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issues in oncology

Quality Improvement Projects Aim at Reducing Errors in Prescribing IV and Oral Chemotherapy

Two quality improvement projects described in the Journal of Oncology Practice resulted in reduced errors in prescribing intravenous (IV) and oral chemotherapy. A project at the University of Texas Medical Branch in Galveston outpatient infusion centers first identified 15 different types of...

colorectal cancer

Patients Diagnosed With Stage I to III Rectal Cancer at Younger Age Have Increased Risk for Positive Lymph Nodes

Patients diagnosed with stage I to III rectal cancer at a younger age are at increased risk of having positive lymph nodes, according to an analysis of data published in the Journal of the National Cancer Institute. “This finding merits further investigation and may ultimately impact treatment...

health-care policy

340B Drug Pricing Program Revisited

I have to disagree with some of the conclusions drawn by Drs. Hagop Kantarjian and Robert Chapman in their editorial on the 340B Drug Pricing Program, which appeared in the January 25 issue of The ASCO Post. Although I’m sure I’m not the best person to provide an alternate view, I do feel strongly...

breast cancer

I Never Forget I Have Cancer

I have a history of fibrocystic breasts, which required biopsies to make certain the cysts were benign, and for years they were. But in 2009, my mammogram screening picked up a suspicious lump in my right breast, which turned out to be stage III estrogen receptor–positive/progesterone...

issues in oncology

Somebody’s Watching You: Meet the Tweet Trackers of the Social Oncology Project

In a one-story concrete industrial building across the street from a lumberyard in Austin, Texas, Greg Matthews and his computers are tracking everything that more than 500,000 U.S.-based physicians post publicly on social media. Every tweet. Every public blog, Facebook, or Instagram post. Every...

Expect Questions and Heightened Interest About Bilateral Mastectomy

Recently released data from the Agency for Healthcare Research and Quality (AHRQ) showed that the rate of mastectomies increased between 2005 and 2013, with much of that increase attributed to bilateral mastectomies among women with early-stage cancer in one breast opting for bilateral...

breast cancer

The Perplexing Increase in Bilateral Mastectomies

The increased rate of bilateral mastectomies, as shown in recently released data from the Agency for Healthcare Research and Quality (AHRQ), is “perplexing,” Ismail Jatoi, MD, PhD, told The ASCO Post. “We are seeing more and more women with unilateral breast cancer opt for bilateral mastectomy,...

survivorship

A Cancer Patient’s Harried Survivorship Story

There are approximately 14 million cancer survivors in the United States, a number that is steadily increasing, thanks to our advances in detection and treatment. However, surviving cancer can leave a host of physical, emotional, and financial hardships for years after diagnosis and treatment. In ...

A Hard Look at the Connection Between Germs and Mental Illness

The relationship between disease and microbes was first proposed in the 17th century, but the basic standards for proving that infection causes disease were not laid down until 1883, when the German bacteriologists Robert Koch and Friedrich Loeffler provided the first evidence of the processes...

A Doctor’s Prescription for a Long Life

Longevity is a common goal among humans. And like all things human, it is not distributed equally. According to world health data, Japan is number one on the longevity list; its 130 million citizens have a life expectancy of about 84.74 years. The sub-Saharan country of Chad is number 224, having ...

A Gene Hunter’s Advice on How to Take Control of Your Genetic Inheritance

Since the late 1970s, researchers have identified several gene mutations that are implicated in cancer. Many of these mutations are acquired during our lifetime, but, as we know, some are inherited in families. Identifying heritable cancer-causing genetic mutations is a double-edged sword,...

A Drop of Blood

I was a third-year internal medicine resident, rotating through the oncology service, when I was asked to perform my first circumcision. My team was rounding on Tom, a 52-year-old gentleman currently receiving third-line treatment for metastatic esophageal cancer; we were discussing at length his...

A Fight to Remember

In 2006, one of my close friends, Robert O’Connor, won the mayoral race for my hometown of Pittsburgh, Pennsylvania. Everyone loved Robert, affectionately known as “Bob” and often referred to as “The People’s Mayor.” Bob was “Mr. Pittsburgh,” and it was his promise to reverse the city’s...

integrative oncology

Benefiting From Mind-Body Therapy

My diagnosis of early-stage breast cancer at age 35 was a shock, also because I come from a family with no history of cancer. In disbelief, I was literally speechless—I lost my voice completely for several days. I grew up in the former Soviet Union and then in the newly independent Kyrgyzstan. My...

