In this issue of Conquering the Cancer Care Continuum, Ms Faiman and Dr Stricker focus on aspects of treatment planning in cancer patients. While they come at the topic from slightly different angles, both cases illustrate that deciding on whether to treat patients, which drugs to use, and what other supportive medications to consider is not a simple cookbook process. In this commentary, I will provide a perspective on my conversations with patients and then discuss some pressing issues that are emerging in this area.
The fourth issue of Conquering the Cancer Care Continuum series addresses Treatment Planning Through the Cancer Care Continuum. Following are 2 key articles to provide insight into the role of the clinical pharmacologist as a member of the multidisciplinary team working collaboratively to render recommendations about treatment planning options. Gone are the days, or they should be, when oncology specialists merely passed on – either on paper or electronically – prescription instructions to be filled by the pharmacologist or pharmacist. These individuals, experts in drug management, interaction, and optimization, are integral to the oncology care team. You will soon read and learn why.
It is projected there will be 18.1 million cancer survivors in 2020, with an estimated $173 billion of associated cancer care costs in the initial and last year of life. The cost of healthcare has grown exponentially since the 1990s due, in part, to improved diagnostic techniques, better treatments, and an aging population.
JS is a 62-year-old female diagnosed with a stage IIB (T2, N1, M0), estrogen receptor/progesterone receptor–negative, HER2-negative invasive ductal carcinoma of the breast 18 months ago and treated with bilateral mastectomy followed by adjuvant docetaxel and cyclophosphamide (TC). Recently, she felt an enlarged supraclavicular lymph node that was subsequently biopsied and showed recurrence of her disease. She presents today for discussion regarding selection of chemotherapy in the recurrent/metastatic setting.
Scenarios like the one above are a daily occurrence in cancer centers around the country and around the world. These situations are fraught with emotion and anxiety as patients are informed, most commonly, that their disease is no longer curable.

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