OBR Daily Commentary

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At AMA Leadership Meeting, ASCO Advocates Will Urge Action on Cancer Policy Priorities

(ASCO in Action) June 9, 2018 - From June 9 – 13, ASCO’s delegates will participate in the American Medical Association’s (AMA) Annual Meeting of the House of Delegates (HOD).

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Thomas Marsland, MD (Posted: June 22, 2018)

quotesGee, I recognize a few of those names.....As you probably can guess from my responses, I tend to binge read my OBR reports....(binge my House of Card series too....). Anyway, some comments on the AMA meeting. AMA as always is a lot of fun. The house of delegates is so diverse with old white dudes like myself mixed with energetic ladies (go Barb...rock star), individuals of all political sides, young docs starting their journey, folks of all racial backgrounds, and people of all sexual identities. We get together and argue the profound and esoteric. The debates are always respectful and we all leave as friends. This year, gun control, opioid issues, physician assistance in dying were hotly debated on the floor. In addition there was the usual alphabet soup of resolutions on MOC, MACRA, and payment resolutions. Our ASCO delegation (EB, RP, SL, KN, MF, ES and yours truly) proposed 5 resolutions. Two were reaffirmed (cancer survivorship care plan, alcohol and cancer). The three in the article were accepted with some amendments. All in all, we were happy with the results. As you know 340B needs a lot of work, and PBMs need some over site too. The electronic transfer of prescribed opioids will make life better for patients and docs. With all this busy agenda we even had time to hit Buddy Guy's House of Blues....(thanks Ray...). So if anyone ever asks what AMA does, the answer is everything. They are a strong voice advocating for our patients and us..... quotes

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Opinions: There’s A Miraculous Chance To Cure Cancer. But We’ll Have To Pay For It.

(Washington Post) June 5, 2018 - New treatments are expensive and experimental, but they sure seem worth it.

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Thomas Marsland, MD (Posted: June 06, 2018)

quotesSo back to the grind stone... in clinic today after and exciting ASCO AM. But as this article suggest there is no free lunch. All of these great exciting life prolonging therapies come at a great cost. The theme of the meeting was personalized care and certainly this offers opportunities to help control the costs but even there with the new (FDA approved) next generation testing we still are often left with many expensive choices for a given patient with really no knowledge of success rates. But there is I think hope on the horizon. I had the chance to meet with a group that is developing highly sophisticated computer programs that can actually predict which of the many mutations noted by the ngs testing will really result in a therapy with a high success rate. (and the flip side avoid those that don't.) The data bases are quite sophisticated and developed from true clinical trial materials. When these types of programs become universally available we really will have the idea of "personalized" therapy come to fruition. Then hopefully these costly treatments will be given to those who truly will benefit. quotes

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Most Oncologists Have Discussed Medical Marijuana With Patients

(ASCO) May 10, 2018 - Survey shows patients with cancer initiate conversations about medical marijuana, but knowledge gaps persist.

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Thomas Marsland, MD (Posted: May 17, 2018)

quotesBeing still relatively new to the west coast I can comment that the topic of medical marijuana has certainly come up more here than in Florida (although it did come up for discussion there also). I second the comment about the lack of control data. There really is a dearth of clinical studies to support widespread use. With that said there are great anecdotal stories to support benefit from its use. One other problem is the quality control from the production and distribution. How much of the active cannabinoid are present and in what proportions? I did have the opportunity to attend a pain conference last year and there was a presentation on medical marijuana. Indeed there are a number of cannabinoid receptors within the CNS and it certainly would be interesting to see good scientific research looking at efficacy correlated with markers and outcomes. Hopefully this will come one day but until then we will just have to continue to rely on the anecdotal information. It clearly works for some patients. quotes

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