Head and neck cancer care at a community-based teaching hospital.

Background: The purpose of this analysis was to demonstrate that the National Cancer Institute (NCI) Community Clinical Oncology Program (CCOP) will result in accruals to national research protocols for patients with malignancies in a community-based teaching hospital.

Methods: We retrospectively reviewed the records of oncology patients eligible for clinical trials referred to the Helen F. Graham Cancer Center (HFGCC).

SES discrepancies and Delaware cancer death rates.

Cancer can be monitored fairly effectively by using cancer registry data for site, stage, age, sex, and race. Adding to this the patient's years of education, now only found on death certificates, should not be difficult since it is an easily measured major SES factor. Most comorbidities should also be easy to obtain since hospitals usually code them.

Medical mission to Honduras. December 20, 1998-January 2, 1999.

This is the story of a team of medical professionals who responded to an appeal from Church World Services in New York to provide two weeks of primary care for Honduran people in areas devastated by Hurricane Mitch. It was a remarkable experience to see how a small team of changing physicians, nurses, and support personnel could function effectively although they had not known each other, or ever worked together before. Over a period of two weeks with two major holiday weekends and an unusual amount of time spent in travel, the team in seven working days provided primary care to about 500 patients ages 1 day to 82 years with limited medical supplies and no laboratory resources.

What is being done about Delaware's high cancer death rate? (1988 through June 1997).

After more than ten years of studies of Delaware's high cancer death rates by Delaware's Division of Public Health, few of the recommendations to reduce the excessive number of cancer deaths have been understood or adopted. Although rural Sussex County's cancer death rate is higher than the other two counties (except for lung cancer), and Delaware has only a few more cancers per population than the national average, industrial toxins commonly continue to be blamed for the State's high cancer mortality rate. People are still not persuaded that over the long run, cancer deaths would be cut by adopting healthy life styles to: 1.

Why is health care reform faltering? Delaware's experience.

Many managed care plans propose short-term economics, without stressing quality, assuring universal access, supporting research, or caring for the poor. None provide much in the way of preventive services. In the absence of any major national changes to assure universal access to health services, local health care providers and state regulatory agencies need to be freed from many restrictive federal laws and regulations.

The Community Clinical Oncology Program (CCOP) story: review of community oncologists' experiences with clinical research trials in cancer with an emphasis on the CCOP of the National Cancer Institute between 1982 and 1987.

Purpose: To review the growth of community physicians' involvement in National Cancer Institute (NCI) clinical research trials as a significant contribution to cancer control, and to show their impact, not yet fully realized, on cancer morbidity and mortality in the United States.

Design: Background information, based on the personal experience of participants, as well as a review of pertinent literature, portrays the evolution of the clinical research component of community oncology in the United States over the last 25 years.

Results: Data from Community Clinical Oncology Programs (CCOPs) I and II have been used to outline some of the results of this far-reaching program.

Is better access to medical care needed in Delaware?

Improved access will require more primary care providers, a reduction in administrative red tape, and a clientele with healthy lifestyles who know how to use the system appropriately. Prevention is a necessary component of access even though it often takes years to produce results and is usually not dramatic or glamorous (the heart attack which does not occur is hard to measure). Over time, the health of Delawareans should show improvement through appropriate access to medical care, which should not only be cost effective but add to the quality of life.