Generate an explanation for the given claim using the provided supporting material from the paragraph. Please consider the following points while generating an output. 1) The claim will always have supporting proof in the paragraph, and the paragraph will have a clear point of view supporting the claim. 2) There can be instances where direct correlation to the claim is not available. Make use of the sentences in the paragraph to provide a corresponding output supporting the claim. 3) The explanation should be at least one and at most twelve sentences long.

Paragraph: There is no discussion of cost in this release. The journal article says several institutions refused to provide their prices. Nevertheless, the high cost of robotic surgery is an important issue. The researchers wrote they were unable to say whether those high costs might be offset [or not] by certain potential benefits (such as shorter hospital stays), but the release should have at least acknowledged the cost issues. The release does report the percentage of patients in the robot-assisted and open surgery groups that were still alive with no signs of disease progression two years after their procedures: 72.3 percent of patients in the robotic surgery group compared with 71.6 percent in the open surgery group and it notes the difference was not statistically significant. It also reports that the robot-assisted surgery patients checked out of the hospital after six days on average, compared to 7 days for those in the open surgery group. The release reports only half as much blood loss in the robot surgery group, but does not report the amounts, which averaged 300 mL in the robot-assisted group vs. 700 mL in the open surgery group that's a difference of less than one pint. The release reports that patients who had robot-assisted surgery spent more time in the operating room than those having open procedures (seven hours vs. six hours). It also reports overall rates of adverse effects (67 percent in the robot group vs. 69 percent in the open group), along with listing the most common problems: urinary tract infections and intestinal obstructions. It would have helped if the release had pointed out that these complication rates were not statistically different. In a way, the release is satisfactory and yet maddeningly unsatisfactory. It tells readers that the study was a randomly controlled trial with 350 patients, but it buries the most important point: that the ability of these researchers to do this sort of rigorous trial comparing robot-assisted surgery with open techniques highlights how few such trials are done. Deep in the release, the researchers are quoted as saying the findings "underscore the need for further high-quality trials to assess surgical innovation before this surgical technique is widely adopted in clinical practice" and further that "It is important to conduct these trials before widespread adoption of technology, as has been the case with robotic prostatectomy (removal of the prostate)." The quality of the evidence should have been the lead. The release does not exaggerate the prevalence of bladder cancer. It does not push treatment on those who are unlikely to benefit. The release could be interpreted as promoting a newer more expensive form of therapy that doesn't provide any advantages over the standard therapy. Although the release reports that the study was supported by the National Cancer Institute, it fails to note the financial disclosures several researchers made about money they have received from companies relevant to this study. The comparison of robot-assisted to open surgery was the main point of the release. The release makes clear that both techniques are available including at the institution that issued the release. The release could have informed readers that, according to the published paper, that all ofthe operators in this study haddone at least 10 robot-assisted cystectomies before being allowed to participate in the study. When widespread adoption of the robot-assisted procedure occurs, it would be possible that many surgeons would not have completed that many robotic cystectomies. While the release does tell readers that what is really new here is the use of randomization to compare robot-assisted surgery to open surgery for bladder cancer, it manages to bury that lead so deep under the poorly worded description of the results of this non-inferiority trial that the thrust of the release is unsatisfactory. The release doesn't employ unjustified, sensational language. Claim: Robotic surgery as effective as open surgery for bladder cancer
This news release about a trial that randomly assigned people with bladder cancer to either robot-assisted or open surgery buried the real news under a weak lead that garbles the findings. The news here is that, contrary to assertions of many proponents of robot-assisted surgery, it is possible to randomize patients in order to get a valuable comparison instead of relying on weaker study designs that can't answer the fundamental question about how old and new techniques compare. The release is rated as satisfactory on many criteria because key information was included in the body of the release, but the headline proclaiming that robot surgery is "as effective" as open surgery misses the larger point. The headline and lead also put a pro-robot spin on the results, which could also be summarized as robot surgery is "not clearly worse." Also not explained: robot-assisted surgery is more expensive. The final sentence of the release, a quote from a researcher, should have been the lead: "It is important to conduct these trials before widespread adoption of technology, as has been the case with robotic prostatectomy (removal of the prostate)." We are bombarded with releases and news stories trumpeting results from studies of robot-assisted surgery that don't actually compare the new technology to existing practice. These studies often lack any control group or use historical data that may not be truly comparable. The promoters of expensive new devices then claim that they are relying on the best available evidence. This trial shows better evidence can (and should) be gathered. And in this case, good quality evidence indicates little difference in the techniques, despite what all the big hospital billboards about robot surgery proclaim.

