U.S. report says, "Cancer care system in crisis"

           The United States is facing crisis in how to deliver cancer care, as the baby boomers reach their tumor-prone years and doctors have a hard time keeping up with complex new treatments, government advisers reported Tuesday. The caution comes even as scientists are learning more than ever about better ways to battle cancer, and developing innovative therapies to target tumors. The doctors try to optimize treatment, the Institute of Medicine found "daunting" barriers to achieving high quality care for all patients. Overcoming those challenges will require changes to the health care system and savvier consumers. The decisions about cancer treatments aren't based on good evidence, and patients may not understand their choices and what to expect, the panel found. For example, some studies suggest that two-thirds or more of cancer patients with poor prognoses incorrectly believe that the treatments they receive could cure them.
                          The risk of cancer increases with age, and older adults account for just more than half of the 1.6 million new cases diagnosed each year. By 2030, new diagnoses are expected to reach 2.3million a year as the population ages. The report warns that there may not be enough oncology specialists to care for them.It's not just a matter of knowing the latest treatments, but deciding whether they are worth it. Perhaps a bigger concerns is the growing complexity of care. Increasingly, scientists are finding genetic differences inside tumors that help explain why one person's cancer is more aggressive than another's. The Institute of Medicine advises the government about health issues. Among its recommendations are more research to tease out how to best treat different patients, new strategies to help doctors keep up with that evidence. and development of tools to help communicate the choices to patients. Treating the disease, which can require precisely matching a tumor's molecular characteristics to a drug, has become so complicated that many physicians lack "core competencies in caring for patients with cancer".Groups such as the American society of Clinical Oncology (ASCO) have developed scores of treatment guidelines for virtually every stage of nearly every kind of cancer. The drug companies that sponsor these clinical trials prefer younger patients who don't have other diseases. The little progress has been made since 1999, the last time the IOM examined the issue, in the quality of care cancer patients receive.