UPMC Hillman Cancer Center

April 2011

Pink Cancer RibbonLast month I had the opportunity to join 4,000+ physicians and researchers from around the world at the 12th meeting on the Primary Therapy of Early Breast Cancer in St Gallen, Switzerland. Every two years we come together as a breast cancer community to review what we have learned about early stage breast cancer. A highlight is a consensus panel that considers how we can turn our knowledge into evidence-based and expert opinion-driven guidelines about the treatment of women (and men) with early stage breast cancer and identify important questions that are imperatives for clinical research. I was privileged again this year to serve as one of several dozen international experts driving this guideline process, which will inform physicians about optimal breast cancer management for the next few years.

Such efforts are at the core of our mission at University of Pittsburgh Cancer Institute (UPCI) and UPMC CancerCenter —which is to optimize care of cancer patients and their families. We pride ourselves on being patient-centered and research-driven in all that we do. Indeed, my participation in this international effort is but one example of our commitment to quality. We in Pittsburgh have been at the vanguard of efforts to optimize and standardize cancer care through the use of evidence-based treatment guidelines.Photo of Dr Ellis Launched in 2005, our pathways program (led by Peter Ellis, MD, Deputy Director for Clinical Services and Associate Chief Medical Officer for UPMC CancerCenter) was designed to ensure that patients receive the same high quality care across all sites in our network. Originally launched as a means to standardize radiation oncology care across our network, this effort has now been expanded to educate physicians and other health care providers about the optimal medical oncology treatments for 17 different cancers that together comprise more than 90% of cases. These clinical pathways are a living document. Expert panels of community and academic physicians meet regularly to review new clinical research findings and refine treatment pathways to be sure that we are delivering the best possible oncology care—treatments that are, in order of priority, the most efficacious, least toxic, and least expensive. Given the nature of oncology care, participation in a clinical trial is always the first choice of therapy (if such a trial exists within our system), because such treatment is frequently the best option for the patient. Not only do we work together to derive such pathways, but we regularly review our individual and collective adherence to these pathways as part of our commitment to providing the best possible care.

Quality of care is receiving much attention at the national level as well. For this reason we are also participating in a national effort to evaluate quality oncology care as part of the Quality Oncology Practice Initiative of the American Society of Clinical Oncology. This national program allows medical oncology practices to assess their adherence to a set of accepted oncology care guidelines—it permits us to both look within and outside to see how we rate with others around the country. We believe we are the largest group of affiliated physicians in the United States to participate in this program, which is another measure of our absolute commitment to quality patient care. We look forward to seeing how we perform according to national guidelines, and using these findings to improve our patient care even more.

Sometimes patients worry that such guidelines are geared to the average patient and do not consider them as a unique individual with a unique illness. They are concerned that such "cookie cutter" medicine might keep them from getting the best possible care. Rest assured that we at UPCI/UPMC CancerCenter are committed to ensuring that each patient gets the best possible care by using all the expertise and knowledge that exists to ensure quality care. And we are committed to working with our patients through clinical trials to advance the personalized cancer medicine of the future. We truly are patient-centered and research-driven in all that we do.