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SIDEBAR: How Should SWOG 9346 Be Interpreted?

The findings of Southwest Oncology Group (SWOG) 9346 sparked controversy at the ASCO Annual Meeting, and the interpretations were debated at an official postpresentation discussion. At the Best of ASCO Boston meeting, William K. Oh, MD, of Mount Sinai School of Medicine, New York—who also served as ...

pancreatic cancer

A Series of Medical Missteps

Since the beginning of my symptoms—occasional pain on the upper left side of my abdomen, accompanied at times by nausea—which started nearly 20 years ago, my condition, pancreatic neuroendocrine tumor, either remained undetected or was completely misdiagnosed until just recently. A series of...

multiple myeloma

Novel Drug Combinations Present New Hope for Effective Treatments in Multiple Myeloma

Developing early-phase clinical trials that incorporate combinations of novel agents targeting different pathways in the hematologic cancer multiple myeloma is a leading focus of the work of Sagar Lonial, MD, Professor of Hematology and Vice Chair of Clinical Affairs in the Department of Hematology ...

breast cancer

Will mTOR Inhibitors Change the Treatment of Endocrine-sensitive HER2-negative Breast Cancer?

For the treatment of endocrine-sensitive metastatic breast cancer, the combination of an mTOR inhibitor and an endocrine agent represents a promising new option. At the 2012 Breast Cancer Symposium, the 18-month update of BOLERO-2, which tested therapy with everolimus (Afinitor) plus exemestane,...

issues in oncology

Challenging Times: A Day in the Life of a Community Oncologist

Community oncologists man the front line of cancer care, treating upward of 85% of our nation’s patients. Over the past 2 decades, regulatory and economic changes have left many practices in a state of flux and uncertainty, some struggling to keep their doors open. To shed light on the community...

breast cancer

Surrounded by Breast Cancer

Nine women on my mother’s side of the family have been diagnosed with breast cancer, and nearly half have died from their disease, including my mother. With odds like these, I was determined to do what I could to stay ahead of this dreaded monster I thought was surely coming for me. First Tests...

Expect Questions from Patients about Impact of Weight on Prognosis

Increased awareness of the strong association between obesity and higher rates of cancer recurrence and mortality needs to be transmitted from oncologists to patients, but the message needs to concern more than just weight, according to Rachel Ballard-Barbash, MD, MPH, Associate Director of the...

Options Shifting for First-line Treatment of Renal Cell Carcinoma

Trials with pazopanib (Votrient) have “provided significant efficacy, toxicity, and tolerability data for pazopanib to be established as a first-line standard of care” for renal cell carcinoma,” Tim Eisen, PhD, of the University of Cambridge, United Kingdom, stated at the 11th International Kidney...

Expert Point of View: John L. Marshall, MD

The pendulum continues to swing in the treatment of stage II and III colon cancer. Not 5 years ago, our party line was that essentially all patients should receive 6 months of adjuvant FOLFOX (leucovorin, fluorouracil [5-FU], oxaliplatin): patients with stage II or III disease, whether rectal or...

SIDEBAR: Mammography Study Stokes Overdiagnosis Debate

Overdiagnosis and the harms associated with unnecessary procedures is becoming a vibrant subject in today’s health-care dialogue, with serious implications for providers and patients alike. A new study from the Norwegian Screening Program concluded that 15% to 25% of breast cancers identified on...

Seeking Solutions to the Dilemmas of Overdiagnosis and Overtreatment

Widespread use of screening technologies has markedly increased early detection rates of cancer, saving countless lives. However, while screening technologies have remarkable sensitivity, their  inability to identify which tumors will progress and which will not has created the phenomenon of...

Promoting a More Balanced Approach to Cancer Prevention and Treatment

Margaret I. Cuomo, MD, is a board-certified radiologist who served for many years as an attending physician in diagnostic radiology at North Shore University Hospital, Manhasset, New York. Dr. Cuomo is the daughter of former New York Governor Mario Cuomo and sister to Governor Andrew Cuomo. She is...

solid tumors

I Am Not a Victim

Six years ago, at age 62, I was feeling in great shape. The year before, I had taken over custody of my 2- and 3-year-old great-grandchildren and decided to change the course of my career from motivational speaker to motivational coach to be home more often with the kids. It was during one of our...

