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SIDEBAR: Colorectal Cancer Survivors’ Comments on Strategies to Regulate Bowel Function

Avoiding Foods I don’t eat beans, I don’t eat onions. I’m kind of careful on greens because they just don’t digest well. I don’t eat as many salads. I couldn’t because they went right through. Behavioral Adjustments You learn, over the years, what you can and can’t do. And you can’t overeat....

colorectal cancer
survivorship

Colorectal Cancer Survivors Face Challenges With Bowel Regulation

The fight against colorectal cancer leaves many survivors with battle wounds, according to studies that show a high incidence of assorted morbidities that can affect quality of life. Clinicians, in fact, may be unaware of the struggles with bowel function that occur during survivorship, researchers ...

Expert Point of View: Thomas W. Flaig, MD

This study has the potential to expand the number of patients who can benefit from organ-sparing therapy,” said Thomas W. Flaig, MD, Associate Professor in the Division of Medical Oncology at the University of Colorado Denver, commenting on the pooled analysis of RTOG 9906 and 0233 presented at the ...

kidney cancer
prostate cancer

Five Key Studies in Prostate Cancer and Renal Cell Carcinoma

The 10th Genitourinary Cancers Symposium, sponsored by ASCO, the American Society for Radiation Oncology, and the Society of Urologic Oncology, was held January 29–February 1, 2014, in San Francisco. The more than 630 abstracts presented addressed essential research in genitourinary malignancies,...

health-care policy

The Evolution of U.S. Cooperative Group Trials: Publicly Funded Cancer Research at a Crossroads

Over the past 5 decades, National Cancer Institute (NCI) Clinical Trials Cooperative Groups have played an enormous role in the fight against cancer, tackling a broad social agenda, including cancer prevention, quality-of-life issues for patients with cancer, and comparison of benefits among...

lung cancer

I Refuse to Capitulate to Cancer

Early last year, just as I returned to my residency in neurologic surgery at Stanford University after completing 2 years of my postdoctoral fellowship in a laboratory developing optogenetic techniques, I started losing weight—dropping from 180 lb to 160 lb in just 6 months—and I was having fairly...

prostate cancer

State-of-the-Art Update on Prostate Cancer

The 2014 Genitourinary Cancers Symposium, held in San Francisco from January 29 to February 1, brought together more than 3,100 participants from around the world involved in the care of patients with genitourinary malignancies. The abstract presentations and plenary discussions offered the latest...

issues in oncology

Transition From Busy Oncologist to Retiree: Challenges and Opportunities

Oncology is a demanding field that requires special qualities to care for very sick patients, many of whom will die prematurely of their disease. Research indicates that years of facing life-and-death decisions in the clinic can be associated with oncology burnout syndrome, which effects physician...

leukemia

Long-Term Benefit With Dasatinib After Imatinib Failure in Chronic-Phase Chronic Myeloid Leukemia

Patients with chronic myeloid leukemia (CML) in the chronic phase who are resistant or intolerant to imatinib (Gleevec) can experience long-term benefit with dasatinib (Sprycel), according to long-term results of a randomized phase III study. The CA180-034 study also found that early molecular and...

prostate cancer

Prostate Cancer Study Showing Increased Survival for Younger Men Undergoing Prostatectomy Not Expected to Increase Surgeries

Extended follow-up in the Scandinavian Prostate Cancer Group Study Number 4 (SPCG4), reported recently in The New England Journal of Medicine,1 found that men with early-stage prostate cancer, particularly those under 65 years old, who were treated with radical prostatectomy had increased survival...

issues in oncology

Have You Heard?

“It’s not a matter of if a child will be seriously poisoned or killed. It’s a matter of when.” Lee Cantrell, PharmD, Director of the San Diego Division of the California Poison Control System and Professor of Clinical Pharmacy at the University of California, San Francisco, commenting on the...

integrative oncology

Reishi Mushroom

Scientific name: Ganoderma lucidum Common names: Ling zhi, lin zi, mushroom of immortality Overview A fungus, reishi mushroom is an important component of the traditional medical systems of China, Japan, Korea, and other Asian countries. It is used to increase energy, stimulate the immune system,...

MD Anderson Honors Two Champions for Women in Medicine and Research

Two champions of gender equality in medicine and research were recently honored by The University of Texas MD Anderson Cancer Center. Laurie Glimcher, MD, the Stephen and Suzanne Weiss Dean of Weill Cornell Medical College and Provost for Medical Affairs of Cornell University since 2012, received...

solid tumors

shRNAs Can Identify T-Cell Inhibitory Mechanisms in Tumor Microenvironment

Although recent findings indicate that targeting of inhibitory receptors on T cells can produce durable responses in some cancer patients despite the presence of advanced disease, the mechanisms controlling T-cell function in immunosuppressive tumors have not been well characterized. In a study...

supportive care

Two Behavioral Interventions Help Cancer Patients Struggling With Sleep Issues, Penn Medicine Study Finds

Patients with cancer who are struggling with sleep troubles, due in part to pain or side effects of treatment, can count on two behavioral interventions for relief—cognitive behavioral therapy for insomnia and mindfulness-based stress reduction—Penn Medicine researchers reported in a recent study...

health-care policy

The FDA’s Bad Ad Program

INSIDE THE BLACK BOX is an occasional column providing insight into the FDA and its policies and procedures. In this installment, Robert Dean, MBA, Director, and Michael Sauers, Deputy Director, of Division II in the FDA’s Office of Prescription Drug Promotion discuss the FDA’s Bad Ad program. The...

