American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

New Drugs, New Docs - Targeted Cancer Treatments, Hospitalists


On this week's show, a new generation of cancer drugs that offer the promise of more personalized medicine. And later in the show: Hospitalists. A new breed of medical specialist who is trying to make hospitals more efficient and safer for patients.

Listen to this episode.

Segment 1: Targeted Cancer Treatments
Guest: Dr. Leonard Lichtenfeld, Deputy Chief Medical Officer for the American Cancer Society and Director of the Society's Cancer Control Science Department

While a cure for cancer remains frustratingly elusive, treatment of the disease is rapidly evolving. Among the more recent - and more promising - means of treating cancers is called "targeted therapy." While traditional chemotherapy can attack both good and bad cells, leading to sometimes agonizing side effects, "targeted therapy" - as the name suggests - works less like a shotgun and more like a rifle, disrupting cancer cells on the molecular level and often proving less toxic to patients.

Targeted cancer therapies have only been around for about a decade, but they're already big business. Since 2000, targeted therapies have accounted for three times as many of the FDA-approved anticancer drugs as chemotherapies. And by 2007, sales had already reached 17 billion dollars a year - compared with sales of only 10 million for conventional chemotherapies: a testament to their popularity as well as to their relative costliness.

Targeted cancer treatment success stories are giving patients and physicians hope that once-deadly diseases will soon become manageable. The leukemia drug Gleevec has been called "the closest thing to a cure for cancer." The chronic myeloid form of the disease was almost always fatal. Now patients can manage the disease with a daily pill. And a recent series in The New York Times documented the extraordinary impact of an experimental drug for treating patients with advanced melanoma, a deadly form of skin cancer.

Physicians and researchers are hopeful that today's targeted cancer therapies will become tomorrow's personalized cancer treatments: therapies tailored to a patient's specific disease. Already, advances in genetics allow cancer patients to be measured for biological markers that can tell doctors how a cancer is likely to progress or whether a drug is likely to be effective or not.

But all these encouraging developments have been tempered by countless other disappointments, as our guest today on The Recovery Room can attest.

Segment 2: Hospitalists
Guest: Dr. Scott Rissmiller, Founder and Medical Director at Carolinas Hospitalist Group

While innovation in drug-making is part of the business model, innovation in medical practice is far less common. Which makes the emergence of Hospital Medicine and the Hospitalists who practice it such a surprising success story.

If your doctor sends you to the hospital, you might expect that she or he would join you there, helping to manage your care. If this was once the case, it's becoming less and less common. More often than not, the first doctor you'll see after admission will be a Hospitalist.

Today's hospitals are increasingly complex environments for treating the very sickest patients, which can make it harder for busy outpatient physicians like primary-care, internal medicine, or family doctors to work efficiently when they join their patients in the hospital. The Hospitalist, on the other hand, is trained to navigate the modern hospital environment, working as a case manager of sorts for hospitalized patients as they're treated sometimes by multiple specialists.

It was 1996 when an article in The New England Journal of Medicine first identified the Hospitalist trend and gave the position its name. At the time, there were less than a thousand practicing Hospitalists. Today, more than half of U.S. hospitals have a Hospitalist program, with as many as 30,000 Hospitalists currently practicing.