Issues in Oncology
With Financial Toxicity in Oncology Care on the Rise, Providers Need to Help Address Patients’ Financial Issues
Ronald Piana
At the 2017 ASCO Quality Care Symposium, Dan Sherman, MA, LPC, discussed potential solutions to the persistent challenge of financial toxicity in the oncology setting. Mr. Sherman is a clinical financial consultant and Founder and President of The Navectis Group, Caledonia, Michigan. Rather than foc...
A Gleason 6 Tumor: Is It Cancer, and Should It Be Treated?
Ronald Piana
The issue is not what we call a Gleason 6, but whether it has the potential to progress. Researchers currently are looking at genetic signatures that can differentiate a nonthreatening Gleason 6 from one that will progress to Gleason 7 or higher and possibly metastasize. — ...
Friends of Cancer Research Rethinks Traditional Clinical Trials
Margot J. Fromer
Ellen V. Sigal, PhD Ellen V. Sigal, PhD, Chair and Founder of Friends of Cancer Research (Friends) began the annual meeting with a conversation with Douglas R. Lowy, MD, National Cancer Institute (NCI) Acting Director, and Robert M. Califf, MD, U.S. Food and Drug Administration (FDA) Commis...
Understanding Biosimilars and Their Impending Role in Oncology Care
Margot J. Fromer
Biosimilars are among the newest threads in the fabric of cancer treatment in the United States, and they are spawning numerous questions for oncologists and patients with cancer. Many of these questions were taken up by participants in a recent Washington forum on “The Future of the U.S. Biosimilar...
As More Biosimilars Move Toward U.S. Market, Questions Remain About Cost Savings and Uptake by Physicians and Patients
Caroline McNeil
In the near future, I don’t think patients will be asked or expected to change from their current drug to a biosimilar. But I think eventually there will be rapid adoption. — Jeffrey Crawford, MD The U.S. Food and Drug Administration (FDA) approved its first biosimilar dr...
COA Releases 2016 Community Oncology Practice Impact Report
The ASCO Post
Bruce J. Gould, MD Ted Okon On October 4, the Community Oncology Alliance (COA) released the 2016 Community Oncology Practice Impact Report, which tracks the changing landscape of cancer care in the United States. It documents a 121% increase in community cancer clinic closings and...
Breaking the ‘Conspiracy of Silence’
Jo Cavallo
We were shocked to find only 5% of patients responded correctly to all four questions, which would imply they had sufficient knowledge about their illness to make informed decisions about their care. — Holly Prigerson, PhD A new study1 showing that just 1 in 20 terminally...
The Halifax Project: A New Approach to Combination Therapy
Ronald Piana
On August 13, 2013, more than 100 cancer researchers and physicians from around the world met in Halifax, Nova Scotia, Canada, to discuss 2 challenging problem areas in cancer. One group was focused on the carcinogenic potential of low-dose exposure to chemical mixtures in the environment, and the o...
Six Perspectives on the Cancer Moonshot Goal of Making 10 Years of Progress in 5 Years
the National Coalition for Cancer Research, With Contributions by the panelists, as well as Ms. Wendy Selig, Ms. Alex Carney, and Mr. Mark Smith.
Panel Participants Richard L. Schilsky, MD, FACP, FASCOChief Medical Officer, ASCO, Alexandria, Virginia Linnea OlsonLung Cancer Survivor, Clinical Trials Participant, Artist, Boston Elizabeth Blackburn, PhDNobel Laureate, President, The Salk Institute, La Jolla, California Michael B. Atkins...
Educating People About Clinical Trials May Improve Their Likelihood of Participation
The facts are well known: Although clinical trials are regarded as the gold standard to investigate whether a new treatment is safe and effective in patients—and have resulted in advances in cancer cures and increases in cancer survivorship—only 3% to 5% of patients enroll in these studies.1 The rea...
Prevention Needed to Stem Global Rise in Human Papillomavirus–Related Anal Cancer
We have the opportunity to prevent the majority of anal cancers, we just need to make it [HPV vaccination] a national and global public health commitment. — Felix A. Mensah, MD The incidence rate of human papillomavirus (HPV)-related anal cancer and its precursor lesion, ...
Low-Dose Chemical Exposure and Cancer
According to estimates from the World Health Organization (WHO) and the International Agency for Research on Cancer (IARC), environmental toxic exposures are responsible for between 7% and 19% of human cancers. However, the 2008–2009 President’s Cancer Panel Annual Report estimated that the “true bu...
