Letters to the Editor
Prostate Cancer Management: A Day Late and A Dollar Short?
Gilbert A. Lawrence, MD, DMRT, FRCR
In the May 15 issue, The ASCO Post reported on the relative cost-effectiveness of approaches to treating localized prostate cancer (“Advances in Prostate Cancer Accompanied by Ongoing Debates,” page 1). The article analyzed an important scientific paper presented at both urology and radiation oncolo...
‘We Need an Index of Biologic Aging’
Ernest Greenberg, MD
As a retired elderly (soon to be 83-year-old) oncologist, I read the recent article on the subject of geriatric oncology, in the March 15 issue of The ASCO Post, with great interest ("Moving the Field of Geriatric Oncology Forward," by Stuart M. Lichtman, MD, FACP, FASCO.) This was particularly so b...
Letter to the Editor: Patient Protection and Affordable Care Act Reconsidered
Calvin J. Dykstra, MD
I read with interest the front-page interview of Dr. Ezekiel Emanuel by Jo Cavallo in the December 15, 2011, issue of The ASCO Post. Dr. Emanuel may have had some of the most prestigious positions in all of medicine, but his opinion of the Affordable Care Act is completely misguided. This legislatio...
Opioid Toolkit: Helping Nebraskan Hospitals to Provide Appropriate Pain Management
The ASCO Post
As the opioid epidemic continues to sweep the United States, providers across Nebraska are facing the challenge of determining the appropriateness of pain treatment options that both meet the needs of the patients and fall within nationally published guidelines. A recent report published by the Nat...
Pathways Reconsidered: Let’s Not Stop ‘Thinking Outside the Box’
Stephen C. Fox, MD, FACP
I read “Are Clinical Pathways Inevitable in Oncology’s Future?” (The ASCO Post, July 15, 2011) including Lesli Lord’s interview with great interest and agree with most everything said in the article. However, I do want to make one comment: There is no specialty for which the 80/20 rule applies more ...
Reflections on a Career in Hematology/Oncology
Ronald E. Turk, MD
I am a retired 82-year-old Hematologist/Oncologist who reads The ASCO Post regularly. I am writing to share some brief thoughts with the authors of two articles in the February 10, 2020 issue. First, I would address the article, A Hopeful Look Ahead in Oncology, written by Dan L. Longo, MD, MACP. ...
Evidence Lacking That Denosumab Alters the Course of Breast Cancer
I am writing to provide personal context to my column on adjuvant denosumab or bisphosphonates for resected breast cancer, which appears on page 52 in this issue of The ASCO Post. I have been upset since 2013 that adjuvant zoledronate has been recommended for women with breast cancer onset after ag...
LETTER TO THE EDITOR: Adjuvant Therapy in Cutaneous Melanoma: The Need for a New Approach
E. George Elias, MD, PhD
Melanoma of the skin remains a fatal disease, and its incidence continues to rise, mostly in young adults during their prime. Surgery remains the most effective therapeutic modality, but patients’ survival depends on the stage of the disease at the time of diagnosis. Various therapeutic agents have ...
LETTER TO THE EDITOR: Treating Cancer or Fear?
Gilbert A. Lawrence, MD
I read the article by Deb Stewart, “Acting on Fear” (The ASCO Post, August 15, 2011, page 1) with interest, disappointment, and empathy. “Acting on fear” in cancer treatment generally, and particularly in breast cancer, is not uncommon. Hence, I was most interested in the article’s major thrust, as...
LETTER TO THE EDITOR: ‘Unrealistic Optimism’ or Losing Sight of the Forest for the Trees?
Stephen G. Chandler, MD
The article: “Unrealistic Optimism Poses Ethical Challenges, May Affect Informed Consent Process” (The ASCO Post, September 1, 2011, page 35) seems to be delving into a subject with an intent that is unclear. I agree fully with Dr. Jimmie Holland that discrimination between “optimism” and “unrealis...
Artemis Project® for a Preventive Breast Cancer Vaccine
Fran Visco, JD
I read with interest the article, “Breast Cancer Vaccines for Primary Prevention Move Toward Clinical Use,” which appeared in the December 15th issue of The ASCO Post (page 28). However, information presented regarding the National Breast Cancer Coalition’s (NBCC’s) Artemis Project for a breast canc...
Well-Deserved Attention on Lung Cancer Screening
Giuseppe Del Priore, MD
SCREENING FOR LUNG CANCER among high-risk groups deserves the attention that Steven E. Vogl, MD, brought to it in his column At Microphone 1 in the February 10 issue of The ASCO Post. Subspecialist oncologists are not always attuned to the needs of their patients outside of their own specialty.1 Eve...
Postmenopausal Estrogen and Risk of Breast Cancer: What Is the Real Story?
