**URGENT**: Call your Senators RIGHT NOW to save the Department of Defense #BreastCancer Research Program (DOD BCRP). Senator John McCain (R-AZ) is offering an amendment to the National Defense Authorization Act (NDAA) on the Senate floor TODAY which would do irreparable damage to the Department of Defense Breast Cancer Research Program. Please call your Senators NOW and give them the following message: 1. Please vote against the McCain Amendment #1482 to the NDAA 2. This amendment would do irreparable damage to the DOD BCRP – one of the most efficient, innovative and successful government programs. 3. As a breast cancer survivor/activist, the DOD BCRP is incredibly important to me and has produced results which have directly benefited survivors like me, including those who have served and currently serve our country in the armed forces. Find your Senators here: http://www.senate.gov/senators/contact/
OR use this Link: http://www.capwiz.com/aacr/dbq/officials/
"We just returned from the American Medical Association (AMA) House of Delegates (HOD) gathering. Once again, it proved to be extensive, revealing, and eventful. ASCO’s Dr. Barbara McAneny was reelected to the AMA Board of Trustees, where she will now serve as the Chair. Dr. Chris Nunnink and I serve as ASCO’s delegates. We also welcomed the addition of Dr. Thomas Marsland to the House as an alternate delegate.
As usual, a number of issues were discussed. The general concerns that seem to garner the most attention focused on the Maintenance of Certification (MOC) and the restructuring of how to monitor AMA general advocacy issues. In addition, funding for critical access hospitals, discussions about physicians given special licenses without having to complete a residency program (Missouri enables physicians to go into practice after medical school without further training to compensate for the lack of residency slots), scope of practice, screening for lung cancer, and ensuring the access and prompt care of United States veterans all took center stage.
The AMA heard very clearly the concerns voiced not only by ASCO members but also by several other societies in regards to the MOC. The AMA has taken a stance that while we cannot be against measuring competence, the MOC as it is proposed does not meet the needs of physicians. It is clear that more has to be learned about this program’s ramifications. Like ASCO, the AMA is very sensitive to the MOC, and this will unquestionably be revisited during the interim meeting in November."
Susan Zager's insight:
According to Balaban, "the defeat of legislative efforts to permanently fix the Medicare Sustained Growth Rate (SGR) policy by Congress was understandably unnerving. This led to discussions that, although aired on the floor, were mostly carried out in either hallways or closed Board discussions. It seemed to me that this event has the possibility of creating a more tenacious and solidified societal stance. It was more than stunning that Congress would not pass the proposed SGR fix that appeared to have both bipartisan and bicameral approval. It clearly underscored the bipartisan antics that are so pervasive in our Congress. It is far from clear as to what more could have been done to assure this fix. There is little question that unwavering professional/political pressure will need to continue post-election. One voice, one solidified opinion from those representing this nation’s health care will have to remain and become stronger. This demonstrates even more reason to join the AMA and take part in the grass-root process.
"WASHINGTON, DC – Bipartisan legislation was introduced by U.S. Representatives Bill Posey (R-FL) and Debbie Wasserman Schultz (D-FL) to help aid breast cancer patients in their recovery following surgical procedures.
There is the risk of infection following breast cancer surgery due to the placement of post-surgical drains. Medicare currently covers the cost of post-surgical water resistant coverings in some circumstances, but not breast cancer surgery.
The Post-Mastectomy Infection Reduction Actauthorizes Medicare to also extend this coverage for breast cancer patients when it is determined to be medically necessary to reduce the risk of infection.
“If a patient develops a surgical site infection and has to be readmitted to the hospital, not only is this bad for the patient but it would likely cost thousands of additional dollars,” said Rep. Posey. “The small cost of water resistant coverings in cases where the physician believes they are medically necessary to prevent infection will save lives and money by reducing the risk of infection. As a cancer survivor myself I can understand the struggle that so many with cancer and other diseases go through on a daily basis.”
"Connect with leaders in cancer treatment, advocacy, and policy to build a new paradigm in cancer care. Join host Doug Ulman, cancer survivor and President/CEO of the LIVESTRONG Foundation, featured presenter Dr. Clifford A. Hudis, President of the American Society of Clinical Oncology (ASCO), and other distinguished speakers for a two-day event in Washington, D.C., May 8–9, 2014."
