ASCO (American Society for Clinical Oncology) top 5 evidence-based recommendations for 2013. Two are very relevant for me, one less so, two not relevant.
ASCO’s 2012 top 5 list. Two might sometime apply to me, two others are about earlier stages of breast cancer. An excerpt, from the one about when to stop chemotherapy:
Smith and Hillner15 suggested the simple rule that patients must be well enough to walk unaided into the clinic to receive chemotherapy. When oncology practitioners receive direct feedback about overuse and misuse of chemotherapy in the end-of-life setting, they quickly improve practice, with chemotherapy in the last 14 days of life falling from 50% to less than 20% in one quarter.35 Stopping anticancer treatment should always be accompanied by appropriate palliative and supportive care and referral to hospice, and the best practice would be continuation of palliative care started concurrently at the time of diagnosis for “any patient with metastatic cancer and/or high symptom burden.”
Interesting that so much of these latest recommendations center around breast cancer rather than other cancers. (Lung & prostate are also mentioned often, but not much else.) Reasons might include: so many people have it; it’s so often curable; treatment options are changing fast due to new drugs and lots of trials; high consumer pressure to improve treatment side-effects & efficacy (the effect of having mostly healthy patients, as in birth); more backward than other realms of cancer care?
3 thoughts on “Best practices in cancer treatment, 2012 & 2013”
Howard Brody proposed the “top five” for every specialty three years ago, and then Chris Cassel, when she was prez of the ABIM foundation, started “Choose Wisely,” which is aimed (also) at patients. Brilliant moves!
Following the NCCN protocols should have eliminated the need for the lists, but…. science travels upstream against habit.
Ellen,thank you so much for documenting all of your journey. I wish I was closer to be there with you sometimes, to give you a hugs and hold your hand. I know you are in good hands! Thinking of you, wishing you the best. Deep breaths! Love you
Hey Ellen. That’s some brain you have. That you can process all this information is quite astounding. And brave.
There is a whole beautiful world of people holding you in heart and mind throughout the day. Count me in that circle, too. One never knows where the next miracle is going to come from….or when. And also how somehow there is some pretty amazing grace that enables us to plow thru life, hold on, thrive, collapse, float again,
Let go, sing, rest , find peace.
I hope all of this comes your way.
Blessings on you and love.