The Best HCAHPS Score: A Rodeo Invitation
Chandrakanth Are, MBBS, MBA, FRCS, FACS
Continue to adhere to the basics of our profession, and patient satisfaction will not be far behind. And it should not be a surprise if the HCAHPS scores also go up! — Chandrakanth Are, MBBS, MBA, FRCS, FACS An otherwise healthy, actively working, independent 60-year-old patient ...
Breast Density Legislation: An Opportunity for Better Risk Assessment
Caroline Helwick
The density legislation is here to stay and is likely to become more widespread. Whether you agree with this legislation or not, this is the playing field in front of us, and as such, we should look at this as an opportunity to institute thorough risk assessment. — Kevin Hughes, MD...
ASCO Updates Value in Cancer Care Framework
On May 31, 2016, ASCO published an updated framework for assessing the relative value of cancer therapies that have been compared in clinical trials. The framework, published by Schnipper et al,1 defines value as a combination of clinical benefit, side effects, and improvement in patient symptoms or...
ASCO Value in Cancer Care Task Force
Lowell Schnipper, MD The Value in Cancer Care Task Force was established in 2007 to educate oncologists about the importance of discussing costs associated with recommended treatments, empower patients to ask questions about the anticipated costs of their treatment options, identify the dri...
Leading Surgical Oncology Societies Call for Global Curriculum to Address Variations, Inadequacies in Training
The lack of an adequately trained workforce of surgical oncologists can be a major detriment in efforts to address the rising global cancer burden, according to two leading international surgical oncology societies. In two jointly published reports,1,2 the Society of Surgical Oncology (SSO) and the...
A Perilous Time for Refugees With Cancer
The numbers are difficult to fathom. According to a report by the United Nations High Commissioner for Refugees (UNHCR), in 2015, over 60 million people worldwide were forcibly displaced as a result of conflict, persecution, generalized violence, or human rights violations.1 Over 9 million of those ...
CancerCare Issues Report on Nationwide Surveys of 3,000 People Diagnosed With Cancer
The national nonprofit organization CancerCare has announced the publication of a comprehensive report on experiences, perceptions, and needs of people who are living with and beyond a cancer diagnosis. The 2016 CancerCare Patient Access and Engagement Report is a compilation of results fr...
Breakthrough Therapy Efforts Result in Unprecedented Success
Margot J. Fromer
Ellen Sigal, PhD Friends of Cancer Research (Friends) and the U.S. Food and Drug Administration (FDA) have been working together for many years on an idea known as breakthrough therapy, and it has produced results beyond anyone’s hopes. Said Ellen Sigal, PhD, Friends Chair and Founder, “Whe...
ASCO Urges Aggressive Efforts to Increase HPV Vaccination and Prevent Cancer
The ASCO Post
Use of human papillomavirus (HPV) vaccines should be rapidly expanded to protect thousands of young people in the United States—and millions worldwide—from life-threatening cancers, ASCO said April 11 in a policy statement. Published by Bailey et al in the Journal of Clinical Oncology,1 the statemen...
Immunotherapy Could Be the Wave of the Future, but Problems and Challenges Cannot Be Ignored
Margot J. Fromer
Immunotherapy is on its way. A few agents have already been approved: ipilimumab (Yervoy) in 2011 for melanoma; nivolumab (Opdivo) in 2015 for non–small cell lung cancer (NSCLC) and then later that year for renal cell carcinoma; and pembrolizumab (Keytruda) for NSCLC. In addition, many clinical tria...
Friends of Cancer Research Encourages FDA to Modernize and Consolidate
Margot J. Fromer
“In order to take advantage of today’s advancements in science, drug development, and patient treatment, the U.S. Food and Drug Administration’s (FDA’s) structure needs reorganization to focus its resources and ensure the best outcomes for patients. Friends of Cancer Research (Friends) proposes enha...
Survival Period for Esophageal Cancer Is Tied to Race and Income
The ASCO Post
African American patients with esophageal cancer survive fewer months after diagnosis than white patients, but only if they also have low incomes, according to a study presented by Loretta Erhunmwunsee, MD, at the Annual Meeting of the Society of Thoracic Surgeons. Dr. Erhunmwunsee led the study w...
Somebody’s Watching You: Meet the Tweet Trackers of the Social Oncology Project
Kirsten Boyd Goldberg
Greg Matthews In a one-story concrete industrial building across the street from a lumberyard in Austin, Texas, Greg Matthews and his computers are tracking everything that more than 500,000 U.S.-based physicians post publicly on social media. Every tweet. Every public blog, Facebook, or In...
Quality Improvement Projects Aim at Reducing Errors in Prescribing IV and Oral Chemotherapy
Charlotte Bath
Two quality improvement projects described in the Journal of Oncology Practice resulted in reduced errors in prescribing intravenous (IV) and oral chemotherapy. A project at the University of Texas Medical Branch in Galveston outpatient infusion centers first identified 15 different types of deviat...