Susan Zager's insight:
"Building on the emerging paradigm of personalized medicine in oncology, Rev 2014 will bring together leading clinicians, patients, patient advocates, business leaders, policy makers, and other prominent leaders in the cancer community, joined by a unifying mission—to improve the lives of people affected by cancer."
"The Fiscal Year 2015 Appropriations process marks a period of crucial decisions on how to fund America’s top priorities, including combating deadly and disabling disease. The funding allocated to the National Institutes of Health (NIH), coupled with private-sector investment, saves young lives; empowers those with disabilities to maintain productive, fulfilling lives; and is an underappreciated force behind local and national economic growth, our national security and America’s status as a global economic and innovation leader. Appropriators can act this year to restore NIH to a growth path consistent with the significance of medical progress to Americans and the level of scientific opportunity.
The NIH budget is lower today than it was in 2012. How have we fallen so far behind? Is it no longer important to conquer diseases that kill children, to do more for wounded warriors or to stop devastating conditions like Alzheimer’s and cancer?
Congress needs to do something NOW to make up for the massive gap between the funding needed to reignite medical progress and the minimal funding allocated to this priority over the last several years. Will funding for NIH receive a real funding boost in FY15 or will medical progress continue to lose ground?
Susan Zager's insight:
Tell Congress to treat medical progress as a priority, and boost funding for 2015. This is an easy to fill out program to write your representatives.
This year’s House of Representatives letter in support of level funding for the Department of Defense (DOD) peer-reviewed Breast Cancer Research Program (BCRP) has begun circulating. Your immediate action is needed!
We need you and all members of your networks activated and contacting your Representatives to urge them to show their support for ending breast cancer by signing the letter. The deadline for signing is Noon, Monday, March 31!
Susan Zager's insight:
Please email your congressional representatives to support level funding for the DOD (Department of Defense) peer-reviewed research program (BCRP).
I urge you to show your support for ending breast cancer by signing the letter to Defense Appropriations Subcommittee Chairman Frelinghuysen and Ranking Member Visclosky calling for $120 million—level funding—for the DOD peer-reviewed Breast Cancer Research Program for FY 2015.
The action you are taking will let your Representatives know how important the DOD BCRP is to breast cancer research. If a Representative has questions you can’t answer, email the NBCC at: NationalActionNetwork@BreastCancerDeadline2020.org
If your Representative agrees to sign the letter, her/his staff should email one of the following staffers of the letter sponsors to make it happen:
Dante Cutrona in Representative Jim Gerlach's office or Jennifer Chandler in Representative Jim McGovern's office
Email the NBCC- NationalActionNetwork@BreastCancerDeadline2020.org
and let them know that your Representative has agreed to sign the letter or if you have any questions.
"Recently, a friend of mine sent me a message on Facebook, asking me why I hated the Susan G. Komen Foundation so much (I had been railing about Kohl's Pink Elephant in the Room campaign). I sent her a five-point, abridged version with my reasons, but I wanted to really write a well thought-out reason as to why I think Komen is the problem, not the solution.
Komen is allergic to reality.
Really? Oh really? Breast cancer is the pink elephant in the room, and let's not ignore it? Since when is breast cancer ever ignored? It's not the pink elephant in the room. It's the pink elephant on a rampage, mowing down innocents in the street. We have an entire month devoted to so-called breast cancer awareness. Every time I went into a retail store in the months of September and October, I was assaulted by crap with pink ribbons.
Breast cancer isn't being ignored. You know what's being ignored and the real elephant in the pink room (see below for more on this reference): metastatic breast cancer, aka Stage 4 breast cancer, which leads me to....
Komen has ignored those living with metastatic breast cancer disease.
According to Peggy Orenstein's April 25, 2013 article in The New York Times called "Our Feel Good War on Breast Cancer," she wrote:
Last October, for the first time, Komen featured a woman with Stage 4 disease in its awareness-month ads, but the wording carefully emphasized the positive: "Although, today, she has tumors in her bones, her liver and her lungs, Bridget still has hope." (Bridget died earlier this month.)"
