Archives for 2018

Clinical Trial Award

However, only one in five U.S. oncologists participates in the NCORP – the National Cancer Institute’s pipeline that delivers clinical trials from the academic centers to the community cancer clinics – and it’s easy to understand why: it’s lot of grant-writing, administrative work, and staying informed enough to match patients to trials that might help them.

But if you’re dedicated, you make time for the important things – and Green Bay Oncology physicians are dedicated to clinical research.

Though only a minority of NCORP physicians get recognized (81 physicians) for excellence in patient enrollments, this year FOUR Green Bay Oncology physicians received this honor:

●  Dr. Anthony Jaslowski – Gold Certificate

●  Dr. Brian Burnette – Silver Certificate

●  Dr. Sigurdur Bodvarsson – Silver Certificate

●  Dr. Matthew Ryan – Silver Certificate

    

Recognition is nice, but doing the right thing for people facing cancer is even better – and that’s why our physicians keep at it.

It’s the right thing to do.

Less Chemo for Breast Cancer?

Less Chemo for Breast Cancer?

Nobody likes chemotherapy: not patients, and not oncologists.

We’d all rather avoid it if we can – and now we’ve identified another group of women who can safely do without it.  

Some early-stage breast cancers can spread throughout the body before the tumor is removed surgically– even before the cancer is diagnosed. Those small, spreading cells (called micrometastases) aren’t detectable by current technology. But micrometastases can seed tumors that show up a few years later in the bones, liver, or brain – and ultimately cause death.  

If we give chemotherapy to patients who have micrometastases, we can kill off those little seeds before they take root and improve the chances of cure. But it’s only worth it if the risk of having micrometastases in the first place is sufficiently high – usually around 18% or more. That’s why accurately predicting risk is so critical in treating early stage breast cancer. 

So for people at high risk of having micrometastases (e.g. those with lymph node involvement, or high-risk mutations on the Oncotype test), we recommend chemotherapy.  

For people at low risk of micrometastasis, we don’t. 

So what’s the news flash?  

The Oncotype test reports a patient’s risk of micrometastasis as low, intermediate, or high. We’ve always known what to do with the low and high risk patients, but we’ve been less certain about the intermediate risk group.  

But the largest trial of its kind was just reported in the New England Journal of Medicine, and it looks like we can safely skip chemotherapy in Oncotype-intermediate patients. 

Bottom line: 

  • Women with early-stage breast cancer only seem to benefit from chemotherapy if they have lymph node involvement, or if the Oncotype test indicates they’re at high risk for micrometastases. 

What is Convenient Cancer Care?

What is Convenient Cancer Care?

Our patients want and deserve convenience, but what is convenient?

I thought about this recently while evaluating a hospital patient. She’d been diagnosed recently and so wanted a plan NOW that she’d driven two hours for an earlier appointment. She’d wrestled with all the associated questions – Where do I go? Who’ll drive me there? Will I feel well enough for the trip? Is snow in the forecast? And what about the next appointment?

From my perspective, as a non-patient, non-afraid, non-recently-diagnosed person, a four-hour round trip sounded more inconvenient than waiting another two or three days for something closer to home.  Living in the Green Bay area I’ve  always taken for granted the convenience of having everything 10-15 minutes away.  Many health care clinics, 4 different hospitals, in fact I often have to argue with my family as to which grocery store we are going to.  Everything is an easy 10-15 minutes and perhaps if there is a little traffic maybe 20 minutes, however, my friends from large metropolitan areas find our idea of “traffic” laughable. But fear sometimes trumps mileage when you’re a cancer patient. I was glad we could get her in that day. I was even happier to tell her about our locations in Escanaba and Manistique, which she didn’t know about.

So was she. Her next appointments would only be twenty minutes away, and you could feel her relief – but there was a catch. She’d have to see a different doctor from now on. I was afraid that might be a deal-breaker.

We’ve got a dedicated team of providers at Green Bay Oncology, and they’re happy to spend hours commuting to ten different locations from as far south as Chilton to as far north as Manistique – and I mean who else is willing to do that? How valuable is that?

But not every provider can drive everywhere. The doc she knew didn’t go there, and she’d have to pick another.

Now when my insurance plan suddenly forces me to choose a different doctor (yes, it happens to providers too) I find that VERY inconvenient. It’s an outrage, and I’ve lived it. I was in full-on apology mode and I braced for her objection.

Know what? She didn’t mind, not at all in fact. She did the quick math (four hours vs. twenty minutes round-trip) and minded not at all. Convenience trumped familiarity.

Turns out, I maybe don’t know that much about patient convenience after all. Or maybe what I think is convenient isn’t always what they think is convenient.

But I’m not the important one here, and maybe we ought to let the patients tell us what is and isn’t convenient – and design our systems accordingly – rather than the other way around.