ASH Clinical News October 2015 | Page 58

BACK of the BOOK Heard in the Blogosphere Logistic Toxicity Aside from treatment toxicities and financial toxicity, cancer patients must also deal with “logistic toxicity,” or the administrative burden of health care. Processing medical bills, filling out paperwork, coordinating frequent medical appointments — these additional responsibilities compound the physical and financial toll of the disease. Patients and physicians describe the common, but unmeasured problem, in Forbes. “If you consider all the forms, the administrative burden is tremendous. Billing errors, or problems with coding, result in hundreds and thousands of dollars in costs that are avoidable. The concept of ‘logistic toxicity’ makes a great deal of sense. Cost is one problem, but by no means is that the only challenge. Like ‘financial toxicity,’ it influences patients’ well-being, time at work, and leisure.” —Yousuf Zafar, MD, MHS, medical oncologist at Duke University “I’m concerned about the burden the health-care system places on people with cancer. A cancer diagnosis is overwhelming enough, without having to add the myriad of logistical difficulties of coordinating with insurance and with multiple providers who don’t talk to each other. Patients have to be able to advocate for themselves, but that’s a lot to ask of someone who is going through treatment.” —Shelley Fuld Nasso, chief executive officer of National Coalition for Cancer Survivorship Is Science Broken? Given the onslaught of recent retractions in high-profile scientific journals, FiveThirtyEight spoke with scientists about the problems hounding science, finding that science isn’t broken – it’s just a lot harder than people give it credit for. “Science is great, but it’s low-yield. Most experiments fail. That doesn’t mean the challenge isn’t worth it, but we can’t expect every dollar to turn a positive result. Most of the things you try don’t work out — that’s just the nature of the process.” “With cancer, this monster takes hold of you, and you let things go. When you’re thinking about cancer, especially stage 4, certain things jus