Susan Zager's insight:
This article has so many important observations written by Lara Huffman (@getupswinging) why Komen is not based in reality ignoring those with stage IV. It brings up the stolen campaign from METAvivor observing the reality that metastatic breast cancer is the pink elephant in the room not Komen's over processed in your face cheery breast cancer that no one can get away from with all of their marketing. Lara reminds us of the great points in Peggy Orenstein''s article in The New York Times (April 25, 2013) called "Our Feel Good War on Breast Cancer", where Peggy spoke about the Komen ad picturing a woman ( Bridget) with stage IV breast cancer who had hope (sadly Bridget died), implying that no one is allowed to be angry if they have stage IV breast cancer or any stage.
Rachel Cheetham Moro, who died of metastatic breast cancer was the blogger who wrote Cancer Culture Chronicles. She had this to say about Komen and its campaign:
"How dare Komen so FALSELY suggest that a screening mammogram is all it takes to avoid metastatic breast cancer? How dare Komen so CRUELLY suggest that "not getting screened for breast cancer in time" would be THE reason and the FAULT of the person with metastatic disease who misses out on all the experiences and joyous events of a long and healthy life that so many others take for granted? How dare you, Komen?"
(The article has so many other great points that Lara examines why so many are anti-komen, as we recommend you read the whole piece.)
In the end Lara Huffman sums it up best: "To summarize, I'm not against Komen because of one thing or two things. It's more like a handful of things that have led me to know with all my heart and conviction that Susan G. Komen is the problem, not the solution. I believe Komen began with good intentions but has morphed into this pink ribbon behemoth. Women (and men) are dying from this disease every year, and we need to refocus (screw awareness -- WHO ISN'T AWARE OF BREAST CANCER?). They deserve better, much much better."
"Reuters Health) - Disparities between rich and poor in who survives major cancer surgeries may have more to do with the hospitals where they're treated than with individuals' wealth or lack of it, a new study suggests.
Researchers found that even the wealthiest patients at hospitals treating primarily poor communities tended to fare worse after major cancer surgeries than the poorest patients at hospitals treating primarily wealthy communities.
"We know people in the lower socioeconomic status have worse outcomes, but it's always harder to get at the underlying mechanism for those worse outcomes," Dr. Amir Ghaferi told Reuters Health.
Ghaferi is the study's senior author from the Center for Healthcare Outcomes and Policy at the University of Michigan in Ann Arbor.
Several studies have found that a person's risk of death after major cancer surgery is linked to economic status, Ghaferi and his colleagues write in JAMA Surgery.
Poor people who have part of their stomach removed because of cancer, for example, are 55 percent more likely to die than their richer counterparts, the researchers note.
Economic status is often an indicator of other factors, however. Those include a person's general health or the quality of the healthcare available in their community.
While a hospital's quality is often measured by how many of its patients experience complications during their stays or after operations, the authors of the new study used a measure known as failure to rescue or FTR.
FTR identifies patients who die after major complications following surgery, because the hospitals were unable to "rescue" them.
"From February 18th through March 8th, the Kohl’s Cash ® for the Cure campaignoffers a $10 Pink Kohl’s Cash coupon for every $50 you spend. The coupon increases with every $50 purchase. Then at your next purchase at Kohl’s that amount is deducted from the total at checkout (so long as you make the purchase by March 8th). Spend $250 to receive $50 in Pink Kohl’s Cash, again not really cash but a price reduction on a future purchase. Kohl’s then donates $1 to Susan G. Komen® for each valid coupon redeemed. For multiple transactions using the same coupon, Kohl’s makes only a single $1 donation.
The campaign ends tomorrow and Kohl’s already met its goal of donating $1 million to Komen. To reach that goal at least 100 thousand Kohl’s Cash cards were redeemed. At $50 for each $10 card (the lowest of the denominations) consumers spent at least $5 million at Kohl’s, most likely more since the purchases rewarded are in $50 increments. If you spent $90 you would still get the $50 coupon and Kohl’s would still donate just one dollar. And if for whatever reason you do not redeem your coupon by March 8th I guess you would lose it.
Susan Zager's insight:
Gayle Sulik looks at the Kohl’s Cash ® for the Cure campaign and explains how Kohl's used the METAvivor "Elephant in the Pink Room" campaign that is supposed to be about Metastatic Breast Cancer and instead got consumers to spend 5 million dollars at Kohl's, while donating 1 million dollars to Komen using a "breast cancer campaign" that is a "cause marketing relationship" between Kohl's and Susan G. Komen.
