We all want to believe that when people get cancer, they will receive medical care of the highest quality. Even as new scientific breakthroughs are announced, though, many cancer patients may be getting the wrong care, too little care, or too much care, in the form of unnecessary procedures. How close is American medicine to the ideal of quality cancer care for every person with cancer? Ensuring Quality Cancer Care provides a comprehensive picture of how cancer care is delivered in our nation, from early detection to end-of-life issues. The National Cancer Policy Board defines quality care and recommends how to monitor, measure, and extend quality care to all people with cancer. Approaches to accountability in health care are reviewed. What keeps people from getting care? The book explains how lack of medical coverage, social and economic status, patient beliefs, physician decision-making, and other factors can stand between the patient and the best possible care. The board explores how cancer care is shaped by the current focus on evidence-based medicine, the widespread adoption of managed care, where services are provided, and who provides care. Specific shortfalls in the care of breast and prostate cancer are identified. A status report on health services research is included. Ensuring Quality Cancer Care offers wide-ranging data and information in clear context. As the baby boomers approach the years when most cancer occurs, this timely volume will be of special interest to health policy makers, public and private healthcare purchasers, medical professionals, patient advocates, researchers, and people with cancer. Table of Contents <ul>
<li>Front Matter</li>
<li>Summary</li>
<li>1 Introduction</li>
<li>2 The Cancer Care 'System'</li>
<li>3 Ensuring Access to Cancer Care</li>
<li>4 Defining and Assessing Quality Cancer Care</li>
<li>5 Health Care Delivery and Quality of Cancer Care</li>
<li>6 Cancer Care Quality Assurance</li>
<li>7 Health Services Research in Cancer Care</li>
<li>8 Findings and Recommendations</li>
<li>Glossary</li>
<li>Acronyms</li>
<li>Index</li>
</ul>

Ensuring Quality Cancer Care

Medical Books

Commission on Life Sciences

National Cancer Policy Board

Institute of Medicine and National Research Council

INSTITUTE OF MEDICINE

Administration & Medicine Economics

National Academies Press

Each year more than 180,000 new cases of breast cancer are diagnosed in women in the U.S. If cancer is detected when small and local, treatment options are less dangerous, intrusive, and costly-and more likely to lead to a cure. Yet those simple facts belie the complexity of developing and disseminating acceptable techniques for breast cancer diagnosis. Even the most exciting new technologies remain clouded with uncertainty. Mammography and Beyond provides a comprehensive and up-to-date perspective on the state of breast cancer screening and diagnosis and recommends steps for developing the most reliable breast cancer detection methods possible. This book reviews the dramatic expansion of breast cancer awareness and screening, examining the capabilities and limitations of current and emerging technologies for breast cancer detection and their effectiveness at actually reducing deaths. The committee discusses issues including national policy toward breast cancer detection, roles of public and private agencies, problems in determining the success of a technique, availability of detection methods to specific populations of women, women's experience during the detection process, cost-benefit analyses, and more. Examining current practices and specifying research and other needs, Mammography and Beyond will be an indispensable resource to policy makers, public health officials, medical practitioners, researchers, women's health advocates, and concerned women and their families. Table of Contents <ul>
<li>Front Matter</li>
<li>Executive Summary</li>
<li>1 Introduction</li>
<li>2 Breast Imaging and Related Technologies</li>
<li>3 Technologies in Development: Genetics and Tumor Markers</li>
<li>4 Development and Regulation of New Technologies</li>
<li>5 Evaluation and Cost Coverage of New Technologies</li>
<li>6 Dissemination: Increasing the Use and Availability of New Technologies</li>
<li>7 Findings and Recommendations</li>
<li>Glossary</li>
<li>References</li>
<li>Appendix: Workshop speakers and other contributors</li>
<li>Index</li>
</ul>

Mammography and Beyond: Developing Technologies for the Early Detection of Breast Cancer

Health, Fitness & Dieting

Division on Earth and Life Studies

Committee on Technologies for the Early Detection of Breast Cancer

National, Research Council

Diseases & Physical Ailments

In our societyâ€™s aggressive pursuit of cures for cancer, we have neglected symptom control and comfort care. Less than one percent of the National Cancer Instituteâ€™s budget is spent on any aspect of palliative care research or education, despite the half million people who die of cancer each year and the larger number living with cancer and its symptoms. Improving Palliative Care for Cancer examines the barriersâ€"scientific, policy, and socialâ€"that keep those in need from getting good palliative care. It goes on to recommend public- and private-sector actions that would lead to the development of more effective palliative interventions; better information about currently used interventions; and greater knowledge about, and access to, palliative care for all those with cancer who would benefit from it. Table of Contents <ul>
<li>Front Matter</li>
<li>
Part 1: Executive Summary</li>
<li>1 Background and Recommendations</li>
<li>
Part 2 2 Reliable, High-Quality, Efficient End-of-Life Care for Cancer Patients: Economic Issues and Barriers</li>
<li>3 Quality of Care and Quality Indicators for End-of-Life Cancer Care: Hope for the Best, Yet Prepare for the Worst</li>
<li>4 The Current State of Patient and Family Information About End-Of-Life Care</li>
<li>5 Palliative Care for African Americans and Other Vulnerable Populations: Access and Quality Issues</li>
<li>6 End-of-Life Care: Special Issues in Pediatric Oncology</li>
<li>7 Clinical Practice Guidelines for the Management of Psychosocial and Physical Symptoms of Cancer</li>
<li>8 Cross-Cutting Research Issues: A Research Agenda for Reducing Distress of Patients With Cancer</li>
<li>9 Professional Education in Palliative and End-of-Life Care for Physicians, Nurses, and Social Workers</li>
<li>Index</li>
</ul>

