Expert’s Corner
Improving End-of-Life Discussions With Patients Who Have Advanced Cancer
Jo Cavallo
Although studies have shown that patients with advanced cancer want their oncologists to discuss their advance care plans with them, fewer than half of those patients have that conversation. The reasons are many, including the difficulty many oncologists have in initiating conversations about noncur...
Balancing a Reverence for Life With a Belief That Patients Have a Right to a Dignified Death
The U.S. right-to-die movement took root in the mid-1970s, when Derek Humphry helped his wife, who was dying of breast cancer, take her own life. Five years later, Mr. Humphry founded the Hemlock Society, the first right-to-die organization in the United States,1 and set off a firestorm of controver...
How Climate Change Is Impacting Cancer Care and What Can Be Done to Reduce Oncology’s Footprint on the Environment
Worldwide, the global average surface temperature has risen at a similar rate of 0.17°F per decade since 1901, with the warmest year on record occurring in 2016 and the second warmest occurring in 2020. However, according to NOAA, since the late 1970s, the United States has warmed faster than the gl...
Defining Cure in Multiple Myeloma
The past 2 decades have seen so many advances in the treatment of multiple myeloma; in addition, median patient survival has grown from just 3 years in the late 1990s to between 8 and 10 years today,1 with some patients exceeding that prognosis by many years. Although still considered a stubbornly i...
Canadian Oncologists Report Costly Delays in Their Drug Regulatory Process
Canada’s publicly funded health-care system has a complex drug approval and funding process. Due to multiple assessment steps and bureaucratic processes, newly developed cancer drugs can often experience long delays before oncologists may use them to treat their patients with cancer. Several Canadia...
Bridging the Gender Gap in Oncology
Women account for a growing proportion of the oncology workforce. Multiple studies, however, show that women oncologists are underrepresented in leadership positions, may have significantly lower salaries than men, and may be subjected to discriminatory practices stimulated by a medical culture perm...
Emerging Reasons for Optimism in Lung Cancer
Despite public smoking cessation initiatives and improved methods for early detection and treatment, lung cancer persists as the leading cause of cancer death in both men and women in the United States. However, over the past decade, smoking cessation efforts, increased screening, and new scientific...
Predicting Global Cancer Trends in 2021
Although we are just halfway through 2021, the outlook for improvements in global cancer trends looks grim. According to new estimates by the International Agency for Research on Cancer’s Global Cancer Observatory, the global cancer burden rose to 19.3 million cases and 10 million deaths in 2020 and...
How RAS Mutations in Early-Onset Colorectal Cancer May Impact Patient Survival
Although both incidence and mortality rates in colorectal cancer have been declining among people older than 65 by 3.3% and 3% annually, respectively, among individuals younger than age 50, the incidence rate has risen about 2% annually, and death rates have increased by 1.3% annually.1 Colorectal c...
Addressing Sexuality Challenges Throughout the Cancer Care Continuum
Multiple studies have shown that sexuality and intimacy problems are common among patients with cancer, often beginning at the time of diagnosis and persisting through the continuum of care into the survivorship setting. Although these problems have been well documented, many patients and survivors ...
Do Community Oncologists Have Access to Geriatric Specialty Care for Older Patients?
As our population rapidly ages, the burden of cancer incidence increases accordingly, creating an urgent need for greater and more incisive research on the diagnosis, treatment, and survivorship issues for older adults with cancer. Given the numerous challenges faced by today’s busy oncologists, a t...
Harnessing a Worldwide Effort to Combat COVID-19 and Cancer
This past October, in a virtually held ceremony of the General Assembly of the Union for International Cancer Control (UICC), Anil K. D’Cruz, MBBS, MS, DNB, FRCS (Hon), Director of Oncology at Apollo Hospitals in Mumbai, Chennai, and Delhi, India, began his 2-year tenure as President of the global c...
First Lady Dr. Jill Biden Assures the NCI of the Administration’s Commitment to Advancing Cancer Research
In a virtual visit to the National Cancer Institute (NCI) on February 3, 2021, just 2 weeks after her husband, Joe Biden, was sworn in as the 46th President of the United States, First Lady Jill Biden, EdD, recounted that, in her many years of travel across the United States, she learned that canc...