Gayle Sulik writes, "Kohl’s version pretties up the elephant campaign to make the “conversation” palatable for consumers. Instead of raising awareness about the breast cancer that kills, the Kohl’s Cash for the Cure campaign absorbs METAvivor’s message about an important and obvious topic that has been too uncomfortable to discuss for years and turns it into a profit-making venture."
The article makes so many important observations and is worth reading in full.
"In 2003, Barbara Hart, JD, served as lead counsel on an antitrust lawsuit focused on tamoxifen (Nolvadex), the most widely prescribed cancer drug in the world.
“We were retained by both individual tamoxifen patients and benefit fund end payers who all felt strongly about this case,” said Ms. Hart, currently chief operating officer at Lowey Dannenberg Cohen & Hart, in White Plains, N.Y.
The lawsuit addressed a controversial deal forged between two drug companies. In March 1993, brand-name drug manufacturer AstraZeneca agreed to pay $21 million directly to generic manufacturer Barr Laboratories, in exchange for Barr’s consent to not market a less expensive generic version of tamoxifen until AstraZeneca’s patent expired in August 2002. The agreement also stipulated that Barr could sell AstraZeneca-manufactured tamoxifen at a 15% discount before patent expiration.
The agreement between AstraZeneca and Barr, known as “reverse payment” or “pay-for-delay,” sparked 30 lawsuits throughout the United States, culminating in a class action complaint. The complaint specified that the pay-for-delay agreement between AstraZeneca and Barr revived a weak patent that the court had already deemed invalid, and that the companies had created a monopoly on tamoxifen that maintained the artificially high price of the drug and prevented competition from other generic manufacturers for almost a decade.
Ultimately, the district court dismissed the class action case against AstraZeneca and Barr, a decision that was upheld on appeal in 2006. This outcome of the tamoxifen trial, along with a 2005 case examining a pay-for-delay deal for the hypokalemia drug K-Dur 20 (FTC v Schering-Plough Corp.), has made a significant mark on the pay-for-delay landscape. The courts’ decisions in both these cases reflected a broad interpretation of the patent right, rejecting a company’s liability for engaging in a reverse payment agreement and insulating the patentee from competition, regardless of how likely the patent would have been overturned in court."
Susan Zager's insight:
According to the article:
"By the Numbers: Pay-for-Delay
FTC’s estimate of how much brand-name drug companies have earned from delayed generics
Additional cost for American consumers annually as a result of pay-for-delay agreements
Additional cost per drug per patient over the average five-year duration of a pay-for-delay deal
Savings to federal health care plans over the next 10 years if pay-for-delay agreements are banned, according to the White House"
"On Thursday morning the Senior Vice President of Marketing at Kohl’s contacted METAvivor President Kelly Lange to open a dialog about our conflicting awareness campaigns. We are grateful to all our supporters for bringing our concerns to Kohl’s attention. And we are grateful to Kohl’s for hearing our voices and entering into dialogue with us. We hope a mutually agreeable arrangement can be decided upon very quickly. We will keep everyone informed. In the meantime we ask everyone to use your social media outlets to express why metastatic disease is the real elephant in the pink room of breast cancer."
Susan Zager's insight:
On Thursday Kohl's finally contacted METAvivor. We must keep up the pressure on them through social media. On Twitter use the hashtags: #TALKPINK @Kohls @KatieHolmes212 @SusanGKomen @Judy_KomenCEO. We will keep you posted about what comes of it. To see the letter that METAvivor wrote to Kohls on Feb 24th and get more information about this go to: http://www.metavivor.org/blog/metavivor-letter-to-kohls/
"Tomorrow, lawmakers will vote on a bill that would allow the President to quickly pass, i.e. “Fast Track,” an international trade deal that would be extremely detrimental to both breast cancer patients and breast cancer prevention.
This “Fast Track” bill would give the President the authority to push multinational trade deals, like the Trans-Pacific Partnership (TPP), through Congress by restricting lawmakers’ ability to debate or amend these deals.
The TPP is a sweeping “free trade” deal negotiated in secret by the United States and 11 other countries, with the “help” of more than 600 corporate advisors, including institutions and corporations that produce policies or products linked to breast cancer like the American Chemistry Council and Chevron.