Improving Palliative Care for Cancer

X-ray mammography screening is the current mainstay for early breast cancer detection. It has been proven to detect breast cancer at an earlier stage and to reduce the number of women dying from the disease. However, it has a number of limitations. These current limitations in early breast cancer detection technology are driving a surge of new technological developments, from modifications of x-ray mammography such as computer programs that can indicate suspicious areas, to newer methods of detection such as magnetic resonance imaging (MRI) or biochemical tests on breast fluids. To explore the merits and drawbacks of these new breast cancer detection techniques, the Institute of Medicine of the National Academy of Sciences convened a committee of experts. During its year of operation, the committee examined the peer-reviewed literature, consulted with other experts in the field, and held two public workshops. In addition to identifying promising new technologies for early detection, the committee explored potential barriers that might prevent the development of new detection methods and their common usage. Such barriers could include lack of funding from agencies that support research and lack of investment in the commercial sector; complicated, inconsistent, or unpredictable federal regulations; inadequate insurance reimbursement; and limited access to or unacceptability of breast cancer detection technology for women and their doctors. Based on the findings of their study, the committee prepared a report entitled Mammography and Beyond: Developing Technology for Early Detection of Breast Cancer, which was published in the spring of 2001. This is a non-technical summary of that report.

Mammography and Beyond: Developing Technologies for the Early Detection of Breast Cancer: A Non-Technical Summary

Committee on the Early Detection of Breast Cancer

It is innately human to comfort and provide care to those suffering from cancer, particularly those close to death. Yet what seems self-evident at an individual, personal level has, by and large, not guided policy at the level of institutions in this country. There is no argument that palliative care should be integrated into cancer care from diagnosis to death. But significant barriers-attitudinal, behavioral, economic, educational, and legal-still limit access to care for a large proportion of those dying from cancer, and in spite of tremendous scientific opportunities for medical progress against all the major symptoms associated with cancer and cancer death, public research institutions have not responded. In accepting a single-minded focus on research toward cure, we have inadvertently devalued the critical need to care for and support patients with advanced disease, and their families. This report builds on and takes forward an agenda set out by the 1997 IOM report Approaching Death: Improving Care at the End of Life, which came at a time when leaders in palliative care and related fields had already begun to air issues surrounding care of the dying. That report identified significant gaps in knowledge about care at the end of life and the need for serious attention from biomedical, social science, and health services researchers. Most importantly, it recognized that the impediments to good care could be identified and potentially remedied. The report itself catalyzed further public involvement in specific initiatives-mostly pilot and demonstration projects and programs funded by the nonprofit foundation community, which are now coming to fruition. Table of Contents <ul>
<li>Front Matter</li>
<li>Summary</li>
<li>Conclusions and Recommendations</li>
<li>References</li>
<li>Appendix A: Tables A-1 and A-2</li>
<li>Appendix B: Recommendations from Enhancing Data Systems to Improve the Quality of Cancer Care(IOM, 2000)</li>
<li>Acronyms and Abbreviations</li>
</ul>

Improving Palliative Care for Cancer: Summary and Recommendations

Foley,Kathleen

Cancer ranks second only to heart disease as a leading cause of death in the United States, making it a tremendous burden in years of life lost, patient suffering, and economic costs. Fulfilling the Potential for Cancer Prevention and Early Detection reviews the proof that we can dramatically reduce cancer rates. The National Cancer Policy Board, part of the Institute of Medicine, outlines a national strategy to realize the promise of cancer prevention and early detection, including specific and wide-ranging recommendations. Offering a wealth of information and directly addressing major controversies, the book includes: â€¢ A detailed look at how significantly cancer could be reduced through lifestyle changes, evaluating approaches used to alter eating, smoking, and exercise habits. â€¢ An analysis of the intuitive notion that screening for cancer leads to improved health outcomes, including a discussion of screening methods, potential risks, and current recommendations. â€¢ An examination of cancer prevention and control opportunities in primary health care delivery settings, including a review of interventions aimed at improving provider performance. â€¢ Reviews of professional education and training programs, research trends and opportunities, and federal programs that support cancer prevention and early detection. This in-depth volume will be of interest to policy analysts, cancer and public health specialists, health care administrators and providers, researchers, insurers, medical journalists, and patient advocates. Table of Contents <ul>
<li>Front Matter</li>
<li>Executive Summary</li>
<li>1. Introduction</li>
<li>2. Potential to Reduce the Cancer Burden Through Cancer Prevention and Early Detection</li>
<li>3. Lifestyle Behaviors Contributing to the Burden of Cancer</li>
<li>4. Modifying Health Risk Behaviors</li>
<li>5. Potential of Screening to Reduce the Burden of Cancer</li>
<li>6. Improving Participation in Cancer Screening Programs</li>
<li>7. Adopting New Technology in the Face of Uncertain Science: The Case of Screening for Lung Cancer</li>
<li>8. Professional Education and Training</li>
<li>9. Federal Programs That Support Cancer Prevention and Early Detection</li>
<li>10. Research Trends and Opportunities</li>
<li>11. Findings, Policy Implications, and Recommendations</li>
<li>References</li>
<li>Glossary</li>
<li>Index</li>
</ul>

