Oncologists Overwhelmed; Cluster Headaches; and Liver Cancer Cost

New Tests Overwhelm Oncologists

Molecular oncology has revolutionized cancer treatment, but implementing it presents challenges to physicians, an expert argues. Determining whether a patient should receive testing is difficult, and the process from testing to deciding on and administering an appropriate treatment can result in delays, according to H. Jack West, an associate professor at City of Hope Comprehensive Cancer Center in Duarte, California, and vice president of network strategy at AccessHope in Los Angeles. “There are tens of thousands of oncologists in the world — well over 10,000 in the United States alone — and the volume of new information to keep up with is tremendous,” West said. “Put simply, it outpaces the rate at which oncologists can learn it.”

Treatment delays: Nearly half of patients newly diagnosed with non–small cell lung cancer weren’t able to take advantage of precision medicine tools widely available today, according to a study in JCO Precision Oncology.

Failure to act: Problems with an initial biopsy or a failure to act on genetic test results can have negative consequences: Nearly one third of patients did not receive appropriate targeted treatments, West noted.

Cluster Headache Linked to Comorbidities

Cluster headache is linked to a significantly higher risk for comorbid conditions such as mental disorders and neurologic disease, new research shows. That can lead to significant disability and absenteeism, according to a Swedish study published in Neurology. Patients with cluster headache had a sixfold increased risk for central nervous system disorders and a twofold increased risk for musculoskeletal disorders, the study adds.

Gender difference: Cluster headaches are more prevalent in men, but researchers find that multimorbidity rates are significantly higher in women.

Serious condition: Cluster headache can be severe and debilitating, causing intense pain behind the eyes that has been described as worse than childbirth or kidney stone pain.

Liver Cancer Is Costly for Older Patients

The cost of treatment for the most common type of liver cancer can be burdensome for Medicare recipients, a new study finds. The median Medicare payment exceeds $65,000 and the out-of-pocket cost tops $10,000 in the first year after a diagnosis of hepatocellular carcinoma, according to a study in Clinical Gastroenterology and Hepatology. Hepatocellular carcinoma is the most common type of primary liver cancer and a leading cause of death in patients with cirrhosis.

Cases increase: Hepatocellular carcinoma is projected to become the third leading cause of cancer-related death in the United States by 2040, the study predicts.

Why so costly: Treatment of hepatocellular carcinoma has evolved over the past decade with expanded surgical options, new radiation-based therapies, and newly approved immunotherapies, all of which are expensive.

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