Avrum Bluming
I am responding to an article in the January 25, 2020, issue of The ASCO Post on the conclusion of the 19-year follow-up on the Women’s Health Initiative (WHI) presented by Rowan T. Chlebowski, MD, PhD, at the 2019 San Antonio Breast Cancer Symposium: Postmenopausal estrogen administration does not ...
Shiitake Mushroom: Insufficient Evidence to Support It Boosts Immune System
In the June 25 issue of The ASCO Post, the Integrative Oncology column by Ting Bao, MD, DABMA, MS, and Jyothirmai Gubili, MS, focused on how to counsel a patient about shiitake mushroom. They concluded: “We advised our patient that it is safe to take shiitake mushroom to boost her immune system.” Un...
Misconstrued Review
William H. Goodson III, MD
I’ve been a member of ASCO for longer than I can remember. I read most breast cancer–related articles in The ASCO Post and find them helpful, particularly the reports of as-yet-unpublished papers from meetings. So, it is with great disappointment that, in the November 10, 2015, issue, I read a revie...
Cost of Cancer Therapy: The Elephant in the Room?
Michael J Kraut, MD
I am distressed by your coverage of innovative therapies, such as dual HER2 blockade (see The ASCO Post, January 1, 2012, and Supplement to February 15, 2012), without mentioning that these therapies will never be cost-effective given the current pricing of the agents involved. If we wish to maintai...
Being an Expert Witness in a Legal Proceeding: A Learning Experience
Michael B. Van Scoy-Mosher, MD
I read with great interest and appreciation the Law and Ethics in Oncology column, “Should You Become an Expert Witness in a Legal Proceeding? Here Are the Pros and Cons,” by Thaddeus Pope, JD, PhD (August 25, 2019, issue of The ASCO Post). I am an oncologist and have been an expert witness in a var...
Pseudosophisticated Language and Needless Confusion?
Charles P. Duvall, MD, MACP
I’ve been a loyal ASCO member since the early 1970s (aka “back in the day”) and wanted to share a growing pet peeve. I thought of attacking an individual author, but my sense tells me the source of my annoyance is really now a cultural problem and one that can only be fixed at the editor level. With...
Nivolumab in Lung Cancer
Philip Champion MD, FRCPC
I find The ASCO Post to be a good way to hear about new ideas that I might otherwise have missed. I read an article recently about the approval of nivolumab (Opdivo) for treating metastatic squamous non-small cell lung cancer (The ASCO Post, April 10, 2015). I thought it would have been much more us...
The ASCO Post Replies
The ASCO Post
Nivolumab (Opdivo) was approved by the U.S. Food and Drug Administration (FDA) for the treatment of lung cancer on March 4, 2015, before clinical data from the pivotal trials (CheckMate 017 and CheckMate 063) were presented at a major oncology conference or published in a peer-reviewed journal. Data...
Conversations with Breast Cancer Patients
Ernest Greenberg, MD
I am a retired oncologist, previously an attending physician at Memorial Sloan-Kettering Cancer Center, with a professional lifetime experience in caring for patients with all stages of breast cancer, and now I am a regular reader of The ASCO Post. In recent months there have been several articles ...
Letter to the Editor: More Thoughts on PSA
James Mohler, MD, and Donald L. Trump, MD
An article that appeared in the August 15 issue of The ASCO Post (“Rethinking the Role of PSA Screening in Public Health”) contains false statements about the discovery of prostate-specific antigen (PSA) and its effectiveness as a test for early detection of prostate cancer. Contrary to what’s repo...
Clinical Trials for Patients in Africa
Ogidiagba Louis Efe, MBBS
Thank you very much for The ASCO Post Evening News,* which ensures I don’t miss anything that happened at the ASCO 2013 meeting. Due to financial constraints I could not attend the ASCO Annual Meeting in Chicago. My comment is that pharmaceutical companies should extend their oncology drug trials ...
More Thoughts on Rationing Cancer Care
Gilbert A. Lawrence, MD, DMRT, FRCR
I read the article about “The Ethics of Rationing Cancer Care” with interest (The ASCO Post, Dec 15, 2012). The issue of rationing (or rational) care has likely been debated since Hippocrates. Yet the topic has become a focus of acute interest with the current fiscal crises facing countries around t...
Letter to the Editor: Dr. Ablin’s Reply
Richard J. Ablin, PhD, DSc (Hon)
Given my explanation and widely publicized opinion on the improper use of the prostate-specific antigen (PSA) test for screening asymptomatic men for prostate cancer—most recently expressed in a feature article in The ASCO Post (August 15, 2012)—I was pleased to read that Drs. James Mohler and Donal...
