What Does the Medical Profession Mean by "Standard of Care?"
 

Interesting Correspondence from the Journal of Clinical Oncology: http://jco.ascopubs.org/cgi/reprint/JCO.2009.24.6678v1

Hopeful

Re: What Does the Medical Profession Mean by "Standard of Care?"
 

Interesting discussion. Me thinks the concept gets stretched at times in cancer world..where "standard of care" may not offer much care at all.
On the other hand, it was helpful me to hear the phrase when mom was getting a surgery consult and the surgeon was considering skipping a node biopsy. This didn't match with what I had read. I asked someone at ACS and they said it wasn't standard of care. That gave me the courage to confront the surgeon.

Re: What Does the Medical Profession Mean by "Standard of Care?"
 

To me it means the accepted protocol. For example, when I was diagnosed in 2004 standard of care was not "segmented" to Her2 neg and Her2+ (since Herceptin could not be used in the adjuvant setting). Therefore, standard of care was as such:

No nodes, less than 1cm tumor - masectomy or lumpectomy with rads

larger than 1c but less than 2 with no nodes - 4 AC (plus rads if lumpectomy)

as soon as a positive node or greater than 2cm tumor - 4AC and 4 Taxol.

Herceptin changed protocol since the trials also included TCH so TCH or AC followed by TH became standard of care for Her2+.

My cousin just finished treatment - her2 neg and a medium oncotype (lobular so she had double masectomy. Her affected side had 3 tumors (all 1.2 cm or smaller - 2 were the same ER+PRneg and another was ER+PR+). No nodes - got 4 taxotere+cytoxan which is becoming standard of care too (as oncs are getting away from adriamycin especially for Her2 neg women).

It will get more and more complicated as more tumor markers are discovered too.

Standard of care is really " what is done now". But now means alot of choices too.

Re: What Does the Medical Profession Mean by "Standard of Care?"
 

Standards of Care used by most oncologsts are reccomended by The NCCN - National Comprehensive Cancer Network. www.nccn.org

Here is their all inclusive guide:

NCCN Clinical Care Guide

Regards
Joe

Re: What Does the Medical Profession Mean by "Standard of Care?"
 

I think the correspondence is trying to define what standards a treatment has to meet in order to be called, "standard of care," and has concluded that the term has a definition in a court of law, but no real definition in medicine: "the term standard of care should be used with caution. Currently, it can be self-awarded either by a group of like-minded individuals or by a specialist society or organization and is a term which can be abused with the intention of providing impact and authenticity to a point of view. At worst it could be considered to be self-promoting. This possiblity is acknowledged by the National Institutes of Health Consensus Development Program, which states the following 'Most other scientific and medical conferences rely on content experts to make reccomendations; however, this raises the possibility of potential conflicts of interest given the expert's financial and career ties to the topic.'"

Hopeful