November 2009

It is well-recognized that medicine is becoming far more complex with each passing year, especially cancer medicine. It was not that many years ago when an oncologist caring for a patient with advanced lung cancer would only need to know if the malignancy was small cell versus any other histology (squamous, adenocarcinoma, large cell, bronchoalveolar) to develop a rational management plan.

August has traditionally been a sleepy month for government regulatory agencies, but this year, Washington's usual summer torpor was interrupted by a rush of new initiatives, as more than three-quarters of a trillion dollars from the American Recovery and Reinvestment Act surged into a mind- boggling range of projects.

UnitedHealthcare, one of the largest insurers in the United States, has launched the Oncology Care Analysis database, which it designed with assistance from the National Comprehensive Cancer Network (NCCN). UnitedHealthcare plans to provide oncologists with assessments of their care for individuals with breast, colorectal, or lung cancer.

Advances in diagnostic imaging have led to general improvement in treating patients for various maladies. Recently, advances in breast diagnostic imaging with magnetic resonance imaging (MRI) in unselected patient populations have exposed a number of pitfalls that threaten well-established, data-proven medical practice.