Leaked texts of the TPP shows that the trade deal threatens access to affordable, effective treatments for women who are diagnosed with breast cancer and undermines efforts to reduce toxic exposures that increase our risk of breast cancer in the first place.
This "Fast Track" bill has already passed out of the Senate. The House plans to hold the final vote on “Fast Track” tomorrow. Thousands of activists are mobilizing against this bill.
Please join them and contact your Representative now to tell them not to “Fast Track” away our health!"
Susan Zager's insight:
This is about making sure we have innovation with pharmaceutical companies, access to medicines and stop the use of toxic chemicals in products that cause disease especially cancer.
"NORTH ANDOVER — An amazing laugh. Dynamic blue eyes. A smile that lit up the room. These are the things Fiona Maguire will remember about her husband Peter Devereaux, a well-liked Marine and male breast cancer advocate who died Thursday after a six year battle with the illness. He was 52.
“He really had a great, light personality. He liked everyone. He was probably the least judgmental person you’d ever meet in your life,” Maguire said. “He never looked at people for money they made, or how they looked,or anything like that. He was really just a kind man.”
Devereaux became well known as an advocate for breast cancer patients through talks he gave at fundraisers in Greater Boston and beyond. Devereaux was part of the largest group of male breast cancer patients ever recorded: former Marines who were stationed at Camp Lejeune. At the North Carolina base, Marines and their families were exposed to toxic water from at least 1957 to 1987. Devereaux served four years with the Marines beginning when he was 18 and was stationed at Camp Lejeune for 16 months."
Susan Zager's insight:
Peter was pretty incredible.I was fortunate to meet him with other advocates at SABCS. Our prayers go out to all of his family and friends.
Thank you for taking action today with activists across the country! The US House of Represenatitives will vote for the first time on this bill as early as this week. Let Congress know that you’re watching and you won’t fall for phony reform! Together, we will make sure that Congress hears our message.
Here’s an easy step by step guide for taking action to demand that your representatives oppose the Chemicals in Commerce Act. 1. Call this number (it’s an automated service that will direct you to your Congressional representative): 1-888-907-6886 2. Press “1” to find your member of Congress by entering your zip code 3. Enter the appropriate number to reach your House of Representatives congressperson(s) 4. When a person or answering service answers, say the following:
“Hi my name is _______ and I am very concerned about toxic chemicals in consumer products, the places we live and work and their impact on my family’s health. I’m calling Representative ___________ to ask him/her to oppose the Chemicals in Commerce Act. We need reform that will protect pregnant women from toxic chemicals, not giveaways for the chemical industry."
5. Thank them for their time and hang up.
Susan Zager's insight:
Let congress know that you oppose the Chemicals in Commerce Act by following the instructions above.
"We need women throughout the United States with early-stage breast cancer who are taking a hormonal therapy—Arimidex (anastrozole), Femara (letrozole), or Aromasin (exemestane)—for a research study evaluating whether acupuncture can help reduce joint pain and stiffness. We have recruited for the study in the past but the reserarch team needs more women to sign up!
Hormonal therapy is used to treat postmenopausal women with hormone-sensitive breast cancer. Joint pain and stiffness is one of the most common side effects associated with these drugs. Acupuncture is a traditional Chinese medical treatment during which thin needles are used to stimulate specific points in the body. Previous studies have found that acupuncture can reduce knee and back pain. This study is looking at whether acupuncture can also reduce joint pain caused by hormonal therapy for breast cancer.
Please read on to learn more about what’s involved and who can participate. If this study isn’t right for you, please pass it on to someone you know who is experiencing joint pain from hormonal therapy for breast cancer!
Susan Zager's insight:
If you have early stage breast cancer, are taking hormonal therapy, and experiencing joint pain you can participate in this research study for the Dr. Love Research Foundation Army of Women.
What's the study about?
The purpose of this study is to test whether 12-weeks of acupuncture can help reduce joint pain or stiffness caused by hormonal therapy for breast cancer.
The researchers need to enroll 228 women in this study.
"I was invited to participate in the 2014 Rev Forum, a “big-tent” type of event sponsored by LiveSTRONG and Genentech, and featuring the participation of ASCO’s Conquer Cancer Foundation, who had extended the invitation to me. The Rev Forum brings together a diverse group of participants—from clinicians, to policymakers, artists, advocates, and most importantly, patients, to rethink cancer care. As I considered what issues we could address, one thought was first and foremost in my mind: how to engage and empower more patients in these types of discussion.