The Practice of More than One Art

The positive healing effects of music can be traced as far back as ancient Greece and the belief that Apollo was God of medicine and music. In his book De Anima, Aristotle wrote that flute music could purify the soul. By the end of the 19th century, researchers were showing a correlation between...

Top 10 Most Viewed Articles on ASCOPost.com for 2012

Novel Multikinase Inhibitor Improves Survival in Metastatic Colorectal CancerBy Caroline HelwickThe novel tyrosine kinase inhibitor regorafenib, given as a single agent to patients with treatment-refractory metastatic colorectal cancer, significantly improved overall survival and delayed disease...

issues in oncology

Significant Reduction in Cancer Risk Seen with Daily Multivitamin Use in Middle-aged and Older Men

Large-scale trials over the past several years have shown a general lack of effect of single vitamins or small numbers of vitamins given at high doses in preventing cancer. However, as recently reported in JAMA by Gaziano and colleagues, the Physicians’ Health Study II has found a modest but...

ASCO CEO Discusses the Society’s Initiatives

Created in 1964,a the American Society of Clinical Oncology (ASCO) has become the world’s preeminent professional cancer organization, with more than 30,000 members in the United States and abroad, unified by its founders’ “common concern for the patient with cancer.” The ASCO Post recently spoke...

breast cancer

I’m Not the Same Person I Was before Cancer

It’s not clear to me—and my doctors can’t say with any certainty—whether taking birth control pills for many years had anything to do with my getting breast cancer 3 years ago, at age 44. But the cancer growing in my left breast was diagnosed as stage I, estrogen receptor–positive. Although I never ...

The Rise of the Vintage Readers Book Club 

Providing care beyond medical treatment, the multidisciplinary field of psychosocial oncology addresses the psychological, social, and emotional health of the patient with cancer. On an occasional basis, The ASCO Post will explore the realm of psychosocial oncology with a column guest edited by...

health-care policy
legislation

President Obama Signs High-mortality Cancer Bill into Law

Just hours before the end of the 112th Congress, constitutional deadline for approval of a bill passed by that Congress, President Barack Obama signed into law the first legislation requiring comprehensive plans of research action for high-mortality cancers, with lung and pancreatic cancers given...

issues in oncology

Developing Cancer Care Pathways for the New Environment

As community practices and the insurance industry seek cost-effective ways to adapt to the Patient Protection and Affordable Care Act, the evolving concept of cancer care pathways is emerging as a strategy that may help control oncology costs and add value to care. At ASCO’s recent Quality Care...

issues in oncology

Measuring and Improving Quality in Oncology Practices

The seed for ASCO’s Quality Oncology Practice Initiative (QOPI®) was planted a decade ago by Joseph Simone, MD, when he contemplated the feasibility of studying a volunteer group of oncologists to measure the quality of care they provide and share those results with their colleagues. Dr. Simone’s...

health-care policy

Does Health-care Quality Translate to Value?

On March 23rd, 2010, President Obama signed into law the Patient Protection and Affordable Care Act, enacting sweeping change in our health-care system. An underlying theme of the legislation is the realignment of our payment system so that it places value over volume of services. At ASCO’s first...

issues in oncology

Are We Winning the War on Cancer?

On December 23, 1971, President Richard Nixon signed the U.S. National Cancer Act. This date is widely considered to mark the beginning of the so-called “War on Cancer,” although that phrase was introduced only later on. Over recent decades, journalists have from time to time questioned whether we...

Coalition of Cancer Cooperative Groups Celebrates 10 Years of Clinical Trial Participation Awards

For any community practice, participation in a clinical trial can be a time-consuming, intense commitment. But this commitment is integral to the advancement of new methods and therapies, which is why the Coalition of Cancer Cooperative Groups has exactly one mission: increasing clinical trial...

cost of care

Cost of Cancer Drugs: What Price for What Benefit?

