This week brings some excellent reading about why and how to educate patients so they can help make better decisions about their own care.

What happens when patients get to read their own medical records? The Oct. 2^nd  Annals of Internal Medicine published two editorials and results of a quasi-experimental trial of 100 primary care doctors who voluntarily provided 13,500 patient volunteers with access to their doctors’ notes for a year. To read details, read further, but some results in brief :

• patients loved being able to read their visit report, and 75% said they were more likely to take medicines as directed;
• doctors didn’t see increased patient anxiety, visits, or time demands.

Meanwhile, an expert panel of “thought leaders” gathered by the Institute of Medicine released an in-depth report about helping patients make better care decisions by giving them the best available medical evidence. The results, summarized in an online JAMA article  and discussed by Dr. Robert Miller for ASCO Connections, included:

• 8 in 10 patients want their provider to listen, but only 6 in 10 say it happens;
• 8 in 10 want to hear the full truth about their diagnosis;
• fewer than half of patients say their provider asks about their goals and concerns. Read the rest of this entry »

Oncologists have joined eight other physician specialty organizations in the Choosing Wisely® campaign with a list of the Top Five Cancer-Related Tests, Procedures, and Treatments That Many Patients Do Not Need.

Choosing Wisely asked each of the specialist groups to come up with a list of five things doctors and patients should question in order to improve evidence-based care, avoid tests or treatments that don’t help, and reduce the burden of health care costs. Here are the Top Five lists from the other groups.

The American Society of Clinical Oncology  built the Top Five List for Oncology, based on work that ASCO’s Cost of Care Task Force has been doing for several years to identify diagnostic tests or treatments that are commonly ordered, expensive, and of unproven value.

While the Top Five list is based on evidence for effective cancer care, its recommendations are not written in stone. They are guidelines for patients, families, and doctors to begin a conversation about tests and treatments and costs in order to make good decisions about the best care for each individual.

Briefly the Top Five list recommends

1. Stop active cancer treatment when patients are too ill to benefit, aren’t eligible for a clinical trial, previous treatments haven’t worked, and there are no more standard treatment options.
2. Don’t use advanced imaging tests (CT, PET, bone scans) for early prostate cancer which has a low risk of spreading.
3. Don’t use similar imaging tests for early breast cancer that has a low risk of spreading.
4. Don’t use PET, CT, bone scans or biomarkers to follow-up breast cancer patients without symptoms after treatment intended to cure them.
5. Don’t give medicines to stimulate white cells in patients with a low risk of developing low counts with fever.

More specifically the Top Five for Oncology published ahead of print in the Journal of Clinical Oncology April 3  are: Read the rest of this entry »

Moscone Center

We’re getting ready for the 2012 Gastrointestinal Cancers Symposium next week at the Moscone Center in San Francisco.

Kim Ryan, Nancy Roach, and I will be there checking out the latest colon and rectal cancer prevention and treatment research and talking with leaders in the colorectal cancer field.

Colon and rectal cancer is featured on Saturday, January 21, but we’ll also be looking at research results for cancers in the upper digestive tract, liver, and pancreas on Thursday and Friday, visiting exhibits, and meeting with members of the Fight Colorectal Cancer Medical Advisory Board.

• Watch for our reports from the Symposium on the Fight Colorectal Cancer Research and Treatment News.
• Follow our tweets on Twitter @FightCRC.
• In February, join us and Dr. Dan Sargent from the Mayo Clinic for a Report from the 2012 GI Cancers Symposium webinar. Read the rest of this entry »

Soon after diagnosing a patient with advanced cancer, a doctor should begin discussing options for palliative care—the management of symptoms—according to a new policy statement from the American Society of Clinical Oncology (ASCO).  ASCO also released a new, free guide called Advanced Cancer Care Planning for patients to help initiate those conversations.

Read the rest of this entry »

Colondar Models Erika and Cathy

When colorectal cancer spreads to other parts of the body, young people under 50 who get chemotherapy benefit as much as those who are older.

With drug combinations, there is no difference between those under 50 and those who are 50 and older in responding to chemotherapy, how long it takes before cancer gets worse, or in survival time. Read the rest of this entry »