Expert Point of View: Carlos Arteaga, MD

Carlos Arteaga, MD, of Vanderbilt-Ingram Cancer Center, Nashville, Tennessee, said, “Breast-conserving therapy is the right thing to do. This study will not change current practice guidelines. Mastectomy is generally reserved for larger tumors and those with multifocal disease. The study just...

breast cancer

Study Shows Breast-Conserving Therapy Beats Mastectomy, but Questions Remain

Breast-conserving therapy (lumpectomy plus radiation therapy) appears to improve 10-year overall survival for women with early breast cancer compared with mastectomy, according to a very large population-based study from the Netherlands.1 However, the study raises more questions than it answers,...

colorectal cancer

Expert Point of View: Wells Messersmith, MD

Wells Messersmith, MD, Professor and Head of Medical Oncology and Director of the Gastrointestinal Cancer Program, University of Colorado, Denver, discussed the two studies. Closer Look at STEAM Dr. Messersmith said the FOLFOXIRI (fluorouracil [5-FU], leucovorin, oxaliplatin, irinotecan) vs FOLFOX...

colorectal cancer

Studies Evaluate Bevacizumab-Containing Regimens in Metastatic Colorectal Cancer

Two trials reported at the 2016 Gastrointestinal Cancers Symposium evaluated bevacizumab (Avastin)-containing regimens in the first-line treatment of metastatic colorectal cancer and supported some, but not all, previous findings. The STEAM trial found some numerical differences but no...

global cancer care

The Time Is Now for the Worldwide Cancer Community to Be Proactive

The ASCO Post recently spoke with nationally recognized surgical oncologist Chandrakanth Are, MBBS, MBA, FRCS, FACS, Jerald L & Carolynn J. Varner Professor of Surgical Oncology & Global Health; Vice Chair of Education; and Program Director, General Surgery Residency, University of Nebraska ...

prostate cancer

New High-Intensity Focused Ultrasound Advances Treatment for Prostate Cancer

For the estimated 220,000 men who will be diagnosed with prostate cancer this year, deciding on a method of treatment can be a challenge. Some with early-stage cancer pursue active surveillance, while others with more severe cancer immediately pursue surgery, including prostatectomy. Others fall...

prostate cancer

Biomarkers in Prostate Cancer: PARP Inhibitors and Defects in DNA Repair

New data on molecular biomarkers in advanced prostate cancer are accumulating at a fast pace. The studies in this area can now be broadly grouped in two distinct areas—those that broadly relate to androgen signaling and those that relate to DNA-repair pathways. The Androgen-Signaling Pathway With...

breast cancer

Introduction of New Diagnostic Devices in Oncology: New Is Not Necessarily Better

“New!” “Improved!” “Throw out that old [fill in the blank] and go buy a new [fill in the blank]!” Sound familiar? The key to marketing is to convince customers that they need a product without which they had previously been quite happy. All too often, this strategy is accompanied by a caveat emptor ...

breast cancer

Potential Overdiagnosis of Contralateral Breast Cancer With Preoperative Breast MRI in Older Women With Breast Cancer

In an analysis of the Surveillance, Epidemiology, and End Results (SEER)-Medicare database reported in the Journal of Clinical Oncology, Shi-Yi Wang, MD, PhD, of Yale School of Public Health, and colleagues found that the use of preoperative magnetic resonance imaging (MRI) was associated with...

supportive care

How Rehabilitation Services Provide Benefit for Patients With Spinal Metastases

The benefits of rehabilitation in traumatic spinal injuries are well established. Recently, studies have shown similarly positive results in cancer-related spinal injuries, indicating that rehabilitation can play a complementary role in the care management of this patient population....

issues in oncology

Closing the Clinical Trial Gap for Adolescents and Young Adults With Cancer

Although overall survival rates for patients with cancer continue to soar—with 14.5 million cancer survivors today1—most of that gain is among pediatric and older adult patients. For adolescents and young adults with cancer—defined by the National Cancer Institute (NCI) as those in the 15- to...

issues in oncology

Is This the Dawn of Cancer Biosimilars?

