Letters to the Editor
More on the Complexity of Prior Authorization
The ASCO Post Staff
We read with interest the recent commentary by S. Monica Soni, MD, and Andrew A. Hertler, MD, FACP, on prior authorization (June 10, 2023, issue of The ASCO Post). The nuances of prior authorization in our health-care landscape are both complex and consequential. Conceived as a safeguard against pot...
Rwanda’s Vision for Increasing Cervical Cancer Prevention One Village at a Time
Regine Nshimiyimana Maniraho, DNP, PharmB, AOCNP
Cervical cancer is a serious problem in many low- and middle-income countries such as the African country of Rwanda. Although the cervical cancer rate in Rwanda remains more than twice the U.S. rate, there has been improvement in recent years that cancer research organizations can learn from to help...
The Influence of Structural Racism and Poverty on Outcomes in Leukemia
Nithya Krishnan, MD, and Amy Kiamos, DO
In the United States, Black American patients with acute myeloid leukemia (AML) have notably worse survival outcomes compared to White patients. In addition, Black patients are less likely to receive intensive chemotherapy and undergo allogeneic stem cell transplants. Many researchers have reported ...
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...
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...
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. ...
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 ...
‘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...
Physicians Should Lead by Example to Combat the Obesity Epidemic
Damien Hansra, MD
American patients are suffering from an obesity crisis, where it is estimated that 300,000 deaths per year are due to obesity.1 The obesity trend is predicted to worsen, where it is projected that 85% of U.S. adults will be overweight or obese by 2030.2 Consequently, obesity-related illnesses are on...
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...
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...
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...
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...
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 ...
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 ...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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 ...
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. ...
Health-care Crisis Reconsidered
Jonathan Schwartz, MD
As an oncologist in private practice, I usually read with great interest the many articles in The ASCO Post on issues regarding the politics of oncology practice. These articles deal with the major topics of the day, ranging from the high cost of oncologic care to shortages of generic drugs, to alle...
The Language of Cancer
Gopal N. Gupta, MD
I am a member of ASCO and read with interest your piece entitled “The Language of Cancer” in the October 15, 2012, issue of The ASCO Post. By way of introduction, I am an attending physician specializing in urologic oncology at Loyola University Medical Center. My group recently published an articl...
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...
Another Perspective on Accountable Care Organizations
Jonathan Schwartz, MD
I read with great interest Dr. Richard Boxer’s editorial on accountable care organizations in the January 15 issue of The ASCO Post. Much of what he says is unfortunately true. There are several points that I would like to make, however. First of all, Dr. Boxer states that the “principle that defin...
Conflicts of Interest
Laurence Baker, DO
In looking at a recent issue of The ASCO Post, I noted that expert opinions from specialists were published alongside a number of clinical reports. Below each opinion was a disclosure statement, often saying that the expert had no conflict of interest to report. While I do not know each of these ind...
Disclosure: Appropriate or Not?
M. Steven Piver, MD
The ASCO Post is an outstanding publication that I always look forward to reading. I also understand there are policies and rules to be followed, particularly regarding conflicts of interest and disclosures from contributors. I am writing in regard to “Cancer Has Made Me A Better Doctor,” by David P...
Mammography Screening and DCIS
Judith Malmgren, MS, PhD
I would like to suggest that ASCO take a proactive approach to the treatment of ductal carcinoma in situ (DCIS) and the problem it presents to the oncology community. There has been and continues to be heated debate around the value of mammography screening because of “overdiagnosis,” which in my op...
More Recollections on Emil 'Tom' Frei III, MD
Larry Weisenthal, MD, PhD
I have read with interest the recent tributes to Emil “Tom” Frei III, MD, who passed away in April. I was backstage at the ASCO Annual Meeting in 1981, when Dr. Frei was giving his Karnofsky acceptance address. I had a slide presentation at the combined ASCO/American Association for Cancer Research ...
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 ...
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 ...
‘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). ...
Support Group Offers Resources for Patients with Oral/Head and Neck Cancer
Chris Leonardis
I am the Outreach Administrator/Newsletter Editor at Support for People with Oral and Head and Neck Cancer (SPOHNC). SPOHNC is a national nonprofit organization involved in the development of support programs. As such, it can have an enormous positive impact on meeting the psychosocial needs of pati...
Seeking Clarity on the PSA Story
Richard J. Ablin, PhD, DSc (Hon)
My feature interview in the August 15, 2012, issue of The ASCO Post, entitled “Rethinking the Role of PSA Screening in Public Health”1 drew swift reaction from well-known figures in the prostate cancer field. The subsequent Letters to the Editor, three in all, constituted a two-pronged attack. They ...
Déjà Vu Redux: Lessons from the SWOG-8516 Study in Aggressive Lymphomas
Wyndham H. Wilson, MD, PhD
Joseph M. Connors, MD, authored a commentary in the June 25 issue of The ASCO Post inspired by a recent New England Journal of Medicine publication on dose-adjusted EPOCH-R chemotherapy (etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab) for primary mediastinal B-cell ...
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...
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 ...
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...
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...
'Doing Nothing' Is Not an Option
Khalid Rehman, MD, FACP
I applaud The ASCO Post for continuing to raise awareness about futile medical care at the close of life with the recent publication of a commentary by Dr. Chandrakanth Are (“A Great Privilege to Die Beneath an Open Sky,” The ASCO Post, September 15, 2013, page 1). I would suggest, however, that we...
To Die Beneath an Open Sky
Elizabeth D. Simmons, MD
I read the essay by Chandrakanth Are, MBBS, FRCS, FACS, published recently in The ASCO Post and found it both thoughtful and compelling (“A Great Privilege to Die Beneath an Open Sky,” The ASCO Post, September 15, 2013, page 1). Dr. Are made one statement with which I take exception, however, and th...
Platinum-Based Treatment of Triple-Negative Breast Cancer
Larry Weisenthal, MD, PhD
The last issue of The ASCO Post reports encouraging results with platinum-based treatment of triple-negative breast cancer (September 15, 2013). We predicted these findings 4 years ago in a presentation at the 2009 Breast Symposium.1 We compared the activity of a series of agents (platinum, taxane,...