Paragraph: Cancer patients increasingly are having their care guided by gene tumor boards, a new version of the hospital panels that traditionally decided whether surgery, radiation or chemotherapy would be best. These experts study the patient's cancer genes and match treatments to mutations that seem to drive the disease. "We dissect the patient's tumor with what I call the molecular microscope," said Dr. Razelle Kurzrock, who started a board at the University of California, San Diego, where Cairnes is treated. It's the kind of care many experts say we should aim for precision medicine, the right drug for the right person at the right time, guided by genes. There are success stories, but also some failures and many questions: Will gene-guided care improve survival? Does it save money or cost more? What kind of gene testing is best, and who should get it? "I think every patient needs it," especially if cancer is advanced, said Kurzrock, who consults for some gene-medicine companies. "Most people don't agree with me yet. In five years, it may be malpractice not to do genomics." Few people get precision medicine today, said Dr. Eric Topol, head of the Scripps Translational Science Institute. "The only thing that's gone mainstream are the words." HOW IT WORKS NOW If you have a cancer that might be susceptible to a gene-targeting drug, you may be tested for mutations in that gene, such as HER2 for breast cancer. Some breast or prostate cancer patients also might get a multi-gene test to gauge how aggressive treatment should be. Then most patients get usual guideline-based treatments. If there's no clear choice, or if the disease has spread or comes back, doctors may suggest tumor profiling comprehensive tests to see what mutations dominate. That's traditionally been done from a tissue sample, but newer tests that detect tumor DNA in blood liquid biopsies are making profiling more common. The tests cost about $6,000 and many insurers consider them experimental and won't pay. Gene tumor boards analyze what the results suggest about treatment. They focus on oddball cases like a breast cancer mutation in a colon cancer patient, or cancers that have widely spread and are genetically complex. The only options may be experimental drugs or "off-label" treatments medicines approved for different situations. But as tumor profiling grows, it's revealing how genetically diverse many tumors are, and that oddball cases are not so rare, said Dr. John Marshall. He heads the virtual tumor board at Georgetown Lombardi Comprehensive Cancer Center that also serves cancer centers in Pennsylvania, North Carolina, Michigan and Tennessee. "There is a little bit of faith" that testing will show the right treatment, but it's not a sure thing, said Dr. Lee Schwartzberg, who heads one participating center, the West Cancer Center in Memphis. Dr. Len Lichtenfeld, the American Cancer Society's deputy chief medical officer, is optimistic yet wary. Drugs that target BRAF mutations work well for skin cancers called melanomas, but less well for lung or colon cancers. "Just because a mutation occurs it doesn't mean that drug is going to work in that cancer," he said. LUCKY CASES When it does, results can be dramatic. Cairnes' cancer was between her stomach and esophagus, and had spread to her liver, lungs and lymph nodes. Tissue testing found 10 abnormal genes, but on the liquid biopsy only EGFR popped out as a good target. Two drugs aim at that gene but aren't approved for her type of cancer. A tumor board advised trying both Erbitux and Tarceva, the drug her husband also had taken. Within two weeks, she quit using pain medicines. After two months, her liver tumor had shrunk roughly by half. There are signs that cancer may remain, but it is under control. She feels well enough to travel and to take care of her granddaughter. "I'm very, very grateful to have a targeted therapy," Cairnes said. "I cannot expect a better outcome than what we're seeing right now," said her doctor, Shumei Kato. WHAT STUDIES SHOW But is gene-guided treatment better than usual care? French doctors did the first big test, with disappointing results. About 200 patients with advanced cancer were given whatever their doctors thought best or off-label drugs based on tumor profiling. Survival was similar about two months. Another French study, reported in June, was slightly more encouraging on survival but exposed another problem: No drugs exist for many gene flaws. Tests found treatable mutations in half of the 2,000 participants and only 143 got what a tumor board suggested. Some doctors worry that tumor boards' recommending off-label treatments diverts patients from research that would benefit all cancer patients. For example, the American Society of Clinical Oncology's TAPUR study tests off-label drugs and shares results with their makers and federal regulators. LETTING PATIENTS CHOOSE Ann Meffert, who lives on a dairy farm in Waunakee, Wisconsin, endured multiple standard treatments that didn't defeat her bile duct cancer. "She was going to be referred to hospice; there was not much we could do," said Dr. Nataliya Uboha, who took the case to a tumor board at the University of Wisconsin-Madison. The panel gave several options, including off-label treatment, and Meffert chose a study that matches patients to gene-targeting therapies and started on an experimental one last October. "Two weeks in, I started feeling better," she said, and when she saw test results, "I couldn't believe the difference." Many lung spots disappeared and the liver tumor shrank 75 percent. She is not cured, though, and doctors are thinking about next steps. And that could involve a fresh look at her tumor genes. ___ Marilynn Marchione can be followed at @MMarchioneAP __ This Associated Press series was produced in partnership with the Howard Hughes Medical Institute's Department of Science Education. The AP is solely responsible for all content. Claim: Ultra-personal therapy: Gene tumor boards guide cancer care.