In the business community, distinctions are clearly made between engagement and empowerment. Engagement reflects one’s understanding of purpose and mission, and the shared commitment from all involved to seeing an organizational goal accomplished. In contrast, empowerment refers to the ability to do what one wants and/or feels necessary to accomplish a task. The best way to realize a mission or achieve a goal is to be both engaged and empowered.
As a clinician, I want my patients engaged. It is important to me that they understand their diagnosis, prognosis, and the treatments they are being asked to take. I want them to feel invested in their therapy and to understand their side effects and how they will be monitored. When my patients are engaged, I see myself as a partner in their care. Their treatment becomes a shared responsibility and the doctor-patient relationship is one of equals. To me, patient engagement lies at the heart of ethics in medicine and informed consent. Indeed, it is a reflection of good patient care."
Susan Zager's insight:
It's so refreshing to read Dr. Don Dizon's words reflecting the importance of patients being engaged in their cases. When facing a cancer diagnosis patients and doctors have the shared responsibility to work together in decision making related to targeted treatments, financial issues, care guidelines, side effects and options related to each individual case.
Don Dizon will be speaking at Rev Forum, a conference in Washington DC, May 8-9, 2014, (with registration still open), where medical professionals, patients and doctors can "connect with leaders in cancer treatment, advocacy, and policy to build a new paradigm in cancer care." For more information about Rev Forum go to: http://www.rev-forum.com/.
"The American Society of Clinical Oncology (ASCO) is deeply frustrated by the failure of Congress to permanently repeal the flawed sustainable growth rate (SGR) formula used to set Medicare physician payments and passage of the 17th patch to the system.
ASCO and the entire physician community worked closely with House and Senate committees to successfully develop and pass an unprecedented bipartisan, bicameral policy to reform the broken Medicare physician payment system. We are disappointed that this remarkable progress and hope for real change has been cast aside by partisan politics over paying for the cost of repeal. The failure of Congress to repeal SGR and to instead move forward with yet another SGR patch represents a threat to physician practices and the access of Medicare beneficiaries to high quality, affordable cancer care. It is not a solution and simply means that we will face this crises next year for an 18th time.
The U.S. cancer system simply cannot continue to meet the growing needs of patients with cancer unless fundamental, systemic change is enacted. Congressional committees agreed on this widely supported legislation, H.R. 4015/S. 2000, which would have repealed the SGR and made meaningful progress toward addressing many of the challenges outlined in ASCO's recently released State of Cancer Care in America: 2014 report, including disparities in access to care and the closure or consolidation of small practices that serve more than one-third of cancer patients throughout the United States.
Although we are dismayed that elected leaders threw away an unprecedented opportunity to resolve a longstanding problem, ASCO will continue to press Congress to do its job by repealing the SGR formula and replacing it with a more stable and rational system that ensures access to high quality cancer care for all Medicare beneficiaries."
"The results of an American Society of Clinical Oncology survey of medical oncologists in the United States dealing with their satisfaction with “work-life balance” and their plans for retirement are contrary to some earlier assumptions -- findings that an accompanying editorial called “startling.”
Both articles are now available online ahead of print in the Journal of Clinical Oncology. The survey (doi: 10.1200/JCO.2013.53.4560) by Tait D. Shanafelt, MD, Director of the Department of Medicine Program on Physician Well-being at the Mayo Clinic, and colleagues found that the satisfaction was lower than that for all other medical subspecialists and that this dissatisfaction had a strong relationship with plans to cut back hours and leave current practices -- a situation that will likely adversely affect the pending oncologist shortage expected by 2020, the researchers said.
The accompanying editorial by Rebecca S. Guest, MD, MPH, and Dean F. Bajorin, MD – titled “Take Care of Yourself: We Need You” (doi: 10.1200/JCO.2013.54.5319) -- noted that oncologists’ determination to provide the highest standards of care for their patients “should similarly apply to oncologists themselves, personally as well as professionally.”
Asked for his opinion, ASCO Chief Medical Officer Richard L. Schilsky, MD, said that the survey results were not completely surprising and showed that many medical oncologists, although highly satisfied with their career choice, are less so with their work environments and are overwhelmed by, for example, the paperwork generated by regulatory requirements.