ASCO’s President-Elect Focuses on Advancing Equitable Cancer Care Through Innovation
Internationally renowned for his pioneering research in combining high-dose radiation therapy and chemotherapy in the treatment of locally advanced head and neck cancer to improve patient survival, ASCO’s President-Elect Everett E. Vokes, MD, FASCO, is dedicating his tenure as President to expanding...
Celebrating 50 Years of Cancer Progress: The International View
Although the National Cancer Act of 1971 has resulted in tremendous advances in cancer research, which have led to sharp declines in cancer mortality in the United States—from 1991 to 2018, there has been a 31% decrease in overall cancer death rates—and more than 17 million cancer survivors,1 much o...
Oncologists Launch Global Society to Improve Clinical Research, Standardize Treatment, and Improve Patient Education About Rare Genitourinary Tumors
Late this past year, a group of oncologists led by Philippe E. Spiess, MD, MS, FRCS(C), FACS, Assistant Chief of Surgical Services and Senior Member in the Department of Genitourinary Oncology at Moffitt Cancer Center and Professor in the Department of Urology at the University of South Florida; and...
Ethical Considerations Before Launching a Clinical Cancer Trial
Randomized clinical trials are highly regulated initiatives that must comply with multiple requirements while maintaining high epistemic standards, a balance that becomes increasingly difficult as the research questions surrounding immunotherapy and targeted agents become more complex. To shed light...
How Exceptional Responders Are Providing Clues to Personalizing Cancer Treatment
The findings from a recent study of patients with cancer who had an exceptional response to chemotherapy are yielding new clues on the molecular changes in patients’ tumors. These findings may explain the genetic alterations contributing to these patients’ dramatic and long-lasting responses to trea...
Overcoming Gender Disparity in Evaluating Sexual Health Following a Cancer Diagnosis
The results from a recent study showcase the disturbing prevalence of sexual dysfunction as a treatment side effect of cancer and gender disparity in how the problem is addressed by physicians.1 The study, conducted by James Taylor, MD, MPH, Chief Resident in the Department of Radiation Oncology at ...
The Emerging Role of Exercise in Cancer Prevention and Treatment
The holistic benefits derived from exercise in preventing and ameliorating chronic health conditions such as cardiovascular disease and diabetes are well documented. However, less is known about the salutary effects exercise may have across the cancer setting, especially during treatment. Originall...
ASCO’s Road to Recovery Report Outlines Lessons Learned From the COVID-19 Pandemic to Improve Oncology Care
In 2020, ASCO established the Steering Group on Cancer Care Delivery and Research in a Post-Pandemic Environment to evaluate the changes made in oncology care delivery, clinical research, and regulatory oversight in response to the COVID-19 pandemic as well as to make recommendations on how to proce...
Treating Colorectal Cancer in the Time of COVID-19
Caroline Helwick
The treatment of colorectal cancer has always been something of an art—but never more so than during the COVID-19 pandemic. The ASCO Post asked three experts in this malignancy to share their concerns and their approaches to achieving good patient outcomes while minimizing the risk of COVID-19 expos...
Trading One Disease for Another: Patients With Chronic Graft-vs-Host Disease May Face Lifelong Complications
Chase Doyle
The field of allogeneic stem cell transplantation continues to improve survival for patients with previously incurable blood cancers. However, up to 50% of patients who undergo transplantation with donor cells will develop chronic graft-vs-host disease, a potentially deadly condition that can also c...
ASCO’s New Chief Medical Officer Plans to Tackle the Global Burden of Cancer and Disparities in Access to Care
In November, ASCO announced that Julie R. Gralow, MD, FACP, FASCO, will succeed Richard L. Schilsky, MD, FACP, FSCT, FASCO, as Chief Medical Officer (CMO) of the Society. Dr. Gralow will begin her new position on February 15, 2021. Dr. Gralow’s long relationship with ASCO dates back to 1995, when s...
Chronic Graft-vs-Host Disease: Future Directions in Treatment
Chase Doyle
Hematopoietic stem cell transplantation (HSCT) has improved survival rates for several hematologic malignancies, but as the number of transplants continues to rise, community oncologists are evaluating more posttransplant complications in the clinics. The ASCO Post spoke with two of the principals ...
How the First International Summit on Interventional Pharmacoeconomics Is Sparking Discussion on Reducing Cancer Costs
Three years ago, former Chief Executive Officer of ASCO, Allen S. Lichter, MD, Laurence H. Baker, DO, Professor in the Departments of Internal Medicine and Pharmacology at the University of Michigan Medical School in Ann Arbor; Leonard Saltz, MD, a gastrointestinal oncologist at Memorial Sloan Ket...
