In the News
Chemotherapy Shortage Impacts Patients, Physicians, Costs, and Clinical Trials
Charlotte Bath
Grim, grimmer, and grinding are among the terms reported in the press to describe the current chemotherapy shortage.1,2 And, “it is not going away,” Mark J. Ratain, MD, FASCO, Chief Hospital Pharmacologist, University of Chicago Medicine, told The ASCO Post. “This is a progressive problem like cli...
ED Visits Among Patients With Cancer: Three Main Messages
There are “three main messages” to be gleaned from a study about emergency department visits and unplanned hospitalizations among patients with cancer, the study’s lead author, Amir Alishahi Tabriz, MD, PhD, MPH, told The ASCO Post. Dr. Alishahi is Assistant Member, Department of Health Outcomes and...
Study Finds Cancer-Related Emergency Department Visits Increased by 67%, Mainly Because of Uncontrolled Pain
Emergency department (ED) visits by patients with cancer increased by 67.1% between the start of 2012 and the end of 2019, compared with an increase of just 7.5% in cancer incidence, according to a recent study in JAMA Network Open.1 Factors identified as possible explanations for the disproportiona...
'Don't Blame the Test'
Charlotte Bath
“There are misconceptions about prostate cancer screening,” Karen Knudsen, MBA, PhD, said in an interview with The ASCO Post about newly published cancer statistics, including an increased incidence of prostate cancer, particularly advanced-stage disease. Dr. Knudsen is Chief Executive Officer of th...
Cancer Mortality Decreased 33% in Newest Data Reported by the American Cancer Society
Charlotte Bath
Overall cancer mortality rates have decreased 33% since 1991, and cervical cancer incidence decreased 65% from 2012 through 2019, according to the latest statistics reported by the American Cancer Society (ACS).1 Amid this good news, however, was a troubling 3% annual increase in prostate cancer inc...
Pregnancy Confers ‘Dual Effect’ on Breast Cancer Risk
Charlotte Bath
“Pregnancy confers a dual effect” on breast cancer risk, “with an initial transient increased risk for breast cancer that is followed by long-term protection over time,” Luis Zabala Blanco, Jr, MD, noted in an update on the pathology of pregnancy-associated breast cancer, which was presented at the ...
Global Effort to Eliminate Cervical Cancer: HPV Vaccinations Are Steadily Increasing in the United States, but Barriers Still Exist
Charlotte Bath
To achieve its goal of eliminating cervical cancer, the World Health Organization (WHO) is calling on all countries “to reach and maintain an incidence rate of below 4 per 100,000 women.” Doing so would depend on the following: A total of 90% of girls being fully vaccinated against human papillom...
Success Story in Prostate Cancer for Many Men
Charlotte Bath
“I now think of prostate cancer as a story of success for many men, given the advancements in both research and treatment options over the past decade,” Behfar Ehdaie, MD, MPH, told The ASCO Post. Dr. Ehdaie is lead author of a study that found MRI-guided focused ultrasound focal therapy is safe and...
MRI-Guided Ultrasound Focal Therapy May Delay or Avoid Prostatectomy or Radiotherapy in Patients With Intermediate-Risk Prostate Cancer
Charlotte Bath
MRI-guided focused ultrasound focal therapy produced “a high degree of success” and “a low rate of genitourinary adverse events” when used to treat select patients with intermediate-grade prostate cancer, Behfar Ehdaie, MD, MPH, and colleagues reported in The Lancet Oncology.1 Dr. Ehdaie is Associat...
Short and Shorter Screening Tools for Food Insecurity
A survey of oncology registered dietitian nutritionists (RDNs)1 found that most of those surveyed were not using a validated assessment tool to identify food insecurity but expressed interest in obtaining the Six-Item Short Form of the Food Security Survey Module.2 The six-item food insecurity scr...
Assessing Food Insecurity Among Patients With Cancer
Food insecurity, particularly as it affects cancer survivors, is a serious problem, according to a survey of oncology registered dietitian nutritionists (RDNs) published in the Journal of the Academy of Nutrition and Dietetics.1 “Despite these concerns, most oncology RDNs interviewed are not using a...
Robust and Durable Responses to Pembrolizumab in Patients With Previously Treated MSI-H/dMMR Endometrial Cancer
Charlotte Bath
“Robust and clinically meaningfulantitumor activity,” with durable responses and “encouraging survival outcomes,” were reported among patients with previously treated microsatellite instability–high (MSI-H) or mismatch repair–deficient (dMMR) endometrial tumors who received pembrolizumab in the KEYN...
