This week the American Society of Clinical Oncology along with multiple other Specialty and Primary Care Physician Societies, released formal guidelines on tests and procedures felt to be unnecessary in particular clinical situations.  Each society identified the top 5 medically unnecessary tests in their field.  I have listed the ones specific to oncology below:

1. 1) No Cancer treatment should be used for patients with a low level of functioning who have not benefited from prior treatments that are supported by the evidence
   

2. 2)No Bone Scans, PETs or CT scans to look for metastatic disease in Prostate Cancer patients whose cancer biology is clearly low risk
   

3. 3) No Bone Scans, PETs or CT scans to look for metastatic disease in Breast Cancer patients whose cancer biology is clearly low risk (Stage 0, I or II)
   

4. 4) No routine imaging or laboratory studies during the follow-up of Breast cancer patients who have already completed all cancer treatment and who are not suffering from new symptoms.
   

5. 5)Avoid using up front drugs to stimulate the production of more white blood cells during the administration of chemotherapy that does not usually produce a low white blood cell count
   

I have to say that these guidelines are quite obvious. In my and my colleagues clinical practice it would be highly unusual to see any one of these tests or treatments done for the situations described above.  However, having these medical societies start making these recommendation is a good first step.  I expect to see more of these guidelines continue to be published in the coming years.  It allows physicians to practice evidence based medicine under the cover of a strongly worded society statement.

ASCO also came up with a worthwhile patient booklet