FOR INFORMATION CONTACT:
Don Jewler, ACCC Communications Director
301.984.9496, ext. 208
djewler@accc-cancer.org
For Immediate Release: February 1, 2006
Affording the Technology of Quality Cancer Care
To Buy or Not to Buy? Cancer Programs Struggle to Make Right Choice
ROCKVILLE, MD—The nation’s community cancer centers face tough choices in acquiring cutting-edge technologies for the diagnosis and treatment of cancer. New technologies hold great promise, but some come with price tags of $1 million or more. Although cancer centers want to promote innovation, programs cannot rely on a “Field-of-Dreams-type” response to new—and often expensive—technology in cancer care, namely, if they buy it, patients will come.
A special session at the Association of Community Cancer Centers’ 32nd Annual National Meeting, March 15, 2006, will focus on the latest innovations in cancer care and examine how cancer centers can best decide which new technologies to implement within their own institutional financial restraints.
“Cancer centers must first have—or be willing to develop—evidence demonstrating that a new technology will improve patient outcomes,” said Cliff Goodman, session moderator for “Affording the Technology of Quality Cancer Care.” “Next, they must take a business perspective that assesses whether the anticipated reimbursement stream will provide sufficient return on the ongoing investment in capital, staffing, and upkeep required to maintain high-quality care.” Goodman is with the Lewin Group, a healthcare consulting company.
The “New Technology” panel will focus on three key questions:
- What is the need for new technology?
- What measurable benefit to patients and to the cancer program will this innovation bring?
- What is the cost versus the realistic return on investment and within what time frame?
Among the specific technologies to be examined are the da Vinci® Surgical System; the CyberKnife® and Gamma Knife® radiosurgeries; and image-guided radiation therapy; as well as recent innovations in imaging and advances in genetic testing.
- The da Vinci® Surgical System is a state-of-the-art surgical robot that gives surgeons more precise views as well as greater dexterity. The da Vinci® Robotic System uses miniature instruments to perform the surgical procedure, allowing for very small incisions. A surgeon controls the da Vinci unit from a remote console that precisely translates the surgeon’s hand, wrist, and finger movements to the robotic arms inside the patient while providing a three-dimensional view of those movements. Some cancer programs are treating early-stage prostate cancer, for example, with the assistance the surgical robot, reducing the risk of impotence and incontinence while eliminating an uncomfortable recovery period.
- CyberKnife® delivers targeted radiation to anywhere in the body, while minimizing exposure to surrounding normal tissue. With sub-millimeter accuracy, CyberKnife® can be used to treat tumors, cancers, vascular abnormalities and functional disorders. This new technology achieves surgical-like outcomes without surgery or incisions. Using X-ray image cameras and computer technology, the CyberKnife® locates the tumor in the body. A computer program then evaluates the unique shape and location of the tumor to determine exactly how each of 1,200 or more beams of radiation will target the tumor. An X-ray source located on the CyberKnife®'s robotic arm delivers concentrated beams of radiation to the tumor from multiple positions and angles. The CyberKnife® continually checks and compensates for any patient movement during treatment to ensure accuracy.
- Gamma Knife® also achieves surgical-like outcomes without surgery or incisions. This new technology offers a non-invasive method for treating brain disorders with the delivery of a single, high dose of irradiation to a small and critically located intra-cranial targets through the intact skull. The extreme precision of Gamma Knife® makes it possible to administer a high radiation dose to the diseased area, minimizing the risk of damaging healthy tissue. The Gamma Knife® is used for treatment of vascular malformations, benign tumors, metastases and other malignant tumors, as well as functional disorders. It requires immobilization to prevent head movement using a lightweight stereotactic head frame fixed to the outer skull.
- Imaged-guided radiation therapy (IGRT) allows the physician to check the location of the patient’s tumor before each treatment, then deliver painless and precise radiation therapy based on a carefully customized plan. IGRT combines precise 3-D imaging from computerized tomography (CT scanning) with highly targeted radiation beams. Because organs may shift positions slightly as the patient breathes or moves, delivering the planned radiation treatment accurately to the target is a significant challenge. A geographical miss of the target organ could lead to over-treatment of critical structures.
- New advances in diagnostic radiology may help advance earlier cancer detection, enhance efficiencies, and ultimately help direct more effective treatment strategies. Combined positron emission tomography (PET) and computed tomography (CT) scanners, for example, are changing the way cancer centers diagnose, stage, and monitor cancer. More powerful scanners for brain or whole body imaging are improving image quality and resolution. And chest imaging technology—dual-energy subtraction chest radiography—is being used to look for changes in the lungs of lung cancer patients that would indicate tumor recurrence.
- Recent advances in genomics (the study of genes and their function) are bringing about a revolution in our understanding of the genetic and molecular biology of tumor growth. With this knowledge, researchers are developing tools to predict which patients are at greater risk for developing certain cancers or for having a recurrence after treatment.
The Association of Community Cancer Centers provides a national forum for addressing issues that affect community cancer programs, such as regulatory and legislative issues, measurements of the quality of care, and clinical research. Its unique membership of more than 650 hospital cancer programs and oncology private practices includes all members of the cancer care team: medical and radiation oncologists, surgeons, cancer program administrators and medical directors, oncology nurses, pharmacists, radiation therapists, oncology social workers, and cancer program data managers.