Communication Is Key to Overcoming Resistance to COVID-19 Vaccination
Charlotte Bath
The three most common reasons patients with cancer surveyed at an outpatient infusion therapy clinic gave for not having received at least one dose of COVID-19 vaccine were: My doctor has not told me to get the vaccine. I do not think it is safe for me because I have cancer. I’m afraid of the s...
Why Some Patients With Cancer Are Reluctant to Receive COVID-19 Vaccination: Survey Shows Need to Improve Patient-Physician Communication
Charlotte Bath
“My doctor has not told me to get the vaccine.” That was the number one reason patients with cancer gave in a survey at an outpatient infusion therapy clinic for not having received at least one dose of the COVID-19 vaccine. Rivalling that reason were concerns about safety and fear of vaccine side e...
Disconnect Between Expectations and Outcomes: Major Factor in Treatment-Related Regret Among Patients With Localized Prostate Cancer
Charlotte Bath
“A disconnect between patient expectations and outcomes” is a major contributor to treatment-related regret among patients with localized prostate cancer, according to a study published in JAMA Oncology.1 The disconnect, “both as it relates to treatment efficacy and adverse effects, appears to drive...
Update on the Role of Low-Dose Aspirin in Colorectal Cancer Prevention
Charlotte Bath
Updating its 2016 recommendation on the use of aspirin to prevent cardiovascular disease and colorectal cancer, the U.S. Preventive Services Task Force (USPSTF) issued a draft recommendation statement. It noted the potential harms of daily aspirin, with the most serious being bleeding in the stomach...
Enhanced Surveillance and Risk-Reducing Intervention Options for Individuals With PALB2 Variants
Charlotte Bath
PALB2 germline pathogenic variants are associated with a substantially increased risk for breast cancer and a smaller increased risk for pancreatic and ovarian cancers, warranting enhanced surveillance and the option of risk-reducing interventions, according to a global team of cancer genetic specia...
Reduced-Intensity Chemotherapy for Older, Frail Patients With Advanced Gastroesophageal Cancer
Charlotte Bath
Patients who had advanced gastroesophageal cancer but were considered unsuitable for full-dose chemotherapy because of their advanced age and/or frailty “had an improved patient experience with no significant detriment in cancer control” when treated with reduced-intensity chemotherapy in the phase ...
Responses to Pembrolizumab and Ipilimumab After Anti–PD-1/L1 Failure in Advanced Melanoma
Charlotte Bath
Despite new and effective treatments for melanoma with checkpoint inhibitors and targeted therapies, patients with metastatic melanoma who progress on frontline treatment generally do very poorly. “We really need to make sure we give these patients access to drugs that we know have some efficacy,” J...
A Shift in the Treatment of Advanced Melanoma
Charlotte Bath
Answers to questions about first-line treatment of metastatic melanoma are “going to be shifting,” Jason J. Luke, MD, told The ASCO Post, with the change coming on the heels of the phase III RELATIVITY-047 trial reported at the 2021 ASCO Annual Meeting.1 That abstract reported that using two immuno...
Adding Targeted Agent to Treatment Shows Significant Benefits in Pediatric Patients With High-Risk Hodgkin Lymphoma
Charlotte Bath
Integrating the antibody-drug conjugate brentuximab vedotin into the front-line treatment of pediatric patients with high-risk Hodgkin lymphoma “facilitated significant reduction in radiation exposure and yielded excellent outcomes,” Monika Metzger, MD, MSc, Director for the Central and South Americ...
Surge of Patients With Advanced Cancer Expected Due to Delayed Diagnosis and Treatment During Pandemic
Pent up demand for cancer screenings, diagnostic workups, and treatments delayed or curtailed since the start of the pandemic is expected to result in a surge of patients—some with more advanced disease as a result of delays—seeking appointments with oncologists. “We are starting to see...
How Interested Are Patients in Integrative Therapies, and How Much Are They Willing to Pay for Them?
Charlotte Bath
The top two barriers to accessing complementary and integrative therapies, according to a survey of 576 patients with cancer and caregivers, were cost, cited by 56%, and a lack of knowledge about the therapies, cited by 52.1%. “Other barriers included a lack of time (29.2%), location of the services...
Clinician Recommendations May Pique Patients’ Interest in Complementary and Integrative Therapies
Charlotte Bath
Patients with cancer expressed more interest in complementary and integrative medicine services when these services were recommended by an oncologist or other medical professional or were provided for free in a clinical trial, according to a survey reported in JCO Oncology Practice.1 The survey incl...
Older Breast Cancer Survivors May Consider Discontinuing Screening Mammography in the Setting of Limited Life Expectancy
Charlotte Bath
Newly issued mammography screening guidelines for breast cancer survivors aged 75 and older recommend discontinuing routine mammography for those with a life expectancy of less than 5 years and considering discontinuation of routine screening for those with a life expectancy between 5 and 10 years. ...
