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Through the Choosing Wisely campaign, cancer specialists have proposed seven changes to standard cancer treatment that will make treatment less painful and far less expensive.

Ever since the proposal of Obamacare, American medical experts have been looking for ways to avoid rationing medical care to reduce costs, but rather to avoid waste in medical care to reduce costs and also to improve outcomes for their patients.

Three years ago, Dr. Howard Brody of the University of Texas Medical Branch challenged American doctors to identify common tests that don't make a difference in good medical care. Since early 2013, the American Board of Internal Medicine Foundation and consumer watchdog organization Consumer Reports have collaborated in the Choosing Wisely campaign, alerting doctors to procedures that lack a scientific basis.

Recently the campaign identified seven common practices in cancer treatment that don't really work.

Through the Choosing Wisely campaign, the American College of Surgeons  recommends that oncologists stop:

  • Removal of lymph nodes (a procedure that often results in lymphedema, uncontrollable swelling in the arms) in women treated for stage I or stage II breast cancer, without a procedure called sentinel node biopsy, which can show that lymph nodes are not yet cancerous.
  • Routine colonoscopy of people whose life expectancy is less than 10 years who do not have a personal or family history of colon cancer. This change would eliminate routine colonoscopies for most people over the age of 75.

Also, the Commision on Cancer recommends that doctors avoid:

  • Starting cancer treatment before determining the extent of the cancer and discussing the treatment plan with the patient.
  • Performing major surgery on the chest or abdomen without first making sure that breathing passages can be kept open in case of pneumonia and there are veins available for administering IV pain medication.
  • Using surgery as a first line of treatment for cancer without considering whether other methods would offer better quality of life.
  • Performing mastectomy for breast lumps that are not known to be cancerous unless a needle biopsy cannot be done.

Also the Commission on Cancer recommended that cancer doctors plan for success. Cancer patients should be subjected to follow-up cancer monitoring without the doctor offering the patient a "survivorship plan," an outline of what future treatment will be, before testing for the recurrence of cancer.

The idea behind the new guidelines for cancer treatment is that patients should understand what their doctors are doing before they do it.

Doctors should not duplicate the efforts of other doctors, and medical procedures should be limited to those that are "truly necessary" and "free from harm," and doctors should avoid the rest.

But what if the best efforts of doctors don't result in remission?

The Choosing Wisely campaign has also created new guidelines for end of life care, for people who have cancer and for people who suffer from other terminal ages.

Continue reading after recommendations

  • Medscape Medical News. Seven Common Cancer Surgery Practices That Should Stop. Medscape, 4 September 2013. Schnipper LE, Smith TJ, Raghavan D, Blayney DW, Ganz PA, Mulvey TM, Wollins DS. American Society of Clinical Oncology identifies five key opportunities to improve care and reduce costs: the top five list for oncology. J Clin Oncol. 2012 May 10. 30(14):1715-24. doi: 10.1200/JCO.2012.42.8375. Epub 2012 Apr 3.
  • Photo courtesy of The U.S. Army by Flickr :
  • Photo courtesy of Physio-Control, Inc. by Flickr :

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