ASCO Provides Support and Guidance for the White House Cancer Moonshot Initiative
Although President Richard Nixon signed the National Cancer Act in 1971, essentially declaring a war on cancer, the genesis of the idea had actually been born 2 years earlier, after the first landing on the moon set off a new era of scientific exploration and sparked a belief that any scientific ach...
ASCO Issues Policy Statement Calling for Improvements to Clinical Pathway Programs in Oncology
The ASCO Post
ASCO released a new policy statement with recommendations to ensure that clinical pathways in oncology promote—not hinder—the care of patients with cancer. Published by Zon et al in the Journal of Oncology Practice,1 the statement asserted that the way in which these treatment management tools in ca...
Perceptions of End-of-Life Care Differ Sharply Between African Americans and White Americans
Ronald Piana
Studies demonstrate that patients with advanced cancer who are not actively engaged in planning their end-of-life care often receive overly aggressive, physically taxing, costly and unnecessary treatment toward life’s end. Recent findings indicate that African Americans appear to be more apt to requ...
ASCO Calls for Comprehensive Payment Reform to Address Issue of Site Neutrality
The ASCO Post
ASCO recently called for comprehensive physician payment reform to support the full scope of services required by patients with cancer, rather than jeopardizing patient outcomes by reducing the available resources in a particular cancer care setting in an effort to achieve “site neutrality” in reimb...
‘Right to Try’ Laws: Helpful or Harmful?
Since 2014, “Right to Try” legislation has been sweeping the nation. Created to enable terminally ill patients to gain access to experimental drugs, biologics, and devices by sidestepping the approval process of the U.S. Food and Drug Administration (FDA), at press time, 22 states have enacted Right...
Johnson & Johnson Creates Independent Bioethics Panel to Evaluate Compassionate Drug Use Requests
In May 2015, Johnson & Johnson announced its partnership with New York University (NYU) School of Medicine in New York to create a first-of-its kind independent bioethics panel to review requests made to the company for compassionate use of an investigational drug and determine how the company s...
Is Proton-Beam Therapy Facing a Difficult Future?
Ronald Piana
Health-care experts are questioning whether proton-beam therapy is on the verge of an economic bubble—ie, a rapid surge in growth for the industry beyond its intrinsic value, inevitably leading to a drastic drop in earnings for proton centers when the “bubble bursts.” A proton-beam facility can cost...
American College of Physicians Releases High Value Care Screening Advice for Five Common Cancers
The ASCO Post
In a paper published in Annals of Internal Medicine1, the American College of Physicians (ACP) issued advice for screening average risk adults without symptoms for five common cancers: breast, colorectal, ovarian, prostate, and cervical. In a companion piece also published in Annals2, ACP outlined a...
First National Data on Breast Cancer Subtypes Mark New Era in Biomarker Epidemiology
Caroline McNeil
This year’s Report to the Nation on the Status of Cancer contains the first national combined data set on the incidence of four major breast cancer subtypes by race/ethnicity, poverty level, geography, and other factors. The findings show that “there are unique racial/ethnic-specific incidence patte...
Cancer Survivors Face Lasting Financial Struggles Long After Treatment Ends, New Study Reports
The ASCO Post
The majority (62%) of America’s middle-income cancer survivors say they were not financially prepared for cancer diagnosis and treatment, according to a new study released by the Washington National Institute for Wellness Solutions (IWS). The study, “Insights from Survivors: Managing the Personal, ...
Delivering Affordable Cancer Care: Is It Possible and What Will It Entail?
Margot J. Fromer
Many experts agree that at 18% of gross domestic product, health care (to paraphrase Shakespeare) is eating the country out of house and home. “The average cost of treating the most common cancers has increased, and as more expensive targeted therapies and other new technologies become the standard...
After a Decade of Decline in Smoking Rates, Progress Has Stalled
Margot J. Fromer
Approximately 20% of all Americans smoke, and 443,000 of them will die each year as a result. Tobacco use is the leading cause of preventable death in the United States and the greatest behavioral determinant of morbidity and mortality (6%–10% of U.S. health-care costs). Nearly 30% of all cancer dea...
Research in Combining Targeted Agents Faces Numerous Challenges
Margot J. Fromer
If the clinical trials endeavor in oncology is falling short of its goals and if targeted agents have not kept their promise, can a new approach to drug development provide a solution? Very possibly, said John Hohneker, MD, Chair of the Workshop Planning Committee for the conference, “Facilitating ...