‘Medicalizing’ Physician-assisted Suicide
Mitchell Garrison, MD
It was with regret that I read the article and commentary on physician-assisted suicide in the June 10 issue of The ASCO Post (“Death with Dignity Program at Seattle Cancer Care Alliance,” by Matthew Stenger, and “One Cancer Center’s Approach to Death with Dignity,” by Frederick R. Appelbaum, MD). ...
Revisiting Ovarian Ablation in Early Breast Cancer: A Mismatch Between Global Values and Clinical Practice Guidelines
ASCO recently released a clinical practice guideline update on ovarian suppression as part of the extant guideline on adjuvant endocrine therapy in hormone receptor–positive breast cancer, and the recommendations were summarized in the June 10, 2016, issue of The ASCO Post. Also in this issue, Katar...
Do We Need So Much Emphasis on ‘Quality Care’?
James R. Gould, MD
Unfortunately, when I see The ASCO Post, my first impression is that you enable a group of researchers (part-time clinicians) to pontificate about their own agendas. The agenda that seems to be missing is the presentation of information that either supports or refutes the freight train of “quality c...
Letter to the Editor: Origins of PSA Testing: The Conversation Continues
T. Ming Chu, PhD, DSc
As Drs. James Mohler and Donald Trump noted in their September 15 letter to The ASCO Post (“More Thoughts on PSA,” 3[14]:2, 2012), Richard Ablin, PhD, discovered a “prostate-specific antigen” of unknown properties, but his PSA is not the antigen in the PSA test we know today. Since Dr. Ablin has no...
Unnecessary Barrier to Blood Donation for British Nationals?
The ASCO Post
I read with great interest Jo Cavallo’s article “Maintaining Blood Donations During the COVID-19 Pandemic”. My wife and I have been British residents in the United States for over 6 years and are frustrated that we cannot donate blood, especially during this raging global COVID-19 pandemic, when blo...
Discrimination in Medical Education—Another Perspective
Richard A. Berjian, DO
I read with great interest Dr. Robert E. Montenegro’s comments in the The ASCO Post, January 25, 2017, where he felt “marginalized” when questioned about his country of origin or the quality of his English. As physicians, we constantly deal in a world of uncertainties and are required to address qu...
Conflict of Interest Reconsidered
Joseph Mason, Jr, MD
I read with interest the letter from Larry Weisenthal, MD, PhD, on “Platinum-Based Treatment of Triple-Negtive Breast Cancer,” which appeared in the October 15 issue of The ASCO Post. Dr. Weisenthal seems to be suggesting that an article in the September issue, regarding a Best of ASCO presentation ...
The Semantics of Palliative Care
Khalid L. Rehman, MD, FACP
The interview with Thomas J. Smith, MD (The ASCO Post, April 15, 2012), the lead author of the ASCO Palliative Care Provisional Clinical Opinion, was timely. However, it left many clinical terms and issues unclear. A significant percentage of modern medicine, including cancer care, is palliative. C...
Is Estrogen Protective Against COVID-19?
Avrum Z. Bluming, MD, MACP
Reports suggest that the severity of coronavirus infection may be significantly more pronounced in men than in women.1 Studies have demonstrated that estrogen reduces both influenza virus replication in human female nasal epithelial cells2 and moderates the cytokine storm in murine models of this in...
Dr. Weisenthal Replies
Larry Weisenthal, MD
Dr. Mason states that I implied that Dr. Telli supports the routine application of chemosensitivity assays. I have no knowledge regarding Dr. Telli’s views on this subject, nor did I in any way attempt to represent her views, much less imply that she was supportive of anything relating to chemosensi...
Clinical Trials, Crossover, and Clinical Equipoise: A Patient's Perspective
Bob Levis
I am writing with regard to two articles on the ethical imperative of clinical equipoise written by Susan O’Brien, MD, and Stephen J. Schuster, MD, and published recently in The ASCO Post.1,2 I was a victim of Pharmacyclics’ policies during one of their randomized ibrutinib trials (PCI-32765) conduc...
Physicians Need to Be Involved in Reducing Costs
Thomas J. Lester, MD
I am so proud of ASCO for participating in the American Board of Internal Medicine Foundation’s Choosing Wisely campaign (see The ASCO Post, May 1, page 19; and page 75 of this issue). I am the Associate Medical Director for a 280-physician multispecialty group in the Hudson Valley of New York, whi...
Clinical Trials, Crossover, and Clinical Equipoise: An Advocate's Perspective
Karl Schwartz
In a previous issue of The ASCO Post, Dr. Susan O’Brien wrote, “It is my understanding that the FDA strongly opposed allowing crossover [in the RESONATE trial]. I presume that is because the FDA also wants to see if there is a survival advantage.”1 The lack of crossover seems a valid concern to me ...
