SGO Issues December 19, 2013
Research Institute grant award winners announced
Disparities in Cancer Care free eLearning Series
Annual Meeting Preview: Pre-conference Satellite Surgical Course
Budget deal halts Medicare cliff for physician reimbursement
Voices: Discovering CA-125
Support the Foundation for year-end giving
Important deadlines and reminders
The Foundation for Gynecologic Oncology’s Research Institute has announced the 2014 grant recipients for the Improving Outcomes Research and Education Award and the Wilma Williams Education and Clinical Research Award for Endometrial Cancer.
The grant awards, which cover the full calendar year, can be funded to a maximum total of $10,000 per year.
The Foundation’s Project Development and Protocol Review Committee received 15 qualified applications for the Improving Outcomes Research and Education Award, which is funded by a grant from the Gynecologic Oncology Group. The following top three research projects were awarded for 2014:
- Exploring care models in gynecologic oncology: The impact of distance and demographic factors on high-volume center care, Kemi M. Doll, University of North Carolina, Division of Gynecologic Oncology
- The acceptability and usefulness of comprehensive Survivorship Care Plans in the care of endometrial cancer survivors, Kristy K. Ward, University of California, San Diego
Feasibility of gynecologic cancer centers of excellence, Jeff F. Lin, Gynecologic Oncology at Magee-Womens Hospital of University of Pittsburgh, Pittsburgh, PA
The Foundation for Gynecologic Oncology’s Wilma Williams Education and Clinical Research Award for Endometrial Cancer Created was created in 2013 through a grant from Dr. James and Vicki Orr. The Project Development and Protocol Review Committee received seven qualified applications and the following two research projects were awarded for 2014:
- Feasibility of the institution of a combination of dedicated nutritional counseling and exercise in Stage I endometrial cancer patients following minimally invasive surgery in the post-operative period, Charles A. Leath III, MD, University of Alabama at Birmingham
- “Preventing endometrial cancer through outreach to Lynch syndrome families,” Kristin Zorn, MD, University of Arkansas for Medical Sciences
The SGO, in collaboration with the American Society of Clinical Oncology, LIVESTRONG Foundation and 11 other multidisciplinary organizations, has developed a free eLearning series that delves into gaps in the quality of health and health care in oncology.
The purpose of this educational series is to increase members’ knowledge and cultural competence through case studies, interactive slide presentations, and self-assessments. This initiative includes the following:
- Disparities in Cancer Care: Do You Know…?
A self-assessment course designed to identify key barriers to cancer care among different racial, cultural, ethnic, and socioeconomic groups.
- Disparities in Cancer Care: Take Action!
A slide-based course designed to help multidisciplinary oncology teams increase disparities knowledge related to socioeconomic status, access to care, age-related issues, and obesity.
- Cultural Competence for Oncology Practice
A slide-based course that will help identify barriers within healthcare related to various aspects of cultural competency– specifically race, gender, religion, age, language and culture.
CME, CNE, and Pharmacy credit are available for these courses, which are available at ASCO University®.
Course directors Kate O’Hanlan, MD, and Mitchel Hoffman, MD, will conduct this training course at the 90,000-square-foot Center for Advanced Medical Learning and Simulation (CAMLS) – a state-of-the-art training and research facility located within a short walking distance of the Tampa Convention Center, site of the 2014 SGO Annual Meeting.
“CAMLS is uniquely poised not just for simulation activities but to begin the process of creating means and standard deviations for the assessment of technical and teamwork competence through simulation-based education, training and research,” said Dr. Hoffman. “The center includes a surgical and interventional training center with large-scale facilities for tissue and animate exercises including 35 surgical skills stations, with trauma and hybrid operating room suites and a robotics suite.”
The satellite surgical course will be divided into a morning didactic session followed by a hands-on robotic lab and laparoscopic labs. The morning session will be comprised of a didactic video, slide and lecture sessions covering robotic and conventional laparoscopic oncology procedures for gynecologic cancers, including radical hysterectomies and pelvic and high aortic lymphadenectomies. The management of intraoperative complications, such as ureteral, bladder, bowel, and vascular will also be discussed.
“Utilizing didactics and hands-on lab, participants will gain knowledge and experience with these techniques in oncologic surgery and management of related intraoperative complications,” said Dr. Hoffman. “The design of the course will allow participants to compare and contrast these two approaches as well.”
