora Horn, MD, MSc, of the Vanderbilt-Ingram Cancer Center, who presented an overview Friday at the National Comprehensive Cancer Network's 19th Annual Conference: Advancing the Standard of Cancer Care, held in Hollywood, Florida.

The title of the talk by Celestia S. Higano, MD, New Developments in the Treatment of Hormone Refractory Prostate Cancer, was notable in the use of a term that has been replaced over the past decade with castration resistant. It was a change that Dr Higano, of the Fred Hutchison Cancer Research Center in Seattle, Washington, admits she did not support at the time.

Advances in treating multiple myeloma have transformed the field over the past decade, giving clinicians more effective therapy options for newly diagnosed patients who are candidates for stem cell transplant and those who are not.

Friday's session of the National Comprehensive Cancer Network's 19th Annual Conference: Advancing the Standard of Cancer Care, featured a well-attended roundtable, The Affordable Care Act: Where Are We Now? Moderated by Clifford Goodman, PhD, of The Lewin Group, the wide-ranging discussion featured panelists Christian G. Downs, JD, MHA, Association of Community Cancer Centers; Liz Fowler, PhD, JD, Johnson & Johnson; Michael Kolodziej, MD, Aetna; Lee H. Newcomer, MD, MHA, UnitedHealthcare; Mohammed S. Ogaily, MD, Henry Ford Health System; W. Thomas Purcell, MD, MBA, University of Colorado Cancer Center; and John C. Winkelmann, MD, Councillor, American Society of Hematology, Oncology Hematology Care, Inc.

Fox Chase Cancer Center's Crystal Denlinger, MD, presented Optimal Post-Treatment Surveillance: Is More Really Better?, addressing a topic that challenges not only patients and their physicians, but also payers as the nation moves toward a healthcare system defined by the maxim "better quality at a lower cost."

In his talk, Melanoma Guideline Update: New Agents and Opportunities for Treatment, John A. Thompson, MD, of the Fred Hutchinson Cancer Research Center in Seattle, Washington, first showed the preferred list of treatments for advanced or metastatic melanoma: ipilimumab, vemurafenib, dabrafenib, dabrafenib plus trametinib, high-dose interleukin-2, and the drugs-to-come in the category: clinical trials.

Who should receive genetic counseling and screening for colorectal cancer (CRC)? And how early should annual colonoscopies happen once those at risk are identified? These are important questions with equally important and complex answers.

Life-saving therapies that halt cancer can take a toll on the skeletal system, leaving survivors with bone loss or more serious injuries such as broken wrists, ribs, or hips. Watchful attention, screening, and therapy are needed to prevent these outcomes.

The National Comprehensive Cancer Network (NCCN) has revised its medical guidelines to expand Lynch syndrome screening. Lynch syndrome is the most common cause of hereditary colon cancer in adults.

Genetic counseling-including testing and risk assessment-is one of the most rapidly growing areas of oncology and has become the standard of care for patients with a personal and family history of breast, ovary, or colon cancer.

Ed Pezalla, MD, MPH, national medical director for pharmacy policy and strategy, office of the CMO, Aetna, says payers and health plans are preparing for patient-centered care by utilizing digital tools. Everything from virtual people to cost search tools are used to assist employed and general patient populations. Dr Pezalla says many of these tools will also be used in the public and private health insurance exchanges to help people make decisions as they purchase health plans.

Dennis Falci, MBA, director, US managed markets training, sales training and leadership development, Sanofi-Aventis SA, says it's no secret-Health Insurance Exchanges are a hot topic in health news.

A 4-year study assessing the impact of early outpatient palliative care versus standard oncology care in a variety of advanced cancers found promising results. The researchers observed that when palliative care teams collaborated earlier in the course of illness, it improved patients' quality of life and satisfaction.

Belgian cancer testing group MDxHealth recently announced an agreement with US health organization Prime Health Services to extend access to its prostate cancer test to 144 million insured people. MDxHealth suggests that collaboration will permit faster reimbursement for cancer testing.

How Can Molecular Diagnostic Companies Show Value if Insurers Won't Pay?

Researchers from the Johns Hopkins Sidney Kimmel Comprehensive Cancer Center in Baltimore suggest that controlling the costs to treat cancer without increasing risk to patients requires a collaborative approach.

The malady of rising medical costs is acute, especially in the field of oncology. As populations age, new cancer cases are expected to reach 21.4 million in 2030, while treatment costs are projected to increase 40 percent by 2020.

Oncology clinical pathways have helped health plans deliver quality care while keeping an eye on costs. The lack of standardization in pathways can be cumbersome on a busy oncology practice. If Medicare adopts a pathways model, it could offer a framework for broader use.