Reducing Disparities in Cancer Care for Sexual and Gender Minority Patients
Jo Cavallo
Although efforts have been made by various medical societies, including ASCO, over the past decade to address the needs of sexual and gender minorities in the cancer care setting, research shows that lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) patients continue to face barrier...
Understanding Breast Cancer Diagnosis and Treatment Disparities in Resource-Challenged Nations
Ronald Piana
Cancer is the second leading cause of death in the Caribbean. Adding to this growing burden, many of the nations in this geographically spread region have under-resourced health-care systems and a lack of cohesive approaches to the delivery of cancer care. To shed light on the public health dilemm...
Discerning the Underlying Mechanisms of Endometrial Cancer Disparities in Black Women
Jo Cavallo
Endometrial cancer is the fourth most common cancer diagnosed in the United States, and the seventh most common cause of cancer death among women.1 This year, nearly 66,000 women will be diagnosed with the cancer, and about 12,600 will die of the disease.2 And although endometrial cancer is one of t...
Assessing the Progress Made in Global Cancer Care and Looking Toward the Future
Jo Cavallo
In October 2020, Her Royal Highness Princess Dina Mired of Jordan ended her 2-year tenure as President of the Union for International Cancer Control (UICC), a global organization with more than 1,198 members from 172 countries and territories committed to reducing the cancer burden and inequitab...
A Urologic Surgeon Assesses the Current State of Prostate Cancer
Ronald Piana
Despite decades of research, multinational clinical trials, regular guideline updates by the U.S. Preventive Services Task Force, and coordinated efforts by ASCO and other major oncology organizations, the management strategy for prostate cancer remains controversial. To keep the oncology community ...
Results From ASCO’s 2020 National Cancer Opinions Survey
Jo Cavallo
As in past years, the results from ASCO’s 2020 National Cancer Opinions Survey showed a startling dichotomy in the perceptions of Americans on a variety of health-care issues. As expected, the two major events this year, the COVID-19 pandemic and a national reckoning over racial injustice, dominated...
A Primary Care Physician Explores Barriers to Cancer Prevention and Clinical Trial Accrual
Ronald Piana
To accelerate progress in the survival rates of people with cancer in the United States and to reduce cancer disparities across the entire spectrum of cancer from diagnosis to survivorship, there needs to be increased access to cancer screening and prevention programs. To shed light on this critical...
Small Case Study Explores Novel Approach to Neoadjuvant Therapy for Skin Cancer
Ronald Piana
Skin cancers are the most common malignancy in the United States and worldwide. Between 1994 and 2014, the diagnosis and treatment of melanoma and nonmelanoma skin cancers in the United States increased by 77%.1 The cost of treating melanoma and nonmelanoma skin cancers to the health-care system alo...
A Young Oncologist Cares for Patients With Cancer Amid COVID-19 Pandemic
Ronald Piana
The COVID-19 pandemic changed the face of U.S. health-care services in such rapid fashion that many providers were caught off guard, learning and preparing on the fly. Patients with cancer, given their multiple physical and emotional challenges, were especially vulnerable. To get a sense of the on-t...
Ending Systemic Racism in Oncology Is Everyone’s Responsibility
Five years ago, as Rachel B. Issaka, MD, MAS, was beginning her second year as a gastroenterology fellow and feeling proud of the progress she was making in her training, she was suddenly confronted with an all-too-familiar slight that underrepresented minority providers may often experience. As Dr....
An MSK Hospitalist Looks at Oncologists’ Attitudes About Inpatient Cancer Care
Ronald Piana
Each year in the United States, about five million adults with cancer are admitted to hospitals. Given our aging population, this trend will increase, putting added stress on the oncology community, which is already dealing with an impending workforce shortage. Although physician extenders, such nur...
Caring for Undocumented Patients With Cancer
Ronald Piana
There are approximately 25 million foreign-born immigrants living in the United States, which is more than 13% of the nation’s total population. Of these individuals, it is estimated that about 11 million are undocumented; by far, the largest group of this immigrant undocumented population is Hispan...