Doctors were just guessing a decade ago when they gave Alison Cairnes' husband a new drug they hoped would shrink his lung tumors. Now she takes it, but the choice was no guesswork. Sophisticated gene tests suggested it would fight her gastric cancer, and they were right.

Paragraph: It is the fourth time that the 86-year-old justice has announced that she has been treated for cancer over the last two decades and follows lung cancer surgery in December that kept her away from the court for weeks. December's surgery was her first illness-related absence from the court since being appointed by President Bill Clinton in 1993 and prompted even closer attention to her health. As the court's oldest member, Ginsburg has been asked questions for years about her health and retirement plans. She has also in recent years attracted particularly enthusiastic fans as the leader of the liberal wing of the court, which includes four members appointed by Democratic presidents and five by Republicans. Both liberals and conservatives watch her health closely because it's understood the court would shift right for decades if President Donald Trump were to get the ability to nominate someone to replace her. Asked late Friday about Ginsburg, Trump said: "I'm hoping she's going to be fine. She's been through a lot. She's strong. She's very tough. But we wish her well. Very well." The court kept Ginsburg's latest cancer secret for three weeks, until she finished radiation treatment. Yet there is no obligation for justices to disclose details about their health, and Ginsburg has generally made more information available than some of her colleagues. Retired Justice Anthony Kennedy, for example, had a stent inserted to open a blocked artery in 2005 but the public only learned about it 10 months later when he returned to the hospital to have it replaced. The Supreme Court said in a statement Friday that a routine blood test led to the detection of Ginsburg's tumor. A biopsy performed July 31 confirmed a "localized malignant tumor," and Ginsburg started outpatient radiation therapy Aug. 5. Ginsburg underwent three weeks of radiation therapy and as part of her treatment had a bile duct stent placed, the court said. Ginsburg "tolerated treatment well" and does not need any additional treatment but will continue to have periodic blood tests and scans, the statement said. The tumor was "treated definitively and there is no evidence of disease elsewhere in the body," the court said. The statement did not say if the new tumor is a recurrence of the pancreatic cancer Ginsburg was diagnosed with in 2009, or a new cancer that arose. She was also treated for colorectal cancer in 1999. "It's certainly not unheard of for the cancer to come back," but it's a more dire situation if it's that rather than a new tumor that was found early enough for effective treatment, said Dr. Michael Pishvaian, a pancreatic specialist at the University of Texas MD Anderson Cancer Center who had no firsthand knowledge of Ginsburg's care. Pancreatic tumors are usually treated with surgery, but she or her doctors may have chosen not to do that for various reasons, and radiation is a standard treatment if surgery is not done, Pishvaian said. Dr. Alan Venook, a University of California, San Francisco, pancreatic cancer specialist who also has no direct knowledge of Ginsburg's case, said it's not possible to know much about her outlook without details from her doctors. If it is a recurrence that took a decade to form, "that tells me it's not a very aggressive cancer," he said. If the cancer is truly limited to the pancreas, "it could have been managed perfectly well with radiation," he said. The court said Ginsburg canceled an annual summer visit to Santa Fe but otherwise maintained an active schedule during treatment. She is scheduled to speak in Buffalo next week and at the Library of Congress National Book Festival in Washington at the end of the month. Before Friday's announcement, Ginsburg's most recent known health scare was in December, when she had surgery for lung cancer. The cancerous growths were found when Ginsburg underwent medical tests after she fell in her court office and broke three ribs in November. Ginsburg was absent from the court in January as she recovered from surgery and missed six days on which the court heard a total of 11 arguments. But she returned to the bench in February, and participated in the court's work during her absence. ___ Chief Medical Writer Marilynn Marchione reported from Milwaukee. Claim: Supreme Court: Ginsburg treated for tumor on pancreas.
Justice Ruth Bader Ginsburg has completed radiation therapy for a cancerous tumor on her pancreas and there is no evidence of the disease remaining, according to the Supreme Court.