Regional Disparities in Cancer Mortality
Nengliang Yao, MS
I was interested to see an article about the continuing declines in cancer death rates featured in the April 15 issue of The ASCO Post (page 94), as I have just published a paper on breast cancer mortality rates.1 Although overall breast cancer mortality rates have decreased significantly, a much sm...
Intralesional Cytokine Therapy in Cutaneous Melanoma: A Call for Clinical Trials
E. George Elias, MD, PhD
Cutaneous melanomas are mostly an immunogenic group of tumors, but they are also heterogeneous. Therefore, therapeutic specificity and autogenetic approaches are essential to secure beneficial results. The objective of sentinel lymph node biopsy, at the time of diagnosis, is to identify patients wi...
Pharmacyclics' Reply
Danelle James, MD, MS, and Jesse McGreivy, MD
We acknowledge the letters submitted to The ASCO Post from a patient advocate and a chronic lymphocytic leukemia (CLL) patient enrolled on the RESONATE study (PCYC-1112-CA). At Pharmacyclics, we are committed to adhering to high scientific and ethical standards as we strive to develop novel therapi...
ARIEL3 Investigators Clarify the Effects of Rucaparib on the Liver
Jonathan A. Ledermann, MD, and Robert L. Coleman, MD
PRIMARY RESULTS from the randomized, placebo-controlled, phase III study ARIEL3—presented at the European Society for Medical Oncology (ESMO) 2017 Congress and published recently in The Lancet1—demonstrated that maintenance treatment with the poly(ADP-ribose) polymerase (PARP) inhibitor rucapari...
FDA on CLL Drug Approval and Expanded Access
R. Angelo de Claro, MD, Edvardas Kaminskas, MD, Ann Farrell, MD, and Richard Pazdur, MD
The ASCO Post article, “Ibrutinib CLL Trial: Where is the Equipoise?” published in May 2013, inaccurately conveyed that the Food and Drug Administration (FDA) requires an improvement in overall survival for chronic lymphocytic leukemia (CLL) drug approval and opposes allowing crossover in the RESONA...
Inside Story on the Genesis of Teen Cancer America
THANK YOU for publishing the excellent article “We Need to Fill the Gap Between Pediatric and Adult Oncology Care” by Sarah Stream (as told to Jo Cavallo) in the March 25, 2018, issue of The ASCO Post. Sarah’s story and her connection to Teen Cancer America actually go much deeper than she reported ...
Natural Cancer Remedies
Damien Hansra, MD
The cost and side effects associated with traditional cancer therapy are major concerns, and in part many patients are seeking natural remedies such as graviola, curcumin, and moringa, due to these concerns. Traditional cancer therapy is increasingly effective, and oncologists are achieving better r...
LETTER TO THE EDITOR: Individualism in Clinical Decision-making
Jonathan Schwartz, MD
I found a statement by Dr. Peter Bach in the August 15, 2012, issue of The ASCO Post (in the article, “As Conflicting Guidelines Evolve, Experts Continue to Debate the Merits of Cancer Screening”) very troubling. To wit: There’s a cognitive dissonance between the practice of evidence-based medicine...
Updates on Ruxolitinib from ASCO and ASH 2012, including Long-term Survival Data
Srdan Verstovsek, MD, PhD, Ruben A. Mesa, MD, Ronald Hoffman, MD, Jason Gotlib, MD, Rami Komrokji, MD, and Hagop M. Kantarjian, MD
Ruxolitinib (Jakafi), a novel, oral JAK1 and JAK2 inhibitor, was approved by the FDA on November 16, 2011 for patients with intermediate- or high-risk myelofibrosis. The approval was based on its efficacy in reducing spleen size and improving disease-related burdensome symptoms. In the brief In the ...
Perception of Bias
Richard Herrmann, MD
I am a veteran member of ASCO (> 33 years) and a regular reader of The ASCO Post Evening News, which usually provides very interesting information. A recent issue contained an article about a review presented by Tony Reid, MD, PhD, at a Best of ASCO meeting on “Important Findings in Metastatic Co...
The ‘True’ History of the Discovery of Prostate-specific Antigen
William J. Catalona, MD
I am frequently asked about the “true” history of prostate-specific antigen (PSA). As PSA has become more important, a controversy about its discovery has increased. I lived through much of this history and have known many of the “players.” Here are the relevant facts, as I believe them to be true. ...
Limited Access to Radioimmunotherapy in the Community Setting May Lead to Extinction of a Unique Lymphoma Treatment
The ASCO Post
I am writing to ask the ASCO community for help in addressing a policy decision by the Nuclear Regulatory Commission (NRC) that requires oncologists to take a 700-hour course (on the full range of nuclear medicines) to give one medicine to their patients: prepackaged radioimmunotherapy. It’s apparen...
