Elastography

Recent clinical research studies on a new imaging technology are demonstrating amazing results in detecting cancer without so much as breaking the skin. The technology, elastography, is mainly utilized through ultrasound but also is used in MRI. How does elastography work? Below is the best diagram I could find that best visually demonstrates how elastography works.

Credit: MSNBC.com

Recently, studies have demonstrated remarkable detection accuracy rates in thyroid, prostate, and breast cancer detection. Last year, a small breast cancer detection study involving 80 women accurately distinguished 100% of malignant tumors and 99% of non-malignant tumors. In another small preliminary study for detecting prostate cancer presented last month, elastography demonstrated excellent detection accuracy. The authors went so far as to state, "the cancer detection rate with real-time elastography was superior to the rates of other modalities..." This month a thyroid study conducted in Italy demonstrated encouraging results stating that elastography has "great potential" in certain tumor types.

Additionally, the costs for elastography are predicted to be remarkably less expensive then the cost for a typical biopsy today. The results will be almost immediate as well as you don't have to send tissue away for interpretation by a clinical pathologist.

For now, further research on a larger scale is being planned with hopes of demonstrating similar results. If the technology demonstrates the same accuracy level on a wider scale, many are predicting that biopsies will drastically be reduced which will result in less unnecessary invasive procedures, less time loss from work, and overall better care for patients.

Gotham Prize for Cancer Research

I come across a novel approach to spur cancer research ideas today. The Gotham Prize for Cancer Research is offering 1 million dollars annually to the most innovative cancer research idea. Anyone can submit an idea even without proof that it will work. A scientific panel reviews all applicants and decides if the idea is worthy of consideration. I applaud such efforts from the private community. We need more and more ideas such as this.

The Difficulty of Managing Clinical Research

We are offering clinical research for our patients. It is no easy task. The mounds of paperwork required by the multitude of agencies involved is unbelievable. It is even more than I imagined and I knew it was bad. I'm amazed that so many centers offer it as part of their programs. Here is a small example of what we faced when starting our program. Agency 1 will not approve you for x until Agency 2 approves you for y. While at the same time, Agency 2 won't approve you for y until Agency 1 approves you for x. I joke with our Clinical Research Coordinator when she gets frustrated with the red tape that she is like one of those show dogs who jumps through all the hoops except there never is an end. Below is a list of several of the agencies whose requirements and regulations we have to meet to offer clinical trials.

• FDA - Food and Drug Association

• NIH - National Institutes of Health

• NCI - National Cancer Institute

• CTSU - Clinical Trials Support Unit

• OHRP - Office of Human Research Protections

• RPC - Radiological Physics Center

• ITC - Image Guided Therapy QA Center

• CTEP - Cancer Therapy Evaluation Program

• QARC- Quality Assurance Review Center

• NSABP - National Surgical Adjuvant Project for Breast & Bowel Cancer

• RTOG - Radiation Therapy Oncology Group

• ECOG - Eastern Cooperative Oncology Group

• SWOG - Southwest Oncology Group

• GOG - Gynecologic Oncology Group

There are many more. We have a legal agreement with each of these organizations and thus have to send them through the legal department for review which can take a considerable amount of time. And I haven't even mentioned what it takes to get a protocol approved through yet another acronym, the

• IRB - Institutional Review Board

Another problem we have is recruiting enough patients to go on trial. Patients like the idea of clinical trials but they don't like the idea of possibly receiving a placebo. I wouldn't either. Thus many opt for traditional treatment until there are no other options. Many by then don't have the will, the energy, or the qualifications to go on a clinical trial.

If you're looking for a clinical trial a great website is

Clinical Trials.gov

You can search by drug, diagnosis, or just about any other thing you can think of. The only problem is it is hard to navigate or understand if you don't have much of a medical background. But by the time an individual or family member has resorted to searching for clinical trials they usually know enough to point themselves in the right direction.

Now, don't get me wrong. Clinical Trials are a great thing. They should just be a lot easier to offer and manage especially with the continued declining reimbursement environment we are facing every year.

Great Quote

I heard a great quote today about faith based health care center. The person said there should be a sign above the door that says "The Great Physician Works Here." I like that.

I'm Back

Wow. What a hiatus. Over the last year family medical issues have precluded me from spending time on blogging. Actually, I've been blogging but on a personal level rather than professional. I've learned a lot about healthcare over the last year which has made me a better Oncology administrator. Additionally, my professional role has expanded to other related areas that will allow me to comment in a broader sense. I look forward to sharing that here.