He said that now that there’s a pretty clear description of the problems, ASCO and the oncology community have to focus on finding solutions, including providing tools to help with business operations, being more sensitive about the workplace environment, and working hard to introduce better payment models.
The survey was sent to 2,998 medical oncologists -- with an equal number of men and women evenly distributed by years in practice -- between October 2012 and March 2013. About half (1,490) responded, with about two-thirds (1,117) completing full-length studies, and evaluation of work-life balance and career plans focused on the 1,058 who had not yet retired. Slightly more than half (51.6%) were women, and the average respondent was 52 years old.
Only one-third of the oncologists (345) said they were satisfied; more than one-quarter (270) indicated the likelihood of reducing their clinical work hours within the next year; and about one-third (351) said they intended to leave their current positions within two years. The reasons cited for cutbacks were to spend more time with family or to pursue administrative or leadership opportunities.
The study found that about 45 percent of oncologists experienced symptoms of burnout, including emotional exhaustion or depersonalization, and more than one-quarter (273) said they planned to retire by age 64, with more than 20 percent planning retirement before age 60.
The reasons cited for seeking an earlier retirement included declining Medicare and private insurance reimbursements and the introduction of electronic medical records; reasons for postponing retirement included continuing to enjoy work and decreased retirement accounts.
We recommend reading the details of the studies. The conclusions of the survey were: "Satisfaction with WLB among US oncologists seems lower than for other medical specialties. Dissatisfaction with WLB shows a strong relationship with plans to reduce hours and leave current practice. Given the pending US oncologist shortage, additional studies exploring interactions among WLB, burnout, and career satisfaction and their impact on career and retirement plans are warranted."
The editorial provided more insight and projected that in 2020 there will be a shortage of medical oncologists to meet the growing demand for cancer care in the United States. "They suggested one way of dealing with the crisis would be for half of oncologists to delay retiring for five years, a solution that the work-life balance study showed to be unlikely."
As patients it is easy to see why burnout can be a problem and the study also looked at the long hours and all of the complexities with the ever demanding needs of more paperwork.
The editorial says it best: "In closing, oncologists hold a common determination to provide the highest standards of care for their patients. Those standards should similarly apply to oncologists themselves, personally as well as professionally. Take care of yourself. We (patients and families) need you.
"SINCE the early 1970s, studies have shown that black Americans have a higher death rate from cancer than any other racial or ethnic group. This is especially true when it comes to breast cancer. A study published last week in the journal Cancer Epidemiology found that, in a survey of 41 of America’s largest cities, black women with breast cancer are on average 40 percent more likely to die than their white counterparts.
The principal reason for this disparity is the disconnect between the nation’s discovery and delivery enterprises — between what we know and what we do about sick Americans.
In 1967, I started working in Harlem as a cancer surgeon. At that time, and through the 1980s, Harlem was a community of poor black people, and the death rate from cancer there was among the highest in the country. At Harlem Hospital, the five-year survival rate for breast cancer was a dismal 39 percent, compared with roughly 75 percent for Americans over all.
I imagined that I could “cut cancer out of Harlem.” But I soon learned that the disease would not yield to a surgeon’s knife. Why? Because the patients were coming in too late. I examined many black women who were visiting the clinic for the first time and who already had incurable breast cancer, sometimes with ulcerated and bleeding breast masses.
I began to see that cancer’s invasiveness was deeply rooted in human conditions, and began asking questions such as: What does it mean to be black in America? What does it mean to be poor? And what does it mean to be black and poor and at the same time to have cancer? Saving lives under these conditions has dominated my career ever since.
The reasons for black and white differences in breast cancer outcomes are complex. Although the incidence of the disease is higher among white women, black women are more likely to die from it. Young black women tend to develop a particularly aggressive form, which no doubt contributes to the disparity. But for many years, the dominant cause of higher mortality has been late-stage disease at the time of initial treatment, in part as a result of black women being less likely to undergo mammography."
