CANCER: Many Cancer Patients Shortchanged on Treatment
Too many Americans with cancer are not receiving the best therapy, in part because there are no widespread guidelines for cancer care, says a new report issued today by the National Cancer Policy Board. "We think that there are individuals who do not receive cancer care that is of proven value today. We have reason to believe it is a substantial number of people," said Joseph Simone, vice chair of the board, which was created by the Institute of Medicine and the National Research Council (Manning, USA Today, 4/7). Simone added, "For many Americans with cancer, however, there is a wide gulf between what could be construed as the ideal and the reality of their experience with cancer care." He noted that there is little data available "on the quality of care for most cancer centers." What cancer statistics that are available, the report found, tend to focus on incidence and survival rates, but "shed little light on treatments selected and whether a patient received inappropriate care" (Lane, Newsday, 4/7).
For example, the authors found that post-surgical survival rates for some types of cancer can be two to three times higher at high-volume cancer centers, but there "are no data on whether most cancer patients should go to a high-volume cancer center instead of a smaller hospital near home" (AP/Richmond Times-Dispatch, 4/7). Other problems identified included "the underuse of therapies such as radiation and chemotherapy after surgery, inadequate patient counseling and treatment options, poor reporting of lab studies and inadequate biopsies." The report called for the development of guidelines for the "prevention, diagnosis and treatment of cancer and for pain management at the end of life." Simone also emphasized that outcomes must be measured (USA Today, 4/7). Until there is a system to help patients optimize their care, the report recommends that cancer patients seek out oncologists who specialize in their form of cancer and its stage of development. The report also calls on physicians to discuss treatment options with patients and for a single doctor to coordinate care among specialists. The AP/New York Times reports that the board plans to collaborate with other agencies later this year to outline solutions (4/7).
In an effort to ensure that all private health insurers provide standard cancer screening to enrollees, Reps. Carolyn Maloney (D- NY) and Sue Kelly (R-NY) recently introduced the Cancer Screening Coverage Act of 1999. Co-authored by the American Cancer Society, the bill would require private insurers to cover routine cancer screening for breast, cervical, colo-rectal and prostate cancers. ACS President Charles McDonald said, "Currently, there are no federal laws requiring private health plans to cover early detection and screening costs for any type of cancer. This must change. Screening and early detection save lives and save medical dollars" (ACS release, 4/6). The legislative push comes as a report issued yesterday found that the U.S. cancer rate in the early 1990s was "41% higher for men than for women." The rate is higher for men than for women because "[t]here are more cases of prostate cancer than of breast cancer," the second leading causes of cancer deaths for each sex, respectively, after lung cancer, and because more men than women smoke. Among men, the cancer rate was 21% higher among black men, who have a higher rate of prostate cancer, than white men. White women were more likely than black women to get cancer -- largely because they have more risk factors for breast cancer -- but black women were more likely to die from cancer (Ritter, Chicago Sun-Times, 4/7).
EntreMed Inc. announced yesterday that it will collaborate with the National Cancer Institute to conduct joint research on an anti-cancer compound, 2-methoxyestradiol, a metabolite of estrogen. The Rockville, MD-based firm said the four-year Cooperative Research and Development Agreement would spur research on the compound, which early studies show kills rapidly growing cells by cutting off their blood supply (Baltimore Sun, 4/7).