In 2011, national health-care spending in the United States was about $2.7 trillion, larger than the entire French national budget.1 U.S. national health-care spending is about 17% of the national gross domestic product. Total Medicare expenditures in 2011 were $549 million.2 In the debate about...

cost of care
health-care policy

The Doctor Who Championed Patient Navigation in Harlem 

After completing his residency at Memorial Sloan-Kettering Cancer Center, Harold P. Freeman, MD, arrived at Harlem Hospital Center in 1967, where the overwhelming majority of his patients presented with late-stage disease. That early experience with underserved patients would shape his career as...

solid tumors

Gene in Eye Melanomas Linked to Good Prognosis

Melanomas that develop in the eye often are fatal. Now, researchers at Washington University School of Medicine and the Siteman Cancer Center, St. Louis, Missouri, report they have identified a mutated gene in melanoma tumors of the eye that appears to predict a good outcome. The research was...

issues in oncology

As Computers Learn to 'Talk' to Each Other, Patient Care Will Improve 

Last fall, Edward P. Ambinder, MD, Clinical Professor of Medicine, Hematology, and Medical Oncology at the Icahn School of Medicine at Mount Sinai in New York, and a member of ASCO’s Health Information Technology Work Group, spoke about “The Information Age: Cyberspace and Cancer,” at the...

breast cancer
leukemia

Chemotherapy for Breast Cancer Carries a Small, but Concerning, Risk for Leukemia 

The risk for developing a secondary malignancy after chemotherapy for breast cancer is very small, but it is statistically significantly higher than for the general population, a review of the National Comprehensive Cancer Network (NCCN) database revealed in a study presented at the 2012 San...

issues in oncology
cost of care

Integration across the Spectrum: Community Perspective on the Medical Oncology Home Model 

The term “patient-centered cancer care” has become ingrained in today’s health-care vernacular. However, no matter what modifications occur in clinical oncology practice, the terms value and cost-effectiveness are now a solid part of the equation. At ASCO’s Quality Care Symposium, Linda D....

lymphoma

Solving a 30-year Mystery

When I began experiencing severe neck and back pain about 9 years ago, I had no idea it could be a late side effect from the radiation therapy I had received 31 years ago to treat my Hodgkin lymphoma. And none of the doctors I’ve seen over the past decade have been able to make the connection...

breast cancer

Dose-dense Chemotherapy in Breast Cancer: Epirubicin-based Regimens Studied in German and UK Trials

In the treatment of early breast cancer, dose-dense regimens (given every 2 weeks) have proven superior to conventionally dosed chemotherapy (given every 3 weeks), but data on long-term survival are lacking. Two studies presented at the San Antonio Breast Cancer Symposium evaluated the benefit of...

issues in oncology

On Radiation and Cancer Risk

We owe our life to radiation. The universe was created in a thermonuclear explosion, and continued existence of life on Earth depends on plants using chlorophyll to capture light energy emitted by the sun (and exploding supernovas) and converting it into chemical energy, with the subsequent...

cost of care
survivorship

Study Finds Young Cancer Survivors Often Skip Checkups

Athough the majority of the more than 69,000 adolescents and young adults (AYAs) diagnosed with cancer each year will survive their disease, many of them will experience interruptions in their education and a derailment in their career tract, curtailing their lifetime earning potential and reducing ...

breast cancer

My Life Will Never Be Normal 

After being diagnosed with stage II invasive ductal carcinoma in my right breast in 2004, I did an Internet search to learn more about my treatment options so I could be prepared when I met with my oncologist to discuss my treatment plan. I was especially interested in therapies that would be...

issues in oncology
health-care policy

Focus on the Medical Oncology Association of Southern California 

For more than 2 decades, the guiding principle of the Medical Oncology Association of Southern California (MOASC) has been to ensure the continuation of the private practice of medical oncology and to provide the highest quality care to cancer patients. Founded in 1990, MOASC is the largest...