When to Start a Conversation With Patients About Subsequent Primary Cancers
Charlotte Bath
Among patients who survive a primary cancer, concern about recurrence, especially metastatic disease, is extremely common; however, information about future risk for subsequent primary cancers is seldom communicated to these patients, leading to missed opportunities to prevent or detect subsequent p...
Ongoing Surveillance and Efforts to Reduce Smoking and Obesity Needed to Lower Cancer Survivors’ Risks of New Cancers
Charlotte Bath
The risk of developing or dying of a new primary cancer, particularly those cancers associated with smoking and obesity, was greater among survivors of adult-onset cancers than the expected risk in the general population, according to an analysis of data from more than 1.5 million cancer survivors.1...
Significant Survival Benefit From Chemotherapy for Older Women With Triple-Negative Breast Cancer
Charlotte Bath
Women older than age 70 diagnosed with triple-negative breast cancer had significantly improved overall survival if they received adjuvant and/or neoadjuvant chemotherapy, according to an analysis of data from more than 16,000 women enrolled in the National Cancer Database. The estimated 5-year over...
Study Shows Sentinel Lymph Node Biopsy to Be 'Viable Option' for Surgical Staging of Endometrial Cancer
Charlotte Bath
Sentinel lymph node biopsy “had similar diagnostic accuracy and prognostic ability as lymphadenectomy in patients with high-grade endometrial cancer at greatest risk for nodal metastases,” according to the SENTOR trial, a prospective cohort study of 156 patients with clinical stage I disease. Using ...
Mohs Surgery vs Wide Local Excision for Trunk and Extremity Melanomas: Comparable Overall Survival Rates
Charlotte Bath
A cohort study of 188,862 cases of all-stage melanomas of the trunk and extremities found no differences in overall survival between patients treated with Mohs micrographic surgery or with wide local excision.1 “These findings add to the existing body of evidence demonstrating that wide local excisi...
Mitigating the Spread of COVID-19 and Its Impact on Cancer
On March 11, the World Health Organization (WHO) took the step it had been avoiding for weeks and declared that the spread of the coronavirus disease 2019 (COVID-19), and the virus that causes it, now identified as SARS-CoV-2, had reached global pandemic levels, the first pandemic sparked by a coron...
Expect Questions About Mohs Micrographic Surgery
Charlotte Bath
A recent study finding similar overall survival rates for patients with melanomas of the trunk and extremities treated with Mohs micrographic surgery or wide local excision1 raises questions about why and when physicians might recommend, and patients opt for, one or the other procedure. “The most i...
Focus on Preventing Invasive Recurrence in Women With DCIS Does Not Sufficiently Address Breast Cancer Mortality
Charlotte Bath
A study published recently by Giannakeas et al looked at the risk of death from breast cancer for women diagnosed with ductal carcinoma in situ (DCIS).1 The investigators anticipated that treatment would eliminate the risk of invasive ipsilateral recurrence and prevent subsequent mortality from brea...
Expect Questions About Increased Cancer Mortality Risk Among Patients Diagnosed With DCIS
Charlotte Bath
A large cohort study1 finding that the risk of dying of breast cancer was increased threefold after a DCIS diagnosis may cause patients diagnosed with DCIS to ask what they can do to reduce that risk. Currently, there is little that most patients can do. “The lifetime risk of death following DCIS is...
Study Finds Recent-Onset Diabetes With Unintentional Weight Loss Linked to Increased Risk of Pancreatic Cancer
Charlotte Bath
A large cohort study with close to 160,000 men and women reported that “recent-onset diabetes accompanied by weight loss was associated with a substantial increase in risk for pancreatic cancer and may represent a high-risk group in the general population for whom early detection strategies would be...
Recognizing the Coexistence of Symptoms of Pancreatic Cancer
Charlotte Bath
Incidence rates for pancreatic cancer were 6-fold to 10-fold higher among participants in a study who had recent-onset diabetes and weight loss.1 This led the study authors to write: “The coexistence of these symptoms should be recognized by clinicians given that both the relative and absolute risks...
Physician-Patient Partnership Is Key to Recognizing and Managing Side Effects of Immune Checkpoint Inhibitors
Charlotte Bath
“Immunotherapy has a completely different side-effect profile than chemotherapy, and that has caught physicians off guard,” noted Drew Pardoll, MD, PhD, in an article published earlier this year in The Washington Post.1 Since then, efforts have moved forward on several fronts to bring physicians, as...
One in Six Premenopausal Women With Invasive Breast Cancer Is Nonadherent to Tamoxifen Therapy
Charlotte Bath
Measuring serum levels of tamoxifen among premenopausal women being treated for invasive breast cancer identified a “worryingly high proportion of patients, one in six, who were nonadherent to therapy at only 1 year after treatment prescription,” researchers reported in the Journal of Clinical Oncol...
