The NY Times has written a piece
highlighting a series of safety lapses in the delivery radiation therapy in the state of the NY across the past few years (you can access it here
) and I wanted to quickly draw it to your attention. I know from numerous conversations with our members that safety in radiation therapy is an ongoing concern, particularly with the advent of new technologies such as SRS, so this story may not necessarily be "news," but it is the first time I've seen something this in depth written in the mainstream media.
ASCO recently released updated guidelines for genetic testing. The original recommendations were published in 2003 (you can access them here: http://www.asco.org/asco/downloads/Genetic_Testing.pdf). These new recommendations reflect new developments over the past seven years.
The updated recommendations focus on determining the role of genetic testing in cancer; more specifically, whether the tests are "professionally mediated and have clinical utility." Over the past several years, there has been a surge of interest in genetic testing, particularly amongst the general population driven in large part by direct-to-consumer advertising and numerous news reports on the topic. In fact, many would argue that interest far surpasses the technology, presenting cancer providers with some tricky situations. Namely, many patients are asking for the service, whether they are candidates or not, and there are a limited number of clinicians with the skills and infrastructure to provide the service. Cancer programs have responded quickly, hiring genetic counselors and setting up high risk clinics.
In their original statement in 2003, ASCO provided the following guidance on who should receive testing.
ASCO Releases Guidelines for Genetic Testing
My colleague Matt Garabrant just pulled together this great commentary on the potential for SBRT in lung cancer that I wanted to share, as this has the potential to revolutionize lung cancer treatment.
The three major pillars of oncology treatment-surgery, radiation, and medicine-are often entangled in an intricate dance, with oncologists prescribing treatment courses that rely on time-sensitive collaboration between these approaches. When it comes to early-stage lung cancer, however, the historical gold standard for treatment of most early-stage cancer is surgery. Conventional wisdom holds that if you can cut it out, you probably should. And in the instance of stage I cancer in particular, many cases don't even require additional therapy beyond resection.
But as of fairly recently, there has been a growing debate over whether patients with early stage non-small cell lung cancer should receive the "newer" and non-invasive option of stereotactic radiosurgery (coined "SBRT"), or whether they should stick with the conventional approach of surgery. And although NCCN clinical practice guidelines-which still indicate that surgery is the recommended approach for these patients-carry immense weight in the way that patients are treated, in addition to physicians' recommendations, patient choice is a highly malleable variable that increasingly plays into these decisions. And I'd venture to guess that many of you reading this have noticed a billboard, commercial, or other advertisement highlighting the benefits of some advanced radiosurgery technology in your local market. This marketing force is fairly widespread across the country, and lung cancer is one of the fastest growing indications for this modality.
Is SBRT Winning the Battle Over Surgery for Treatment of Non-Small Cell Lung Cancer?