The Patient Protection and Affordable Care Act, signed into law in 2010, did more than make it possible for millions of Americans to afford health care; it also established an abbreviated approval pathway for biologic products that are “biosimilar” to, or shown to be “interchangeable” with, a U.S....

lymphoma

Obinutuzumab in Relapsed or Refractory Follicular Lymphoma

On February 26, 2016, obinutuzumab (Gazyva) was approved for use in combination with bendamustine (Bendeka, Treanda) followed by obinutuzumab monotherapy for treatment of patients with follicular lymphoma who have relapsed after or are refractory to a rituximab (Rituxan)-containing regimen.1,2...

Conquering Cancer With Dr. Kim

There are many different ways to treat cancer: surgery, radiation therapy, chemotherapy, and more, sometimes used alone and sometimes in combination. But, in certain circumstances, the best treatment option for a patient may not look much like treatment at all. Instead of attempting to eliminate...

2016 Pre–Annual Meeting Educational Programs Feature Important Topics for Modern Cancer Care Providers

For oncology professionals looking to maximize their learning and networking opportunities, ASCO will be offering two types of Pre–Annual Meeting Educational Programs ahead of its 2016 Annual Meeting in Chicago this summer. Offered since 2012, Pre–Annual Meeting Seminars are a series of in-depth...

breast cancer

Palbociclib Combined With Fulvestrant in Advanced Breast Cancer Progressing After Endocrine Therapy

On February 19, 2016, palbociclib (Ibrance) was approved for use in combination with fulvestrant (Faslodex) for treatment of hormone receptor–positive, HER2-negative advanced or metastatic breast cancer with disease progression following endocrine therapy.1,2 In February 2015, palbociclib in...

survivorship

Cancer Survivorship Research: Learning From the Past to Improve Future Outcomes

Soon after effective therapies for some childhood malignancies were first identified, early leaders in our field had concerns about what would happen to surviving patients as they aged. In 1975, Giulio D’Angio, MD, one of the founders of modern pediatric radiation oncology, presciently called for...

solid tumors

Everolimus in Advanced Neuroendocrine Tumors

On February 26, 2016, everolimus (Afinitor) was approved for treatment of adult patients with progressive, well-differentiated, nonfunctional neuroendocrine tumors of gastrointestinal or lung origin that are unresectable, locally advanced, or metastatic.1,2 The drug was previously approved for...

Expert Point of View: David Raben, MD

“Proton therapy may very well offer reduced late toxicities. Reflecting back on past reirradiation studies both within and outside of the cooperative groups, it seems that the late toxicities in this retrospective study were somewhat similar,” said David Raben, MD, Professor of Radiation Oncology...

Expert Point of View: David Raben, MD

“As radiation oncologists, we have pushed some important envelopes to try to mitigate long-term toxicity,” said David Raben, MD, Professor of Radiation Oncology at the University of Colorado Cancer Center, Aurora, Colorado. “We’ve been able to utilize intensity-modulated radiation techniques to...

head and neck cancer

Late Toxicity Improved With Response-Adapted Volume De-escalation in Locally Advanced Head and Neck Cancer

Efforts to reduce the late toxicity associated with chemoradiotherapy for locally advanced head and neck squamous cell cancer have focused on radiation therapy dose de-escalation in select populations, according to James Melotek, MD, a radiation oncologist at the University of Chicago. “Patients...

Expert Point of View: Brian Nussenbaum, MD

“This is really the dawn of a new era in the treatment of head and neck cancer, particularly with immunotherapy,” said Brian Nussenbaum, MD, Director of Head and Neck Surgical Oncology at Washington University School of Medicine in St. Louis. According to Dr. Nussenbaum, a better understanding is...

head and neck cancer

Study Supports an Immune Effect of Chemoradiation in Head and Neck Cancer

Definitive radiation, with or without chemotherapy, induces a combination of immune-stimulating and inhibitory effects in patients with squamous cell carcinoma of the head and neck, according to research presented by Jonathan Schoenfeld, MD, MPhil, MPH, at the 2016 Multidisciplinary Head and Neck...