IBM's Watson Goes Through Basic Training in Oncology 

While IBM’s Watson supercomputer may have defeated two former champions on the TV game show Jeopardy! 2 years ago, it is now facing its greatest challenge yet: deciphering huge amounts of scientific data and interpreting clinical information to help oncologists make personalized evidence-based...

solid tumors
colorectal cancer

Colorectal Cancer: A Decade of Progress 

The 2013 Gastrointestinal Cancers Symposium marked the 10th anniversary of the meeting. Richard M. Goldberg, MD, the Klotz Family Chair in Cancer Research, Professor of Medicine, and James Cancer Hospital Physician-in-Chief at The Ohio State University, looked back over the decade to highlight the...

solid tumors
issues in oncology

Targeted Therapy Gaining Ground in the Second-line Treatment of Gastric Cancer 

In gastric cancer, the concept of targeted therapy assumed clinical significance when the addition of trastuzumab (Herceptin) to chemotherapy improved survival by almost 3 months in the ToGA trial.1 Another anti-HER2 agent, lapatinib (Tykerb), now looks promising, as does an agent targeting the...

colorectal cancer

Cancer Has Made Me A Better Doctor

After six recurrences of colorectal cancer, the chances it will recur again are high. But if I concentrate on that, I couldn’t live my life. In retrospect, I should have paid attention sooner to the abdominal pain I was experiencing and not dismiss it as a simple case of gas. But at age 47 and with ...

Building CancerLinQ: The Road to Faster, More Efficient Treatment Delivery 

In June, Clifford A. Hudis, MD, Chief of the Breast Cancer Medicine Service and Attending Physician at Memorial Sloan-Kettering Cancer Center, and Professor in the Department of Medicine at Weill Cornell Medical College, will begin his term as President of ASCO. Among Dr. Hudis’ priorities will be...

integrative oncology

Barrie R. Cassileth, MS, PhD, Champion of Integrative Oncology, Continues to Nurture Growth of the Field 

Over the past decade, integrative oncology has gained wide acceptance as an evidenced-based way to improve the lives of patients with cancer throughout the continuum of their care. The ASCO Post recently spoke with Barrie R. Cassileth, MS, PhD, Chief of the Integrative Medicine Service and Laurance ...

health-care policy

Another Perspective on Accountable Care Organizations

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...

health-care policy
legislation

Focus on the Louisiana Oncology Society 

Founded on September 1, 1992, by John M. Rainey, MD, the Louisiana Oncology Society has had numerous legislative successes (see sidebar) since that time, including leading the effort to support Louisiana’s Oral Chemotherapy Parity Law, which was passed in 2012 and is now in effect throughout the...

SIDEBAR: Achievement Award 

Jimmie C. Holland, MD, Wayne E. Chapman Chair in Psychiatric Oncology, Memorial Sloan-Kettering Cancer Center, received ACCC’s Annual Achievement Award for excellence in advocacy, dedication, and commitment to the care and treatment of patients with cancer. In her acceptance speech, Dr. Holland...

gynecologic cancers

It Takes a Village to Survive Ovarian Cancer 

My odyssey with ovarian cancer started in May 2005, when I saw my gynecologist for an annual exam and mentioned an odd twinge I had been experiencing on my left side. A subsequent pelvic ultrasound followed by an MRI showed that my ovaries were enlarged, and my doctor warned me that the problem...

ASCO’s State Oncology Societies Booth Provides a Place for Relationship Building and Sharing Best Practices

Want to learn how to best lobby your local state legislators on the issues that affect your practice in your state? Or finally meet the executive director of your state’s oncology society? Look for the State Oncology Societies Booth at ASCO’s Annual Meeting this year. The booth will be located in...

leukemia

Ibrutinib CLL Trial: Where Is the Equipoise?

The RESONATE trial is randomly assigning patients with refractory or relapsed CLL to either ofatumumab (Arzerra) or the investigational oral agent ibrutinib. Ofatumumab is an anti-CD20 monoclonal antibody like rituximab (Rituxan), but is more potent as a single agent. It was approved for refractory ...

leukemia

Drug Approvals in Acute Myeloid Leukemia: Can We Do Better? 

Forty years ago, President Richard Nixon announced a “war on cancer.” Some of that war’s first battles were won in the field of acute myeloid leukemia (AML) with two agents, cytarabine and daunorubicin, receiving U.S. Food and Drug Administration (FDA) approval based on their ability to produce...

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