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Showing 1051 - 1100Adolescent and Young Adult Patients Report Unmet Needs for Cancer Information and Psychosocial Support Services
In the News focuses on media reports that your patients may have questions about at their next visit. This continuing column will provide summaries of articles in the popular press that may prompt such questions, as well as comments from colleagues in the field. Psychosocial care needs are not...
Coping with Liver Cancer
From the moment I had a partial hysterectomy in 2010, I started having unexplained bouts of nausea. My surgeon and even my primary care physician chalked it up to everything from the difficult 6-hour surgery I had just had to anxiety over a move I’d recently made from Connecticut to North Carolina. ...
Getting the Right End-of-life Care: Coming to Terms with the Realities of Advanced Disease and Mortality
“Dying is at once a fact of life and a profound mystery.” That was the opening sentence of a 1997 Institute of Medicine report, Approaching Death: Improving Care at the End of Life, a much-needed jump-start in the national dialogue over identifying the barriers that impede the delivery of...
Expert Point of View: Fritz H. Schröder, MD
I am happy to accept the invitation by The ASCO Post to comment on the recent, long-awaited publication of the PIVOT study (Wilt et al: N Engl J Med 367:203-213, 2012) and the accompanying editorial by Thompson and Tangen (N Engl J Med 367:270-271, 2012). The editorial both points out weaknesses of ...
Faculty Q&A Discussion: Anaplastic Large-cell Lymphoma
Dr. Armitage: For ALK-negative anaplastic large cell lymphoma, brentuximab vedotin is the best thing we have to deal with patients with recurrent disease, and who knows where it will end up in primary therapy. But if the patient is ALK-positive, there is a potential for crizotinib (Xalkori) to...
Faculty Q&A Discussion: Communicating with Patients
Dr. Armitage: As oncologists, we face many challenges. I think the most difficult is when you say to a patient with a disease everybody expects will be cured, and every patient expects to be cured, “It is not worth trying to do that. It is time to worry about keeping you as well as possible for as ...
Exciting New Agents Offer Further Treatment Options for Metastatic Melanoma
“This is a very exciting time in melanoma,” said Michael Sabel, MD, of the University of Michigan, Ann Arbor. “For years, we chugged along with few options for systemic therapy. Then in 2010 and 2011, we saw melanoma data presented at ASCO plenary sessions. At ASCO 2012, we expanded in these areas...
Which Rituximab-based Regimen Works Best in Non-Hodgkin Lymphoma?
The treatment of non-Hodgkin lymphoma (NHL) patients has been recently informed by several important studies, which were discussed at the Best of ASCO Boston meeting by Michael E. Williams, MD, of the University of Virginia Cancer Center in Charlottesville. Bendamustine Outperforms R-CHOP in NHL...
SIDEBAR: Should EGFR Tyrosine Kinase Inhibitors Be Continued Beyond Progression?
It is not yet clear if it is beneficial to continue first-line EGFR tyrosine kinase inhibitors in patients with EGFR-mutated lung cancer who experience progression and are started on chemotherapy, according to Dr. Horn. Two trials, one in Asia (looking at gefitinib [Iressa]) and one in North...
SIDEBAR: Is Vitamin D Supplementation Ready for Prime Time?
The VITAL study generated a host of questions about vitamin D among ASCO Annual Meeting attendees, including whether the study’s findings are ready for clinical application, according to Debra L. Barton, RN, PhD, of the Mayo Clinic, Rochester, Minnesota, speaking at the Best of ASCO San Diego...
2012 Is ‘Banner Year’ for Research on Symptom Management
The year 2012 was “a banner year for symptom management,” according to Debra L. Barton, RN, PhD, of the Mayo Clinic, Rochester, Minnesota, who presented data on patient and survivor care at the Best of ASCO San Diego meeting. “I have been doing symptom management for about 20 years, and it seems...
SIDEBAR: Expect Questions from Patients
A recently reported study finding that anticoagulants and particularly aspirin were associated with a reduced risk of prostate cancer–specific mortality1 has the potential to generate a lot of questions because of the large number of patients potentially affected. As the study’s corresponding...
Cancer Memoir Provides Inspiration for Those with Terminal Illness and Their Caregivers
“It almost always begins in darkness, my memory’s trip back to China where Terrence and I meet.” So begins Amanda Bennett’s moving new memoir, The Cost of Hope, the story of an intensely devoted marriage, cruelly shortened by the cancer that killed her husband. The word “darkness” in Ms. Bennett’s...
In DCIS, Radiotherapy Benefits ‘Good Risk’ Patients
Radiation therapy will improve outcomes for patients with ductal carcinoma in situ (DCIS), even if they are considered at low risk for recurrence, according to the Radiation Therapy Oncology Group (RTOG) 9804 trial.1 But the follow-up time is short, and the findings still leave some wiggle room,...
SIDEBAR: Treatment Decisions for Locally Advanced NSCLC Draw on 'Art of Medicine'
With treatment advances, there are now fewer absolutes in managing locally advanced NSCLC, according to Dr. Reckamp. “We are moving toward treating performance status 2 patients, and obviously, that is a heterogeneous group of people,” she elaborated. “For those who need a lot of care, you need to...