Efforts to Broaden Eligibility Criteria for Clinical Trials Seek to Include More Racial and Ethnic Minority Patients
Jo Cavallo
A review of the 2019 Drug Trials Snapshots Report1 from the U.S. Food and Drug Administration (FDA) showed that although female participation in clinical trials grew to 72% from 56% in the FDA’s 2018 Drug Trials Snapshots Report,2 ethnic minority participation in clinical trials actually declined ...
Stage I Lung Cancer: Treatment Advances Have Changed the Game
Caroline Helwick
Read more in the Journal of Oncology Practice (JOP). Visit ASCOPubs.org/journal/jop Patients with stage I lung cancer are achieving excellent local tumor control, thanks to an evolution in radiotherapy and surgical approaches. Jeffrey A. Bogart, MD, Professor and Chair of the Department of Radiat...
Current Progress Against Cancer and What Lies Ahead in the Next Decade
In January, ASCO released its report, Clinical Cancer Advances 2015: An Annual Report on Progress Against Cancer,1 which details research advances over the past decade that have led to longer survival and better quality of life for the more than half-a-million people diagnosed with cancer each year....
A Conversation with David Henry, MD
Given the intricate nature of oncology workflow, terminology, cancer staging, and the high risk associated with chemotherapy administration, an oncology electronic medical record (EMR) system needs to be much more than a storehouse of patient information. According to David Henry, MD, Clinical Profe...
How to Treat Patients With Multiple Myeloma Cost-Effectively Without Compromising Outcome
The dramatic advances in the diagnosis and treatment of multiple myeloma over the past 20 years have resulted in significant improvements in overall survival, with 5-year relative survival rates now around 50% and more than 60% for patients younger than age 70.1 The proteasome inhibitors bortezomib,...
Investigating the Inflammatory Mechanisms That May Be Causing Prostate Cancer in World Trade Center First Responders
Jo Cavallo
The terrorist attacks on September 11, 2001*, on the World Trade Center in New York City resulted in the deaths of more than 2,700 people.1 Nearly 2 decades later, that number may soon be exceeded by the more than 2,000 deaths—and climbing—of first responders to the attack, including firefighters, p...
Web-Based Tool May Help Patients With Cancer Choose the Best Insurance for Their Needs
Ronald Piana
Given the rising costs of cancer care, many patients with cancer and cancer survivors are challenged by financial toxicity, the burden of care costs. Many struggle to choose a health insurance plan that best meets their needs. Moreover, these challenges are often exacerbated by limited health insura...
How Delays in Screening and Early Cancer Diagnosis Amid the COVID-19 Pandemic May Result in Increased Cancer Mortality
Jo Cavallo
Earlier this year, as the COVID-19 pandemic was spreading across the United States, federal health officials and cancer societies urged Americans to delay routine cancer screenings and other elective procedures to keep them out of clinics to avoid potential exposure to the coronavirus and to preserv...
Setting an Ambitious Path to Ensure Health Equity for All Patients With Cancer
Jo Cavallo
In keeping with her Presidential theme of “Equity: Every Patient, Every Day, Everywhere,” in July, ASCO President Lori J. Pierce, MD, FASTRO, FASCO, announced the Society was joining forces with the Association of Community Cancer Centers (ACCC) to increase racial and ethnic minority participation i...
Past CMS and FDA Head Discusses Challenges in U.S. Health-Care Policy and Possible Solutions
Ronald Piana
As evidenced at this year’s ASCO20 Virtual Scientific Program, oncology science, technology, and clinical practice are evolving at a rapid pace, bringing new challenges to the efficient and ethical practice of cancer care at all levels. To shed light on some of the large-scale public health and po...
Update on Detecting and Treating Biologically Diverse Neuroendocrine Tumors
Ronald Piana
Neuroendocrine tumors are rare malignancies that arise in neuroendocrine cells, which can occur throughout the body but are most commonly found in the gastrointestinal tract, lungs, and pancreas. Although most neuroendocrine tumors are indolent and take years to grow, some are aggressive and grow mo...
Pediatric Hematologist/Oncologist Yoram Unguru, MD, MS, MA, Explains the Economic Origins of Drug Shortages and Other Ethical Issues
Ronald Piana
Improvements in protocol-driven clinical trials and supportive care for children and adolescents with cancer have markedly reduced mortality rates over the past 5 decades. Yet, along with clinical advances, oncologists and their young patients with cancer face a host of ethical issues, made more c...
