REPORT OF COMMITTEE ON CANCER
CM-C Report 3-A-06
Subject: Cancer Diagnosis and Treatment
Presented by: Cynthia A. Jumper, MD, Chair
Referred to: Reference Committee on Science and Education
In response to the referral by the House of Delegates at the 2005 Annual Session for further clarification of the policy recommendation, the committee revised the previously proposed policy on cancer diagnosis and treatment. The committee's recommendation is based on current scientific knowledge and trends in the oncology field. The committee believes the Texas Medical Association will benefit from having a policy outlining the recommended steps once a diagnosis is made. This is especially important when reporting data to the Texas Cancer Registry as well as addressing cancer pain management issues in Texas. Texas currently ranks 50th in the nation at managing cancer pain and the committee feels it is our responsibility to implement policy that will reduce the burden of cancer on Texans. The Council on Scientific Affairs has reviewed this policy and approved the recommendation.
The committee recommends that all patients with a suspected or proven diagnosis of cancer should have as a minimum:
- An accurate diagnosis obtained through the most minimally invasive biopsy, resection, or test necessary to provide an accurate cancer diagnosis.
- A proper workup, to include a history, physical exam, diagnostic imaging, lab chemistry tests, hematology tests, and tumor markers to stage the patient accurately. Per the American College of Surgeons Commission on Cancer, Program Standard 4.3, the AJCC Staging form to be completed by managing physician prior to starting definitive treatment and prior to reporting to the Texas Cancer Registry.
- In non-emergency situations, the American College of Surgeons Commission on Cancer suggests a planning conference to include input from diagnostic radiology, pathology, surgery, medical oncology, and radiation oncology to determine the optimal sequence of proper therapy for the patient's cancer. Planning conferences may not be necessary in minimally invasive cancers that will have appropriate follow up by that physician.
- Appropriate treatment of the patient's pain, side effects of their therapy, and support for their health-related quality of life, including palliative care from diagnosis through end of life.
- Appropriate long-term follow up to evaluate for cancer recurrence, second primary cancers, other sequela of treatment and prevention.
All of these cancer policies may not apply to patients whose underlying medical condition may preclude treatment of the suspected or proven cancer. However, optimal treatment of the patient's pain, symptom control, and health-related quality of life should be provided with respect to the patient's preferences.
Recommendation : Approval .
TMA House of Delegats: TexMed 2006
Last Updated On
July 06, 2010
Originally Published On
March 23, 2010