OBR Daily Commentary

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Cancer Risk Rises as Patients Wait for Diagnostic Testing

(Penn Medicine) Apr 10, 2018 - Literature review finds increased risk of cancer, late stage cancer, and mortality with increasing wait time between a positive screening and start of diagnostic testing.

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Thomas Marsland, MD (Posted: April 11, 2018)

quotes This article really hit home with me. As I have transitioned through my career I've had to deal with many changes in the healthcare system. But the one that pisses me off more than any is the delays in diagnosis and treatments in today's health delivery system. I frequently tell my patients that no cancer grows so fast the 1-2 weeks are critical. BUT in today's world that one to two weeks can easily become six to eight weeks from my ordering studies or treatments till the patient actually receives the service. The bureaucratic hurdles that we providers and patients have to jump through to get the appropriate studies or therapies is criminal. I recently read COA is on the hill maybe something good may come in this era of less (sic) regulation..... quotes

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Oncologists Disagree On Use Of Value To Guide Cancer Treatments

(Stanford Medicine/Scope blog) Apr 4, 2018 - A new study found that oncologists have divergent views on how to use “value” to guide cancer treatment recommendations.

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

quotesSo again the "value" question....I share my dear friend Ted Okon's comments about sample size of this study. 31 oncologists in a nation of over 5000 medical oncologist is hardly representative. With that said, value is always problematic. Value to whom?? The patient, the payer, the employer, the provider??? Plus the cost is a constantly changing target. Drugs that were considered horribly expensive may be considered a deal when viewed in light of $500,000 Car-T cell therapy. Organized medicine such as NCCN, ASCO and COA have all weighed in with some suggestions on value. Clearly clinical outcomes, quality of life, and cost are all important in the decision process. I always at least briefly discuss cost with the patient and I suspect most oncologist do. Anyway I suspect this issue will be with us for a long time as I don't see pricing coming down soon. quotes

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Without Context Or Cushion, Do Online Medical Results Make Sense?

(Washington Post/Kaiser Health News) Mar 27, 2018 - Patient portals often provide information without explanation and context.

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Thomas Marsland, MD (Posted: March 28, 2018)

quotesThis is a good review. The article sums up all the advantages and disadvantages of patient access to clinical data. Early, easy, transparent access are important. The negatives are clearly pointed out. Confusion about path, lab and imaging reports often in very technical wording can be very anxiety provoking for patients. Access to someone who can knowledgeably discuss the finding is critical. This however is often problematic for many reasons. In addition when results are particularly bad I personally do not like having phone discussions; there are somethings that really do need a face to face encounter. This again causes delays and anxiety. As we move through these newer models hopefully these issues will be addressed quotes

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Meet the Editorial Board

Community Oncology
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Dean Gesme, MD

FACP FACPE FASCO President, Minnesota Oncology...

Breast Cancer
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Debu Tripathy, MD

Professor and Chair, Department of Breast Medical Oncol...

Lung Cancer
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H. Jack West, MD

Medical Director, Thoracic Oncology Program, Swedish Ca...

Gastrointestinal Cancers
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Howard S. Hochster, MD

Distinguished Professor of Medicine, Rutgers Robert Woo...

Radiation Oncology
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Howard Sandler, MD, MS, FASTRO

Ronald H. Bloom Chair in Cancer Therapeutics
Pr...

Community Oncology
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Jeff Patton, M.D.

CEO Tennessee Oncology...

Precision Medicine Section Editor
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Jennifer Levin Carter, MD, MPH

Chief Medical Officer and Founder, N-of-One...

Financial Sector
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Michael G. King Jr.

Managing Director and Senior Biotechnology Analyst...

Gastrointestinal Cancers
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Richard Goldberg, MD

Director WVU Cancer Institute Director of Cancer Signa...

Editor-In-Chief
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Robert A. Figlin, MD., FACP

Professor and Director, Division of Hematology Oncology...

Health Policy
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Ted Okon

Executive Director Community Oncology Alliance...

Community Oncology
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Thomas Marsland, MD

Vice President Integrated Community Oncology Network ...

Community Oncology
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William Harwin MD

Florida Cancer Specialists President and Managing Part...

Health Policy
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William McGivney, PhD

National Health Policy Expert...

Payer
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Winston Wong, PharmD

President, W-Squared Group...