Susan Zager's insight:
This article has some very interesting points about the differences in outcomes especially for breast cancer in comparing white and black women. While white women have a higher incidence of breast cancer, black women are more likely to die from it. Access to health insurance does not assure access to quality health care, especially for the poor and less educated. "No patient with cancer should go untreated or experience a delay in treatment that diminishes survival. People should not die from cancer because they are poor or black. This is more than a medical and scientific issue. This is a moral issue. "
"The State of Cancer Care in America: 2014 report—released by the American Society of Clinical Oncology (ASCO) and published by the Journal of Oncology Practice—is the first-ever, comprehensive look at demographic, economic, and oncology practice trends that will impact cancer care in the United States over the coming years.
With recommendations for addressing the cancer care delivery system’s most pressing concerns, this landmark ASCO report also examines the rapid expansion of health information technology and the growing emphasis on quality measurement and value.
ASCO developed the State of Cancer Care in America: 2014 report to help cancer care providers, policy makers, and others more effectively shape the future of cancer care during these uncertain times. The Society will issue annual updates that will track trends and identify emerging issues."
"I still remember being taken aback by how young she was. “She” was Mary—a 28-year-old woman who had completed chemotherapy for stage II breast cancer. She was treated elsewhere and had moved cities when her husband got a promotion.
“I’m still getting used to this area, but I am happy my hair came back before we had to move. I can’t imagine trying to set up a new house and have to go through my cancer history with strangers. I just don’t want to be that young mother with cancer.”
We reviewed her medical history, the details of her pathology, her prior treatment and current endocrine therapy.
“How are you doing on tamoxifen?” I asked.
“Fine. I think it agrees with me, fortunately!” she said.
We discussed surveillance after treatment, the frequency of follow-up, and what that should entail, and I told her:
“Based on what we know, checking your labs or doing imaging in the absence of symptoms or a reason don’t help us help you. I don’t recommend testing if you feel well otherwise. How do you feel about that?”
All of a sudden, she appeared uncomfortable:
“Well, my doctors gave me the same advice, but I am not comfortable with surveillance. I don’t want to not get any tests.”
I tried to reassure her, tried to explain my rationale, and that it was based on ASCO guidelines. However, she stopped me before I could get any further.
“I know you are trying to help me, and I understand what you are saying. I have read the guidelines, done my reading. I’ve gone to every site that anyone has told me to read, and I get it—extensive testing doesn’t help women live longer after breast cancer,” she stated."
Susan Zager's insight:
This commentary by Don Dixon, MD reflects how important it is for doctors to listen to their patients needs and work together when it comes to shared decision making.
"Only by understanding the ground on which our patients stand can we begin to walk that path with them, and perhaps, point them towards the road perhaps best traveled.
Until then, I will listen to my patient, her values and preferences. Knowing that she has taken best evidence under consideration, I will do what I did here: proceed with the surveillance testing that both she and I were comfortable with."
"As our supporters are aware, on Friday February 21st METAvivor contacted Kohl’s concerning it’s co-optation of METAvivor’s Elephant in the Pink Room Campaign. At that time we were told the President of Kohl’s would call by the end of the day. That did not happen. With tremendous help from many supporters, a social media campaign was launched forcing Kohl into action. On Thursday, February 27th, Kohl’s Senior Vice President of Marketing called METAvivor President Kelly Lange to talk.
In the end, Kohl’s was only willing to add some information on metastatic breast cancer to their website. We gave them a deadline of 5 pm CST today to respond to our insistence that they also remove the images of and references to an elephant along with the words “Don’t Ignore It”, which in conjunction with their elephant co-opted METAvivor’s “Don’t Ignore Stage IV”. That deadline has now passed with no word from Kohl’s.
METAvivor has also received a letter from Susan G. Komen’s President, Dr. Judith Solerno, but she too has shown no inclination to change the campaign. It is quite ironic that Susan G. Komen, with its well-earned reputation for vigorously defending its own brand through litigation, appears to have no compunction with regard to infringing upon the brands of others.
As we look into legal action, we encourage our supporters to re-launch their media campaigns. For those looking for inspiration we invite you to read Gayle Sulik’s blog -- The Pink White Elephant. Gayle A. Sulik, PhD is a medical sociologist and author of the book, Pink Ribbon Blues -- a very revealing history of breast cancer advocacy. She is also co-founder and executive director of the newly founded Breast Cancer Consortium, a collection of international professionals committed to research and social change."
Susan Zager's insight:
This is totally unacceptable from Kohl's. They need to do the right thing. We have to keep the pressure up on them in any way we can.
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