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Inconsistent cancer treatment and newly adopted guidelines

  Recent work in the medical industry confirmed the inconsistency of cancer care in America.  The physician authors confirmed that despite the many burdens they are already carrying, cancer patients and their families must actively research and control the care they recieve and advocate on their own behalf in order to be assured of proper care.  Dr. Nina Bickell of Manhattan's Sinai Hospital noted that despite the wonderful breakthroughs in American medicine, many patients who would benefit do not receive them.  A 1999 report by the Institute of Medicine in Washington concluded that "there is a wide gulf between what could be construed as the ideal and the reality of [American's] experience with cancer care."

       Dr. Stephen Edge, of the Roswell Park Cancer Institute in Buffalo, noted that "it's scary how much variation there is" in drawing attention to new rudimentary guidelines for cancer treatment.  "While they're fairly simple and straightforward, and they seem very basic, it's quite surprising how many people do not get the care that's recommended".  The guidelines are available at

        The primary causes of inconsistent care are considered to be varied.  One cause is a common denominator of most sub-standard medical care--simple lack of experience.  Doctors who treat a particular condition or who perform a particular procedure repeatedly gain proficiency with practice.  So do the hospital staff that they rely upon.  Cardiac studies have shown that open-heart surgery is safest where the entire OR staff performs more than 200 procedures per year.  Pathologists gain skill in recognizing aberrant cells if they study abnormal cells on a consistent basis.  Specialization carries inherent rewards in proficiency.  Other explanations for inconsistent care included poor communication, lack of screening (either by the patient or by the medical provider) and failure to seek a second opinion from a tertiary care center.

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