OBR Daily Commentary - Breast

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First Opinion: Opioid Stigma Is Keeping Many Cancer Patients From Getting The Pain Control They Need

(STAT) July 6, 2018 - History is repeating itself. Twenty years ago, a pain management crisis existed. As many as 70 percent of cancer patients in treatment at that time, or in end-of-life care, experienced unalleviated pain.

Richard Reililng (Posted: July 07, 2018)

quotesCan't imagine that anyone would find this a surprise. Patients needing pain relief will suffer because of the weak personalities that take narcotics unnecessarily and for less than appropriate reasons. We have tried to fight this in many arenas including the AMA, but the 'bleeding hearts' win the field all the time. Let's hope that our cancer patients get what they need, when they need it, and in the quantity that makes their lives more tolerable in view of their disease processes. 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.

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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Women With Breast Cancer Delay Care When Faced With High Deductibles

(New York Times) May 4, 2018 - When people must pay thousands of dollars before their insurance kicks in, studies show, they postpone necessary tests and treatments.

William McGivney, PhD (Posted: May 11, 2018)

quotesPayer cost-sharing requirements for patients are an anathema, abomination and disgrace all rolled into one. The current story reiterates, yet again, the issue of seriously ill patients delaying or forgoing needed treatment because of cost-sharing terms in their insurance plan. Cost-sharing is such a nice, euphemistic way to describe what is the abhorrence of this insurer patient-gouging strategy. Indeed, as I am wont to ask, is there still really health insurance that protects seriously ill patients from catastrophic events? If there is, it is “slip, slip sliding away” as commercial payer revenue keeps rising. The solution is legislation that would eliminate on the private payer side and public payer side cost-sharing arrangements such as deductibles, co-insurance, and co-pays for those diagnosed with and battling serious life-threatening illnesses. A list of such illnesses should be delineated that deserve such protection to assure patient access to necessary therapies. I developed the Terminal Illness program that Aetna instituted in 1992. To establish a solid patient-oriented and humane piece of legislation is a relatively easy “to do”. Then, we can see who truly stands in support of patients! We should move forward as we seek to serve and treat seriously ill patients in need! quotes

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Meet the Editorial Board

Prostate Cancer
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Tomasz M. Beer, MD, FACP

Professor of Medicine, Division of Hematology/Medical O...

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...