Fulfilling the Potential of Cancer Prevention and Early Detection

Science & Math

Biological Sciences

National expenditures for medical care in the months and days preceding death are enormous. But we do not know whether that money is buying good quality care or optimizing the quality of life of those dying, or whether the situation is getting better or worse over time. The information that exists â€œdescribing deathâ€ at a national level â€" though some of it is very informative â€" is fragmentary. This report recommends ways to fill the information gaps by better use of existing nationally-representative data, and through some new measures, in particular, a new, ongoing National Mortality Followback Survey. The aim is to allow us to benchmark where we are today as a society, and what goals we can set to minimize pain and suffering and maximize the quality of life of all of us who will die in the years to come. Table of Contents <ul>
<li>Front Matter</li>
<li>Executive Summary</li>
<li>1. Introduction and Overview</li>
<li>2. Key Data Elements Pertaining to the End of Life</li>
<li>3. Currently Available Datasets</li>
<li>4. Methodological Issues in the Collection and Use of Data About Dying</li>
<li>5. Conclusions and Recommendations</li>
<li>References</li>
<li>Appendix A: Administrative Information for Relevant Datasets</li>
<li>Appendix B: Information on Selected Variables</li>
<li>Appendix C: Workshop Agenda and Participants</li>
</ul>

Describing Death in America: What We Need to Know: Executive Summary

Only more recently has it been realized that the intense effort to care for and cure a child with cancer does not end with survival. Continued surveillance and a variety of interventions may, in many cases, be needed to identify and care for consequences of treatment that can appear early or only after several decades and impair survivorsâ€™ health and quality of life. The more than two-thirds of childhood cancer survivors who experience late effects -- that is, complications, disabilities, or adverse outcomes -- as a result of their disease, its treatment, or both, are the focus of this report which outlines a comprehensive policy agenda that links improved health care delivery and follow-up, investments in education and training for health care providers, and expanded research to improve the long-term outlook for this growing population now exceeding 270,000 Americans.

Childhood Cancer Survivorship: Improving Care and Quality of Life

The nature of biomedical research has been evolving in recent years. Technological advances that make it easier to study the vast complexity of biological systems have led to the initiation of projects with a larger scale and scope. In many cases, these large-scale analyses may be the most efficient and effective way to extract functional information from complex biological systems. Large-Scale Biomedical Science: Exploring Strategies for Research looks at the role of these new large-scale projects in the biomedical sciences. Though written by the National Academiesâ€™ Cancer Policy Board, this book addresses implications of large-scale science extending far beyond cancer research. It also identifies obstacles to the implementation of these projects, and makes recommendations to improve the process. The ultimate goal of biomedical research is to advance knowledge and provide useful innovations to society. Determining the best and most efficient method for accomplishing that goal, however, is a continuing and evolving challenge. The recommendations presented in Large-Scale Biomedical Science are intended to facilitate a more open, inclusive, and accountable approach to large-scale biomedical research, which in turn will maximize progress in understanding and controlling human disease. Table of ContentsFront MatterExecutive Summary1. Introduction2. Defining "Large-Scale Science" in Biomedical Research3. Models of Large-Scale Science4. Funding for Large-Scale Science5. Organization and Management of Large-Scale Biomedical Research Projects6. Training and Career Structures in Biomedical Research7. Intellectual Property and Access to Research Tools and Data8. Findings and RecommendationsReferencesAppendixIndex

Large-Scale Biomedical Science: Exploring Strategies for Future Research

Committee on Large-Scale Science and Cancer Research

History & Philosophy

This booklet summarizes the findings and recommendations of Improving Palliative Care for Cancer (2001), for the lay Spanish-speaking reader. It describes the types of palliative care and comfort care that should be there for people dying from cancer, and the reasons why, too often, people suffer needlessly without it. The concrete steps that could be taken by society and individuals to improve access to palliative care are also laid out, in the recommendations.

Como Mejorar el Cuidado Paliativo: Podemos mejorar el cuidado de personas con cancer (Spanish Edition)

Medicine

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