Progress, Slow but Sure, Seen for Current Lung Cancer Therapies
This year, we have some abstracts that help move things forward in lung cancer, maybe at a little bit slower pace than in previous years. But there are important points that we can learn from some of these abstracts,” commented Karen L. Reckamp, MD, of the City of Hope, who presented findings on...
SIDEBAR: From Small Centers to Academic Centers
The use of cytoreduction plus hyperthermic intraperitoneal chemotherapy (HIPEC) to treat carcinomatosis “came from the smaller centers,” noted Nita Ahuja, MD, Director of the Peritoneal Surface Malignancies Program at Johns Hopkins Medicine. “A lot of things in medicine come from academia and move...
Successful Use of Cytoreduction and Hyperthermic Intraperitoneal Chemotherapy May Hinge on Prior Experience
A review of 60 consecutive patients with peritoneal carcinomatosis who underwent cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (HIPEC)—sometimes called “hot chemotherapy”—found 0% mortality and 33% morbidity, with “a significant reduction of grade III/IV morbidity,...
Noncolorectal GI Cancer Evidence Incorporated into Guidelines
The noncolorectal gastrointestinal cancer studies selected for this year’s Best of ASCO meetings include some whose results are being folded into practice guidelines or are good candidates for incorporation, according to Alexandria T. Phan, MD, Associate Professor at The University of Texas MD...
SIDEBAR: Don’t Expect Direct Questions from Patients about Pain
Just asking patients “Is there something else you want to address in the visit,” rather than “Is there anything else you want to address in the visit today,” dramatically reduced patients’ unmet concerns during a primary care visit, according to a 2007 study.1 That learning can be applied to...
Pain Remains Prevalent among Oncology Outpatients, with Odds of Undertreatment Twice as High among Minority Patients
In 1994, a landmark study of pain among oncology outpatients prompted a host of pain management initiatives.1 More than 18 years later, a recent study among more than 2,000 cancer outpatients has found that “one-third of the patients who had pain or used analgesics received inadequate treatment for ...
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 ...
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,...
Expert Point of View: Sandra M. Swain, MD
Commenting on the PHARE trial and HERA update presented at ESMO, ASCO President Sandra M. Swain, MD, of Washington Hospital Center’s Washington Cancer Institute, said “Today we have seen that 12 months of trastuzumab is better than 6 months, and 12 months is the same as 2 years of treatment, so...
Delivering Affordable Cancer Care: Is It Possible and What Will It Entail?
Many experts agree that at 18% of gross domestic product, health care (to paraphrase Shakespeare) is eating the country out of house and home. “The average cost of treating the most common cancers has increased, and as more expensive targeted therapies and other new technologies become the...
Integrative Medicine Showing Benefits in Cancer Management
Donald I. Abrams, MD, Chief of Hematology-Oncology at San Francisco General Hospital and Integrative Oncologist at the University of California, San Francisco, Osher Center for Integrative Medicine, has been investigating and incorporating integrative medicine approaches in his clinical treatment...
SIDEBAR: Expect Questions and Respond with Reasoned Explanations
“Soaring spending has presented the medical community with a new obligation. When choosing treatments for a patient, we have to consider the financial strains they may cause alongside the benefits they might deliver,” three physicians from Memorial Sloan-Kettering Cancer Center (MSKCC) in New York...
MSKCC’s Decision Not to Purchase New Cancer Drug Sparks Editorial and Unprecedented Actions
“At Memorial Sloan-Kettering Cancer Center, we recently made a decision that should have been a no-brainer: we are not going to give a phenomenally expensive new cancer drug to our patients.” That was the opening sentence of a New York Times op-ed piece written by three physicians from Memorial...
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...
Dr. Jimmie C. Holland’s Research Has Long Underscored the Importance of Caring for the Whole Patient
Although internationally recognized today as the founder of the subspeciality of psycho-oncology, the field of psychiatry held no interest for Jimmie C. Holland, MD, when she entered Baylor College of Medicine in Houston, Texas, in the mid-1940s. Born in 1928 at the dawn of the Great Depression,...
The Ethics of Rationing Cancer Care
Should cost be a consideration when deciding on treatment for patients with cancer, and if so, what kind of ethical dilemma does that pose for oncologists? With U.S. spending on oncology drugs expected to climb more than 20% annually over the next decade—reaching $173 billion by 2020, according to...
Surgical Resection for Colorectal Cancer Liver Metastases: Who, When, How?
Many patients with colorectal liver metastases can undergo surgical resection with curative intent. Who are these patients and how are they best managed? In an interview with The ASCO Post, Steven A. Curley, MD, Professor of Surgical Oncology at The University of Texas MD Anderson Cancer Center,...
Combination Therapy Not Better than Single-agent Bevacizumab for Advanced Renal Cell Carcinoma in BeST Trial
None of three combination therapies tested among patients with advanced renal cell carcinoma in the BeST trial came close to achieving the primary objective of a 67% improvement in median progression-free survival compared to single-agent bevacizumab (Avastin), Keith T. Flaherty, MD, reported at...
