On this day we salute you who served and protected this great country. Those of us who have not served in the military will never fully know your sacrifice, but realize that you are greatly appreciated. Your gift to our country of time away from family, education, or career is worthy of more than one day of remembrance each year, but know this day of appreciation is heartfelt.
May you feel the love and respect of your country today and every day. God bless you and God bless America!
Too often, cancer patients and their families must choose between traditional hospice limited to palliative care and active treatment of their disease. Fortunately, the Veterans Health Administration (VA) has taken a lead in offering both hospice/palliative care and cancer therapy concurrently in the United States (US). This is a major step in what has been demonstrated in clinical trials to improve quality of life for cancer patients, and, potentially a longer life as well.
Traditionally, when entering hospice, a patient transitioned to a new paradigm – new medical goals, new medical team, perhaps new surroundings. The intent was to provide comfort, symptom relief, and mental relief, both psychologically and spiritually. The US medical establishment has lagged behind the United Kingdom (UK) for the past two decades in merging palliative care into the full range of cancer care.
Palliative care in the US was recognized for its financial benefits initially. Through this model, resources were used more effectively and there were fewer readmissions – both highly prized in the Diagnosis Related Groups reimbursement model, which sets payments and penalizes hospitals for readmissions. But creating a system where patients must choose either hospice or treatment has significant drawbacks. People on the palliative care of hospice no longer had access to treatments that could possibly give them better quality of life, or even extend their lives. Those patients who chose treatments, but not hospice, were denied the extra support and management of symptoms that palliative care offers.
In the 2015 Quality of Death Index, the US came in 9th place behind the UK, the Netherlands, Germany, Taiwan, Belgium, Ireland, New Zealand, and Australia. However, the Centers for Medicate and Medicaid Services (CMS) is currently piloting a new program for Medicare beneficiaries that could change that standing. Patients in the program can receive both palliative and anticancer therapies through any of 140 Medicare-certified hospices enrolled for a period of five years. Patients must fit certain criteria to participate.
Hurdles remain before the US can move up the ladder to providing the best care in the world to its citizens, but with the VA leading the way, and the CMS providing a pilot program for comprehensive care, the US can move up a needed rung on that ladder.
The VA, Washington University, and the American Society for Radiation Oncology (ASTRO) have joined to initiate a new Radiation Oncology Practice Assessment (ROPA) program. For the first time, radiation oncologists will be provided continuous feedback on the headway made in cancer therapy through new and innovative information technology techniques.
There are three major treatments for cancer: surgery, chemotherapy, and radiation. Approximately 60 percent of patients undergo radiation. This program plans to use the information gathered to improve cancer treatment for our Veterans who comprise a large portion of cancer victims. The first year will concentrate on the review of treatments for prostate and lung cancers, including mesothelioma.
Bruce D. Minsky, MD, FASTRO, chair of the ASTRO Board of Directors, stated, “ASTRO is deeply committed to improving the quality of cancer care for our Veterans and all Americans. Our cancer experts are enthusiastic about this new opportunity to better measure and enhance radiation delivery with the goal of producing high quality patient outcomes.”
With this assessment, a more complete determination of a patient’s therapy and their response to it can be provided to the oncologist. The goal is the ability to more closely pinpoint therapies that succeed in the fight against cancer.
December 7, 1941 – a watershed moment in United States history as 2400 Americans died in the attack on Pearl Harbor. There was shock, horror, and an enormous sadness as the realization of this tragedy sunk in and the knowledge that a war for the US had begun, bringing even more death. But there was also a gathering together that we would stand united with our allies to do whatever was necessary to protect our country and defeat our enemies.
Sixty years later, that American spirit was seen once more as we experienced the largest loss of life from an attack on US soil since that day in 1941. Again, we pulled together as this tragedy touched the hearts of every person in all fifty states.
We currently hear of, and experience, the divisions within our country – and they are real. But at the core, we are all Americans who are proud of our country – a country imperfect in many ways – but a country that is willing to send its citizens in harms way to assist freedom in other parts of the world. A country that cares about this planet, that cares about life, liberty, and the pursuit of happiness for each person and their freedom to be the best they can be. From these horrible experiences, we take stock and realize the immense privilege we have to live in this country of opportunity and re-commit to our part in ensuring that the United States of America continues to lead in freedom and justice for all.
1918: The agreement to a temporary cease fire of the First World War, known at that time as “the Great War.” This major event was formalized by the signing of an armistice between the Allied nations and Germany on the 11th hour of the 11th day of the 11th month of 1918.
1921: The Arlington National Cemetery in Washington, D.C. became the resting place of the first American unknown soldier on November 11th.
1926: A resolution that the “recurring anniversary of November 11, 1918 should be commemorated with thanksgiving and prayer and exercises designed to perpetuate peace through good will and mutual understanding between nations” was passed by Congress urging the president to issue an annual proclamation to observe Armistice Day.
1938: This day became a legal federal U.S. holiday in 1938, “dedicated to the cause of world peace and to be hereafter celebrated and known as ‘Armistice Day.’
1954: The 83rd U.S. Congress amended the 1938 act, changing the word “Armistice” to Veterans.” Because other wars continued, World War II and the Korean War, this change honors veterans of all wars.
1968: Congress passed The Uniform Holidays Bill, ensuring three-day weekends for federal employees. Veterans’ Day was one of the four holidays affected.
1971: The fourth Monday in October was celebrated instead of November 11th, but it soon became evident that people, and thus states, disapproved of the change of this historic date.
1975: President Gerald R. Ford signed a law changing Veterans’ Day to its original November 11th date beginning in 1978.
Today, we honor our service men and women, living or dead, who served, and still serve, our nation with honor, in peacetime or war. This is a time to tell these brave warriors and defenders, “Thank you for your service. We salute you.”