Surgeons—Yes, Surgeons—Have a Role in Translational Cancer Research

Surgeons are clearly more comfortable in the operating room than the laboratory, but there is a place for them in translational cancer research as well, according to one surgeon who has led cutting-edge research in pancreatic cancer. “Translational studies require access to patients, to tissue, and ...

symptom management

Phone Triage System Offers Potential to Reduce Patient Visits to the Emergency Department for Cancer Treatment–Related Symptoms

A quality improvement initiative to reduce the reliance of patients on visits to the emergency department for treatment of side effects related to cancer treatment was reported to be highly effective, according to early findings from a new study. 1 The strategy, involving a telephone triage...

issues in oncology

Update on CancerLinQ: A Rapid Health-Care Learning System

On March 26, 2013, ASCO announced that it had completed a prototype of CancerLinQ™, the Society’s groundbreaking health information–technology initiative to achieve higher quality, higher value cancer care with better outcomes for patients. At this year’s 2016 ASCO Quality Care Symposium, Robert S. ...

health-care policy

Regulators Embrace Immunotherapy

The Cancer Drug Development Forum exists to provide, as the name implies, a meeting place to bring together academia, the pharmaceutical industry, and most important regulators for full and frank discussions to facilitate anticancer drug development. In the recent past, the Cancer Drug Development...

symptom management

Anticoagulation in Patients With Cancer: Understanding the Complexities of Prophylaxis and Management

Venous thromboembolic events are more prevalent in patients with cancer than in persons without it. Cancer is associated with a high rate of venous thromboembolism recurrence, bleeding, requirement for long-term anticoagulation, and reduced quality of life. Moreover, thrombosis is the second most...

leukemia

Chronic Lymphocytic Leukemia: The Golden Drug Only for Golden Agers?

As reviewed in this issue of The ASCO Post, Burger and colleagues recently reported findings of the RESONATE-2 trial of ibrutinib (Imbruvica) vs chlorambucil (Leukeran) as initial therapy for elderly patients with chronic lymphocytic leukemia (CLL).1 The study met its primary endpoint of...

symptom management

Neurofeedback Reduces Pain, Increases Quality of Life for Cancer Patients Suffering From Chemotherapy-Induced Neuropathy

A new study from The University of Texas MD Anderson Cancer Center evaluating the use of neurofeedback found a decrease in the experience of chronic pain and an increase in quality of life among patients with neuropathic pain. The study was presented at the annual meeting of the American...

issues in oncology

Families of Cancer Decedents See Early Hospice, ICU Avoidance, and Death Outside the Hospital as Better End-of-Life Care

Families of patients dying with lung or colorectal cancer judged end-of-life care as better when it was less aggressive, involved earlier hospice, avoided intensive care unit (ICU) admission, and included death outside of the hospital, according to a study reported by Wright et al in JAMA. Study...

colorectal cancer
gastrointestinal cancer

Long-Term Follow-up of Prospective U.S. Cohorts Shows Reduced Risk of GI Tract Cancers With Regular Aspirin Use

In a long-term follow up of two large U.S. prospective cohorts reported in JAMA Oncology, Cao et al found that regular use of aspirin was associated with a reduced risk of gastrointestinal (GI) tract cancers. In 2015, the U.S. Preventive Services Task Force recommended the use of aspirin in...

breast cancer
leukemia
lung cancer

Specific Form of CYP3A7 Gene Associated With Poor Outcomes for Patients With Several Cancer Types

Among patients with breast cancer, lung cancer, or chronic lymphocytic leukemia (CLL), those who had a specific form of the CYP3A7 gene (CYP3A7*1C) had worse outcomes compared with those who did not have CYP3A7*1C. This may be related to how the patients metabolize the therapeutics used to treat...

lung cancer

Dietary Glycemic Index Linked to Lung Cancer Risk in Non-Hispanic White Populations

Consuming a diet with a high glycemic index was independently associated with an increased risk of developing lung cancer in non-Hispanic whites, according to a new epidemiologic study from The University of Texas MD Anderson Cancer Center. This research, published by Melkonian et al in Cancer...

colorectal cancer

Laboratory Study Explores How High-Fat Diet Influences the Development of Intestinal Tumors

A study published by Beyaz et al in Nature reveals how a high-fat diet makes the cells of the intestinal lining more likely to become cancerous. It joins a growing body of research that finds obesity and eating a high-fat, high-calorie diet are significant risk factors for many types of cancer....

issues in oncology

Study Evaluates Patient/Oncologist Perceptions of Whole-Exome Sequencing in Advanced Cancer

A majority of people with advanced cancer want to hear findings from DNA sequencing and to learn how those results may affect their health and treatment options, Dana-Farber Cancer Institute scientists report. Their findings were reported by Gray et al in Genetics in Medicine. The discovery...

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