Thursday, November 30, 2006
Thursday, November 23, 2006
How much will Herceptin really cost? -- Barrett et al. 333 (7578): 1118 -- BMJ
How much will Herceptin really cost? -- Barrett et al. 333 (7578): 1118 -- BMJ: "So we could fund Herceptin if we did not treat 355 patients receiving adjuvant treatment (16 of whom would be cured) or 208 patients receiving palliative chemotherapy, and if we found �0.5m from another source. These untreated patients will be people we know. We will be the ones to tell them they are not getting a treatment that has been proved to be effective, which costs relatively little, because it is not the 'treatment of the moment.'"
Entrez PubMed
Entrez PubMed: "Clinical characteristics of patients with sporadic colorectal cancer and primary cancers of other organs"
Tuesday, November 21, 2006
Monday, November 20, 2006
2006 November - Cancer - Our National Shame - The killing cost of drug treatment
globeandmail.com: The killing cost of drug treatment
http://tinyurl.com/ykrl7s
Cancer: Our national shame
The killing cost of drug treatment
For a health-care system based on the principle of equal access, the reality is tragically different
Sunday, November 19, 2006
BMJ: Breast Cancer News - Internet-Based Information Highly Accurate in Internet Breast Cancer Support Groups
* The information in the postings was highly accurate.
* Only 0.22% of postings had false or misleading information.
* 70% of the false or misleading postings were corrected by other participants in the support groups within a median time of four hours and 33 minutes.
Monday, November 13, 2006
Saturday, November 11, 2006
2006 Nov/Dec: Impact of an Educational Video on Patient Decision Making in Early Breast Cancer Treatment
589.pdf (application/pdf Object)
Journal of Medical Decision Making - November/December 2006 issue - full text
Tuesday, November 07, 2006
Monday, November 06, 2006
Sunday, November 05, 2006
Saturday, November 04, 2006
2006 Ovarian cancer: Patterns of surgical care across the United States
Gynecologic Oncology
Volume 103, Issue 2 , November 2006, Pages 383-390
Ovarian cancer: Patterns of surgical care across the United States
Barbara A. Goffa, Corresponding Author Contact Information, E-mail The Corresponding Author, Barbara J. Matthewsb, Michelle Wynnc, 1, Howard G. Muntzd, Denise M. Lishnerb and Laura-Mae Baldwinb
aDepartment of Obstetrics and Gynecology, Box 356460, University of Washington School of Medicine, Seattle, WA 98195, USA
bDepartment of Family Medicine, University of Washington School of Medicine, Seattle, WA 98195, USA
cDivision of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
dSection of Gynecology and Gynecologic Oncology, Virginia Mason Medical Center, Seattle, WA 98101, USA
Received 28 June 2006. Available online 26 September 2006.
Abstract
Objective.
To describe the primary surgical procedures and procedures for intraoperative and postoperative complications, and factors associated with these procedures, in women with ovarian cancer.
Methods.
Using hospital discharge data from nine states, obtained from the Heath Care Cost and Utilization Project from 1999 to 2002, we evaluated 10,432 women with a primary diagnosis of ovarian cancer who underwent at least an oophorectomy for additional procedural ICD-9 codes during their initial hospitalization.
Results.
Surgical procedures performed in addition to oophorectomy included: omentectomy/debulking 81.9%, hysterectomy 73.4%, lymph node dissection 41.4%, appendectomy 23.8%, bowel procedures 19.8%, laparoscopy 5.6%, diaphragmatic procedures 4.9%, colostomy 3.5%, and splenectomy 1.2%. Transfusions were given to 15.5% of patients. Intraoperative and postoperative procedures for complications were coded in 7.4% of patients, including repair of surgical injury 3.5%, procedures for cardiopulmonary complications 2.8%, reoperation 1.1%, and infection treatment 0.3%. In early stage disease 21.4% of women received no additional staging procedures and 46.8% did not have nodal sampling. In bivariate analysis of crude rates, factors associated with lymph node dissection were patient age, race, payer, teaching hospital status, hospital and surgeon volume, and surgeon specialty, p < .01. for all observations. Colostomies were performed by general surgeons in 23.1% of cases, by gynecologic oncologists in 2.7% of cases, and by obstetrician/gynecologists in no cases, p < .001. Complications were associated with age, payer, median household income, and stage, p < .001 for all observations. Complication rates were similar for low- and high-volume hospitals and surgeons. However, in higher volume settings, significantly more patients received debulking procedures, lymph node dissections, and additional surgical procedures, p < .001 for all observations.
Conclusions.
A significant percentage of women with ovarian cancer did not receive recommended surgical procedures. Almost 50% of women with early stage disease were not adequately staged and in women with advanced disease, the percentage who had additional surgical procedures such as bowel resections was much lower than in institutions that report high optimal cytoreduction rates.
Keywords: Ovarian cancer; Surgical care
2006: Waiting times for cancer surgery in Ontario/worse outcomes: 1984-2000
CONCLUSIONS: Waiting times for cancer surgery increased substantially between 1984 and 2000. Waiting times were influenced by disease, patient and health-system-related factors.
006 The Lancet Oncology: Cancer care: WHO's poor relation
OR pdf file:
http://download.thelancet.com/pdfs/journals/1470-2045/PIIS1470204506709123.pdf
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