Web Exclusives

Introduction

The proteasome inhibitor carfilzomib is a promising new agent for the treatment of multiple myeloma (MM). Data presented at the 53rd Annual Meeting of the American Society of Hematology (ASH) highlighted a role for this agent in both the frontline and relapsed and/or refractory settings.

Dr Hansen’s article brings to light financial aspects of healthcare that we do not often consider. A recent economic analysis showed the total cost of cancer care in the US reached $209.9 billion in 2005.1 The high costs of chronic cancer care come in second to cardiac disease (23% and 38%, respectively).2,3 However, increased costs do not yield longer life.

It is well documented that healthcare costs and spending have been growing at staggering rates. Healthcare accounts for ~17% of total gross domestic product (GDP) in the United States. In comparison, in 1960, healthcare only accounted for about 5% of GDP. Our current level of spending is nearly double the average percentage of GDP of every other country in the world. Total healthcare spending comes from many sources, including but not limited to hospital care, physician and clinical services, nursing home care, administrative costs, and prescription drugs.

The evolution of drug research and development toward oral therapies for cancer over the past decade has created a number of questions for the oncology healthcare provider. Will insurance companies pay for these exceptionally expensive medications? How and when will patients receive their medication? Who will be responsible for ensuring patient education and monitoring to maximize safe drug administration and patient compliance?

Dr Hansen provided a comprehensive review of the challenges patients face when diagnosed with cancer. She illustrated that while improved survival is a welcome benefit to many of today’s cancer patients, psychological, social, and emotional struggles exist. Several considerations come to mind, such as where does one obtain information regarding care? Does the patient- provider relationship affect treatment, and what is the role of the oncology nurse (ON) in the care of cancer patients?

The article by Dr Hansen provides a great overview of the challenges facing patients from initial diagnosis of cancer through survivorship. Patients typically are diagnosed with cancer suddenly in the midst of living their lives. The various stressors in life that exist prior to diagnosis can be further exacerbated after diagnosis. As oncology providers, in addition to having knowledge of the options to treat a patient’s cancer, we need to make sure we understand the patient as a whole— both the patient and the person.

The diagnosis of cancer is arguably one of the most emotionally exhausting and potentially psychologically debilitating medical conditions we may experience during our lifetime. However, the impact of this diagnosis is not limited to the patient and frequently resonates among family members, friends, and caregivers as well. When the impact of cancer on the human condition is combined with the knowledge that healthcare practitioners are frequently unable to detect psychological distress in this patient population, the effects can be profound.1

Cancer is an illness associated with substantial physical, emotional, social, and financial ramifications for affected individuals and their families. In a significant number of cases, the diagnosis of cancer is either preceded by a period of gradual, nonspecific symptoms or discovered by routine screening, and individuals are then thrust into a whirlwind of diagnostic testing, invasive procedures, and complicated treatments with very little warning or opportunity to assimilate their circumstances.

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