The National Cancer Policy Forum of the National Academies of Sciences, Engineering, and Medicine held a public workshop, Incorporating Weight Management and Physical Activity Throughout the Cancer Care Continuum, on February 13 and 14, 2017, in Washington, DC. The purpose of this workshop was to highlight the current evidence base, gaps in knowledge, and research needs on the associations among obesity, physical activity, weight management, and health outcomes for cancer survivors, as well as to examine the effectiveness of interventions for promoting physical activity and weight management among people living with or beyond cancer. Workshop sessions also reviewed the opportunities and challenges for providing weight management and physical activity interventions to cancer survivors. This publication summarizes the presentations and discussions from the workshop. Table of Contents Front Matter Proceedings of a Workshop Appendix A: Statement of Task Appendix B: Workshop Agenda

Many cancer patients are diagnosed at a stage in which the cancer is too far advanced to be cured, and most cancer treatments are effective in only a minority of patients undergoing therapy. Thus, there is tremendous opportunity to improve the outcome for people with cancer by enhancing detection and treatment approaches. Biomarkers will be instrumental in making that transition. Advances in biotechnology and genomics have given scientists new hope that biomarkers can be used to improve cancer screening and detection, to improve the drug development process, and to enhance the effectiveness and safety of cancer care by allowing physicians to tailor treatment for individual patients&#8212an approach known as personalized medicine. However, progress overall has been slow, despite considerable effort and investment, and there are still many challenges and obstacles to overcome before this paradigm shift in oncology can become a reality. Table of Contents Front Matter Summary 1 Introduction 2 Methods, Tools, and Resources Needed to Discover and Develop Biomarkers 3 Guidelines, Standards, Oversight, and Incentives Needed for Biomarker Development 4 Methods and Process Needed for Clinical Adoption and Evaluation of Biomarker-Based Diagnostics Acronyms and Glossary Appendix: Developing Biomarker-Based Tools for Cancer Screening, Diagnosis,and Treatment: The State of the Science, Evaluation, Implementation, and Economics, Workshop Summary--Margie Patlak and Sharyl Nass, Rapporteurs

Mammography is an important tool for detecting breast cancer at an early stage. When coupled with appropriate treatment, early detection can reduce breast cancer mortality. At the request of Congress, the Food and Drug Administration (FDA) commissioned a study to examine the current practice of mammography and breast cancer detection, with a focus on the FDAa (TM)s oversight via the Mammography Quality Standards Act (MQSA), to identify areas in need of improvement. Enacted in 1993, MQSA provides a general framework for ensuring national quality standards in facilities performing screening mammography, requires that each mammography facility be accredited and certified, and mandates that facilities will undergo annual inspections. This book recommends strategies for achieving continued progress in assuring mammography quality, including changes to MQSA regulation, as well as approaches that do not fall within the purview of MQSA. Specifically, this book provides recommendations aimed at improving mammography interpretation; revising MQSA regulations, inspections, and enforcement; ensuring an adequate workforce for breast cancer screening and diagnosis; and improving breast imaging quality beyond mammography.

The National Cancer Institute's (NCI) Clinical Trials Cooperative Group Program has played a key role in developing new and improved cancer therapies. However, the program is falling short of its potential, and the IOM recommends changes that aim to transform the Cooperative Group Program into a dynamic system that efficiently responds to emerging scientific knowledge; involves broad cooperation of stakeholders; and leverages evolving technologies to provide high-quality, practice-changing research. Table of Contents Front Matter Executive Summary Overview of Conclusions and Recommendations 1 Introduction 2 The Science of Developing Cancer Therapy 3 Operations, Oversight, and Funding of Cancer Clinical Trials 4 Physician and Patient Participation in Cancer Clinical Trials Appendix A: Previous and Ongoing Analyses Undertaken by NCI Appendix B: Committee Member and Staff Biographies Acronyms Glossary

In recent years, the field of oncology has witnessed a number of technological advances, including more precise radiation therapy and minimally invasive surgical techniques. Three-dimensional (3D), stereotactic, and proton-beam radiation therapy, as well as laparoscopy and robotic surgery, can enhance clinician's ability to treat conditions that were clinically challenging with conventional technologies, and may improve clinical outcomes or reduce treatment-related problems for some patients. Both patients and physicians seek access to these new technologies, which are rapidly being adopted into standard clinical practice. Such demand is often propelled by marketing that portrays the new technologies as the "latest and greatest" treatments available. However, evidence is often lacking to support these claims, and these novel technologies usually come with higher price tags and are often used to treat patients who might have achieved similar benefits from less expensive, conventional treatment. The increased cost of novel treatments without adequate assessment of how they affect patient outcomes is a pressing concern given that inappropriate use of expensive technologies is one of the key factors that threaten the affordability of cancer care in the United States. To explore these issues further, the National Cancer Policy Forum (NCPF) of the Institute of Medicine organized a workshop in July 2015. This is the third NCPF workshop in a series examining the affordability of cancer care. Participants explored clinical benefits and comparative effectiveness of emerging advanced technologies for cancer treatment in radiation therapy and surgery and potential strategies to assess the value and promote optimal use of new technologies in cancer treatment. This report summarizes the presentations and discussions from the workshop. Table of Contents Front Matter Workshop Summary Appendix A: Statement of Task Appendix B: Workshop Agenda