Current Perspectives on Triple-negative Breast Cancers
Triple-negative breast cancer—which lacks expression of the estrogen receptor, progesterone receptor, and HER2 oncogene—is a challenge for oncologists. The emergence of data showing strong heterogeneity for this subtype of breast cancer creates even more confusion regarding prognosis and...
Recognizing and Managing Physician Burnout in Oncology
Although job burnout occurs in all professions, it is more common among physicians, according to a study published recently in Archives of Internal Medicine.1 Physicians on the front line of care, such as those working in emergency rooms or in family medicine, experience the highest rates of...
Analysis Suggests Screening Mammography Results in Substantial Overdiagnosis with Small Effect on Mortality
An analysis of Surveillance, Epidemiology, and End Results (SEER) data from 1976 through 2008 “suggests that whatever the mortality benefit, breast-cancer screening involved a substantial harm of excess detection of additional early-stage cancers that was not matched by a reduction in late-stage...
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 ...
Online Prostate Cancer Information Is Written at Reading Levels above Many Americans’ Literacy Skills
Although 61% of Americans are going online to access health information,1 many of them may not understand what they find there, including information about prostate cancer treatment options. According to a new study published in The Journal of Urology,2 as many as 90 million Americans have literacy ...
Community Research Forum Addresses Conundrums Common to Community Practices that Conduct Research
It is every research site’s biggest concern. The National Cancer Institute (NCI), the FDA, or drug company sponsors could arrive at any time to comb through a site’s documents related to a specific trial. It’s called an audit, and it’s common. And yet, not all sites that conduct research have...
SIDEBAR: Expect Questions from Patients
Results from the Adjuvant Tamoxifen: Longer Against Shorter (ATLAS) study “will have a follow-on effect of being able to guide physicians about the advantages of longer than 5 years of therapy for the premenopausal woman,” said V. Craig Jordan, OBE, PhD, DSc, Scientific Director at the Lombardi...
'Practice-changing' ATLAS Study Supports 10 vs 5 Years of Tamoxifen Therapy in Women with Breast Cancer
"Practice-changing" is the term several physicians and researchers used when asked by the media to describe the results of a study showing that extending tamoxifen therapy from 5 to 10 years for women with estrogen receptor (ER)-positive breast cancer further reduced recurrence and mortality....
Most Patients Do Not Report that Cure Is Highly Unlikely with Chemotherapy for Advanced Cancer
Chemotherapy for metastatic lung or colorectal cancer can provide palliation and modestly prolong life, but is not curative. In a study recently reported in The New England Journal of Medicine, Jane C. Weeks, MD, of Dana-Farber Cancer Insitute, and colleagues found that the majority of patients...
SIDEBAR: Expect Questions from Patients with Diabetes and Cancer
Patients with diabetes and cancer need to know that some chemotherapy drugs and adjuvant agents may require modifications in how they manage their diabetes. For example, patients who are receiving steroids might have to further restrict their diet to keep blood sugar levels under control. “You...
Keeping Diabetes under Control Is Critical to Good Outcomes for Patients Who Also Have Cancer
In the News focuses on media reports that your patients may have questions about at their next visit. This continuing column will provide summaries of articles in the popular press that may prompt such questions, as well as comments from colleagues in the field. Cancer and diabetes can be comorbid...
International Members Cite Networking, Enhanced Patient Care Among Benefits of ASCO Membership
Thanks to the membership category ASCO designed for physicians in developing countries, Brazilian oncologist Milena Mak, MD, can greatly enhance the care she delivers in the very busy 580-bed Instituto do Cancer do Estado de Sao Paulo. And radiation oncologist Pooja Nandwani Patel, MD, can use the...
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...
Expert Point of View: William M. Grady, MD and Jordan Berlin, MD
William M. Grady, MD, of the Fred Hutchinson Cancer Research Center, Seattle, a member of the news planning team for the symposium, commented, “There has been considerable interest in determining whether molecular alterations in primary colorectal cancer are more accurate prognostic indicators than ...
Expert Point of View: Martin Dreyling, MD
“The BRIGHT study had a noninferiority design, but I question why BR was not found superior, because the StiL trial showed a huge difference in progression-free survival favoring BR,” said Martin Dreyling, MD, Professor at the University of Munich in Germany. “In BRIGHT, BR achieved higher...
Expert Point of View: William Oh, MD
“The durability of PSA response is encouraging [with ARN-509], as is the toxicity data, but these are relatively asymptomatic patients,” said formal discussant William Oh, MD, Chief of the Division of Hematology and Medical Oncology, Professor of Medicine and Urology, and the Ezra M. Greenspan, MD, ...
Reduced Risk of PSA Failure with Adjuvant Radiotherapy vs Wait-and-see Approach in Stage T3 Prostate Cancer
Extended follow-up of the German ARO 96-02 trial shows that adjuvant radiotherapy reduces the risk of biochemical failure in men whose prostate cancer extends through the prostate capsule (stage T3), compared with a wait-and-see approach, after radical prostatectomy. Adjuvant radiotherapy reduced...
