Write a reflection this week about executive powers and their limits. Explain Congressional oversight of the president including impeachment, give examples. Do you think the limits work?
or “sends radio wave energy directly into the tumor”. RFA is most commonly used in cancer cases where tumors cannot be taken out with surgery, for example, liver, kidney, and lung tumors (Gersten 2017). The temperature used is around 106-113 degrees Fahrenheit and is administered by a device called the BSD-500 (Excellus BCBS). A surface applicator is applied to the tumor and the area is heated for around an hour. Usually hyperthermia is done within an hour of radiation (UCSF). Side effects sometimes occur and include burns, blisters, discomfort, or pain (Cancer.org). According to Excellus BlueCross BlueShield health insurance, their medical policy states that “based upon our criteria and assessment of peer reviewed literature, superficial hyperthermia has been medically proven to be effective and therefore, medically appropriate when used in combination with radiation therapy for the treatment of patients with the following: Superficially recurrent melanoma; chest wall recurrence of breast cancer; or recurrent cervical lymph nodes from head and neck cancer” (Excellus). Although this insurance approves of certain types of hyperthermia, others are only considered investigational to them. The treatments that are considered investigational are interstitial hyperthermia, regional hyperthermia, regional perfusion hyperthermia, and whole-body hyperthermia. The reason the Excellus BlueCross BlueShield and the FDA have not approved other types of hyperthermia treatment is because studies do not have enough patients, do not have a standard technique, are not random or controlled, and do not have long term results. Currently the Food and Drug Administration (FDA) has approved hyperthermia in the treatment of solid surface and subsurface malignant tumors that are recurrent or progressive despite regular treatment (Excellus). Medicare approves hyperthermia treatment when used with radiation for primary or metastatic cutaneous or subcutaneous superficial malignancies and it is not covered when used alone or with chemotherapy (Center for Medicare and Medicaid Services). Although not all treatments are FDA approved, University of California San Francisco uses “multi-modality hyperthermia” meaning that they customize the treatment to each patient’s cancer, including combining chemotherapy and hyperthermia (UCSF). Cost of treatment is something that is very important to cancer treatment, as if something is too expensive, it limits the availability of treatment. Based on research on line, there are no current prices for the cost of hyperthermia treatment, but we can infer from other countries and the past on what the cost might>GET ANSWER