Higher Risk of Disease Recurrence and Death With Minimally Invasive vs Open Surgery for Early-Stage Cervical Cancer
Charlotte Bath
Women with early-stage cervical cancer treated with minimally invasive radical hysterectomy had a 71% increased risk of recurrence and a 56% increased risk of death compared with those treated with open radical hysterectomy, according to a systematic review and meta-analysis of 15 studies involving ...
Extended-Fraction Radiation Therapy for Bone Metastases Represents Low-Value Care but Continues to Be Widely Practiced
Charlotte Bath
An analysis of radiation therapy patterns among more than 12,000 Medicare patients treated for bone metastases found that 23.4% received extended-fraction radiation therapy, “wasting both health-care dollars and precious patient time,” according to the investigators.1 One-third of the treating physi...
Initiate Conversations About Radiation Therapy for Bone Metastases
Charlotte Bath
Although the American Society for Radiation Oncology (ASTRO) has recommended extended-fraction radiation therapy (more than 10 fractions) not be routinely used for palliation of bone metastases,1 a recently published retrospective cohort study using Medicare data for more than 12,000 patients found ...
Cognitive Impairment in Women Treated for Early Breast Cancer: Chemoendocrine Adjuvant Therapy vs Endocrine Therapy Alone
Charlotte Bath
Women with early-stage breast cancer who received adjuvant chemoendocrine therapy reported greater cognitive impairment at 3 and 6 months than women receiving adjuvant endocrine therapy alone, according to the results from a subgroup of women participating in the TAILORx trial.1 By 12 months, the de...
Statins With or Without Metformin Are Associated With Increased Survival in Patients With High‑Risk Prostate Cancer
Charlotte Bath
A population-based retrospective cohort study involving 12,700 patients found that men with high-risk prostate cancer who took a statin alone or in combination with metformin had reduced all-cause and prostate cancer–specific mortality. The associations between the medications and reduce...
EXPECT INTEREST AND QUESTIONS ABOUT STATINS AND METFORMIN
The ASCO Post
A study showing that statins used alone or in combination with metformin was associated with reduced prostate cancer mortality and all-cause mortality among men with high-risk prostate cancer may raise more questions about these already commonly used drugs.1 “Metformin is the first-line therapy for...
Addressing the Needs of Transgender Patients for Breast Cancer Screening in Comfortable and Inclusive Environments
Charlotte Bath
An analysis of breast imaging center websites and a literature search for research articles on transgender breast health found that “issues related to transgender breast imaging are not well addressed in the radiology literature or in the radiology community, even though more transgender patients ar...
Don’t Expect Transgender Patients to ‘Out’ Themselves
Charlotte Bath
Although more transgender patients are presenting to breast centers for imaging, many “report significant social stigma when seeking care,” according to a study in the Journal of Breast Imaging.1 Reported verbal abuse and other forms of harassment “can lead to transgender patients concealing their g...
Early Data Show Activity for Enfortumab Vedotin Plus Pembrolizumab in Advanced Bladder Cancer
Alice Goodman
It may be possible to use a platinum-free combination as first-line treatment for advanced or metastatic urothelial carcinoma in cisplatin-ineligible patients, if results of the phase Ib/II EV-103 trial hold up. The combination of the newly approved antibody-drug conjugate (enfortumab vedotin) and a...
Using Antioxidants and Other Supplements With Chemotherapy May Increase Risk of Breast Cancer Recurrence and Mortality
Charlotte Bath
Using antioxidants and other dietary supplements before and during adjuvant chemotherapy for breast cancer may increase the risk of recurrence and “to a lesser extent, death,” according to an analysis of dietary and nutritional data from a phase III trial, published in the Journal of Clinical Oncolo...
‘Slow, Incremental Changes’ Are Increasing Participation of Older Adults in Clinical Trials
Charlotte Bath
Older adults continue to be proportionally underrepresented in oncology clinical trials, but the participation rate of adults aged 65 and older is increasing by “slow, incremental changes,” Stuart M. Lichtman, MD, FACP, FASCO, noted in an interview with The ASCO Post. Prompting those changes are the...
Incidence of Squamous Cell Carcinoma of the Anus Has ‘Increased Dramatically’ in Older Women and Young Black Men
Charlotte Bath
“Squamous cell carcinoma of the anus incidence has increased dramatically in elderly women and young black men,” according to a study of recent trends in incidence and mortality. “Advanced-stage [anal squamous cell carcinoma] incidence tripled with a prominent rise in … mortality,” researchers repor...
