Disease Management Update
Volume IV, No. 42
February 14, 2008

Dear Healthcare Intelligence Network Client,

According to the University of Cinncinnati, nearly 215,000 Americans will be diagnosed with a brain tumor in 2008. In this week's Disease Management Update, while one study deals with a "Jekyll and Hyde"-type gene that could both fight a tumor or help the tumor advance in brain cancer glioblastoma cases, another study notes that new brain tumor treatments have never been better as the nation’s leading brain tumor centers have never been better.

Your colleague in the business of healthcare,
Laura M. Greene
Editor, Disease Management Update

If this is a forwarded copy of Disease Management Update and you like what you see, you can register to receive your own copy of this complimentary service. Sign up at:

Table of Contents

  1. Gene Plays “Jekyll and Hyde” in Brain Cancer
  2. Disease Management Q&A: Furthering the Concept of Patient-centered Care
  3. HealthSounds Podcast: Building an Advanced Medical Home
  4. New Brain Tumor Treatments Offer Hope
  5. Survey of the Month: Health and Wellness Coaching
  6. Better Health Outcomes Through Disease Management

1. Gene Plays “Jekyll and Hyde” in Brain Cancer

Many researchers are determined to find new ways to treat brain cancer glioblastoma. One approach focuses on a gene called STAT3. In several tumors, STAT3 takes the role of an oncogene — that is, a gene whose normal functions are derailed and, as a result, becomes a driving force in a tumor’s development. Clearly then, blocking STAT3 would deal a major blow to such tumors.

A new study from Harvard Medical School has found that STAT3 isn’t always the villain. While it does behave as an oncogene in certain types of glioblastoma, in others it becomes what’s called a “tumor suppressor gene,” a type of gene often responsible for keeping the renegade cancer cells in check. In other words, the same gene in the same cancer can play a completely different role from one person to the next, depending on genetic nuances between individuals. The results appeared online February 6 in Genes and Development.

“This discovery lays the foundation for a more tailored therapeutic intervention,” says Azad Bonni, an associate professor of pathology at Harvard Medical School, and senior author on this study. “And that’s really important. You can’t just go blindly treating people by inhibiting STAT3.”

To learn more about this study, please visit:

2. Disease Management Q&A: Furthering the Concept of Patient-centered Care

Each week, healthcare professionals respond to a reader's query on an industry issue. This week's expert is Elizabeth Reardon, consultant, Office of Community Programs, Commonwealth Medicine, a division of the University of Massachusetts Medical School.

Question: The healthcare industry is placing a great deal of faith in the establishment of medical homes to improve care access and quality. However, a recent non-scientific online survey on this topic found that many healthcare organizations aren’t familiar with this term. How can we further this concept of patient-centered care?

Response: (Elizabeth Reardon) It’s always easier when you’re trying to think of a new concept to put it in the context of something you’re already familiar with. A lot of organizations and practices have been following the chronic care model that talks about how you put your system of care together to help people and families who have chronic illnesses. The medical home concept sort of parallels the chronic care model. That program focuses on the healthcare system and the kinds of things you need to have in place in your system. The medical home program is focused on the other end of the stick. They’re more complementary and look for the best way to support patients and their families, especially when people have chronic conditions that are going to pretty well last over the lifespan. If you think of a chronic care model and kick it up a notch to effectively address the needs of patients and families, that’s a good way to start thinking about it.

For more information on medical homes, please visit:

We want to hear from you! Submit your question for Disease Management Q&A to info@hin.com.

3. HealthSounds Podcast: Building an Advanced Medical Home

In this week's Disease Management podcast, Dr. Lonnie E. Fuller, medical director for the Pennsylvania Medicaid ACCESS Plus Primary Care Case Management and Disease Management (PCCM-DM) program, and Dawn Bazarko, UnitedHealthcare's senior vice president of clinical innovation, examine medical home projects already in action. Dr. Fuller explains that it is the solid relationships that patients build with ACCESS Plus providers and office staff, many of whom live in the neighborhood, that keep them coming back in for care, while Bazarko comments on the challenge of marketing the medical home to the commercial population.

To listen to this complimentary HIN podcast, please visit:

4. New Brain Tumor Treatments Offer Hope

Patients diagnosed with one of more than 100 types of brain tumors should remain hopeful as treatment options at the nation’s leading brain tumor centers have never been better, according to Philip Theodosopoulos, M.D., assistant professor of neurosurgery and director of the division of skull base surgery at the University of Cincinnati (UC).

“There’s no question that these tumors remain a difficult problem to deal with. But there are options — good options — and there is plenty of reason for optimism,” says Dr. Theodosopoulos. “We have gotten much better at the treatment of these tumors, and we have minimized the risk to the point that a patient’s risk of developing a new, permanent neurologic symptom as a result of neurosurgery at a major center is close to zero. That was not the case even 10 years ago.”

Two developments in particular have revolutionized the treatment of brain tumors in the last few years. One is functional MRI, which enables brain tumor specialists to locate functional (e.g., language and motor) areas of the brain before surgery and to chart a safe passage around these areas to the tumor. The other revolutionary development is minimally invasive cranial surgery, in which surgeons operate through tiny openings in the nose, eyebrow or skull, with minimal disruption to the brain. Patients who would have been hospitalized a week after traditional surgery are often able to go home the next day, says Dr. Theodosopoulos.

To see more of this study's results, please visit:

5. Survey of the Month: Health and Wellness Coaching

Complete our online survey on health and wellness coaching by February 29, and you'll get a free executive summary of the compiled results.

To participate in this survey and receive its results, please visit:

6. Better Health Outcomes Through Disease Management

McKesson Corporation and CMS Health Integrated are providing CoverColorado with the nation’s first integrated care program for high-risk health plan participants. More than 3,000 people with chronic and high-cost health conditions now have access to an around-the-clock, integrated care program that includes both disease management and case management services.

To download this complimentary white paper, please visit:
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