For learning objectives, registration fees and a full schedule of events, visit the pre-conference courses and sessions page on the SGO website.
To allow a pathway for permanent repeal of the Sustainable Growth Rate (SGR) and replacement of the method for updating Medicare physician payment, the budget bill passed by the House of Representatives on Dec. 12 includes an amendment to halt the more than 20 percent cut in Medicare physician reimbursement.
The amendment included a half percent update to overall physician payments for the first three months of 2014, in the hope that this will allow enough time for Congress to pass the comprehensive legislation needed to address these annual cliffs.
The Senate passed this same budget bill on Dec. 18. Now that the Senate has voted, the Centers for Medicare and Medicaid Services (CMS) will have to calculate the conversion factor to be used to calculate physician payments for Jan. 1 – Mar. 31, 2014.
This budget bill also addresses some of the cuts for FY 2014 and FY 2015 that were mandated under sequestration. Its passage will allow the Appropriations Committees to move forward with an omnibus appropriations bill for FY 2014. This will retain an increase in funding for the National Institutes of Health and biomedical research and also allow for consideration of the ovarian cancer research program at the Department of Defense. Congress will need to pass this appropriations bill when it reconvenes in January, before the current continuing resolution expires on Jan. 15, 2014.
SGO Government Relations Committee will be working with the House GOP MD Caucus and other members of Congress over the next three months to address outstanding issues, including the need for a longer transition period, positive updates for physician payment for the entire 10-year period, and benchmark setting for bonus payments. These issues were articulated in a letter from the Caucus to House leadership on Dec. 13.
I didn’t even know CA-125 existed until I was diagnosed with Stage 3 ovarian cancer. CA-125 is a “tumor-associated protein” for ovarian cancer. It is found in the blood. Before surgery my CA-125 level was in the high 100’s (below 35 is considered normal). I learned from other women diagnosed with ovarian cancer that their numbers were in the 1000’s when they were initially diagnosed.
After surgery my CA-125 was in the low hundreds. After my first chemotherapy treatment the result had dropped to 34. My gynecologic oncologist was hoping my CA-125 level would end up in the single digits. I looked forward to hearing my test results during treatment. My CA-125 continued to drop. I went so far as to plot my results on an Excel chart. I was hooked on following my CA-125 and was thrilled as I watching the line slope downward and level out between 9 and 10.
But it wasn’t until I was done with treatment and on a follow-up plan that I realized how much power this test result had over me. It had the power to make me worry and was the cause of many anxious days. On follow-up visits, the first question out of my mouth would be “What is my CA-125?” It crept up a bit to 11. Oh no! It is in double digits! I worried my cancer had recurred. I felt fine and my scans were clear, so I had not recurred. The number started to move up to 15 in the spring. Could it be allergies? We retested and it moved down to 13.
In the fall of 2008 (two and a half years after finishing treatment) it came time for a follow-up CT scan and CA-125. The CA-125 came back at 16. It was up a tiny bit but still normal. I was feeling good so I wasn’t too worried. But this time the scan showed I had recurred on my liver and spleen. A value of 15 and I am fine but a value of 16 and I have a recurrence?
That is when I decided to learn more about CA-125. I read a number of journal articles and found the booklet published by the Foundation for Women’s Cancer, Understanding CA-125 Levels- A Guide for Ovarian Cancer Patients, to be very helpful. The test is not a perfect one. There are a number of different reasons why a woman’s CA-125 could be elevated. Some women have disease with low CA-125 levels, some have disease with high levels and other conditions that cause inflammation in the abdomen can also cause a high CA-125.
Doctors are now following upward trends in a women’s CA-125 level even if those levels are in the normal range. One line in the booklet stood out for me. “We urge women diagnosed with ovarian cancer to try to keep in mind that the CA-125 test is only one indication of how well the treatment is working.” My gynecologic oncologist continues to use the CA-125 as one of a number of tools she uses to assess my health. Do I still ask for my CA-125 results? Yes, but only after I have chatted with her about my exam and scan results. We look at the whole picture.
Every Day is a Blessing!
Please consider the Foundation in your year-end giving decisions. Your contributions allow SGO to pursue its mission to promote the highest quality of comprehensive clinical care through education and research in the prevention and treatment of gynecologic cancers.