multiple myeloma

The CoMMpass Trial in Multiple Myeloma

When I was diagnosed with multiple myeloma in 2008, at just 47, I was lucky. I was asymptomatic, my cancer was detected through a routine blood test, and I had the smoldering type, so I didn’t need immediate treatment. Plus, I knew that recent advances in more effective therapies were making it...

multiple myeloma

Unraveling the Molecular Complexity of Multiple Myeloma

In 2011, the Multiple Myeloma Research Foundation (MMRF) announced the launch of CoMMpass (Relating Clinical Outcomes in Multiple Myeloma to Personal Assessment of Genetic Profile), a clinical study at the heart of its Personalized Medicine Initiative. CoMMpass will follow 1,000 newly diagnosed...

prostate cancer

Does ‘Specialist Bias’ Contribute to Overtreatment of Prostate Cancer?

Specialist bias, in which specialists recommend the therapy that they are capable of delivering, is thought to influence the treatment of patients with localized prostate cancer and to contribute to overtreatment of men with limited life expectancy,” Ayal A. Aizer, MD, MPH, and colleagues, from the ...

lung cancer

Decision Time for Lung Cancer Screening in High‑Risk Populations

For decades, dedicated members of the oncology community have fought to increase the nation’s focus on lung cancer prevention and treatment. Although smoking cessation initiatives have reduced cigarette consumption, lung cancer 5-year survival has remained stagnant at 15%, lagging far below most...

issues in oncology

‘How Am I Doing, Doc?’

The goal of effective adjuvant therapy is to increase overall survival. It has been suggested cynically that all we need to accomplish, actually, is to delay recurrence until after the time the patients die from another cause. However, patients want to hear from us that “it’s never coming back,”...

issues in oncology

Utah Center for Genetic Discovery to Integrate Genome Data Into Patient Care

The USTAR Center for Genetic Discovery is partnering with California-based Omicia, Inc, to make analyzing a patient’s genome as routine as performing a blood test. The center, codirected by Mark Yandell, PhD, and Gabor Marth, DSc, was launched this month with $6 million from the University of Utah...

breast cancer

Determining Why Younger Women With Breast Cancer Are Less Likely to Survive Than Their Older Counterparts

Although cancer survival rates among pediatric and older adult patients continue to rise, survival rates for adolescents and young adults (AYAs), defined by the National Cancer Institute as those between the ages of 15 and 39, have remained stagnant for decades. In breast cancer especially, AYAs...

supportive care
issues in oncology

Accidental Extravasation of Chemotherapy

Accidental extravasation of chemotherapy is a rare but feared complication of cancer treatment. Risk factors for extravasation include medication-related factors (such as the vesicant properties of the compound, or the volume, concentration, and duration of the infusion), patient-related factors...

issues in oncology

Informed Consent: Not Just About Blood Tests and Procedures Anymore

On February 24, the Institute of Medicine National Cancer Policy Forum convened a workshop, “Contemporary Issues in Human Subjects Protection in Cancer Research,” in Washington, DC. In his introduction to the workshop, Steven Piantadosi, MD, PhD, Director, Samuel Oschin Cancer Institute,...

NIH Opens Its Doors to Research for Extramural/Intramural Collaboration

Ten projects that will enable nongovernment researchers to conduct clinical research at the National Institutes of Health (NIH) Clinical Center in Bethesda, Maryland, were announced recently. Through these 3-year, renewable awards of up to $500,000 per year, scientists from institutions across the...

Help Your Patients Learn About Their Cancer Care Team

On the Cancer.Net Blog, your patients can read about the various health professionals involved in their diagnosis, treatment, and survivorship and listen to podcasts with these professionals discussing their roles in caring for people with cancer. This month, the Cancer.Net Blog highlighted...

Become a Cornerstone of the Conquer Cancer Foundation

Have you given any thought to the legacy you would like to leave? For many of you, your professional legacy will include the patients you have cared for, the research you have conducted, the students you have mentored, and the lives you have touched in the world of cancer care. You also have your...

issues in oncology

Amended 2013 Conflicts of Interest Policy Expands Requirements for Financial Disclosures

The Society’s 2013 Policy for Relationships with Companies is scheduled to go into effect on April 22, with one large change to its original requirements. The policy will still require the full disclosure of all financial relationships by all authors; however, since announcing the new policy in...

issues in oncology

Cancer Research Funding Still Tight—and Getting Tighter

Margaret Foti, PhD, MD (hc), CEO of the American Association for Cancer Research (AACR), welcomed about 150 congressional staffers to a March briefing in Washington, DC, with a plea for increased federal funding. “Extraordinary progress is being made in cancer research today, as evidenced by the...

pain management

Individualized Care Key to Cancer Pain Management at Sidney Kimmel Comprehensive Cancer Center

Learning about the particulars of each cancer patient’s pain and treating each case uniquely is the key to keeping pain manageable. That is the goal of the Duffey Pain and Palliative Care Program at The Sidney Kimmel Comprehensive Cancer Center in Baltimore. The team consists of physicians, nurse...

thyroid cancer

Thyroid Cancer On the Rise: Is It Clinically Meaningful?

According to data from the Surveillance, Epidemiology, and End Results (SEER) program, rates for new cases of thyroid cancer in the United States have been rising on average 6.4% each year over the past 10 years, and death rates have been rising on average 0.9% each year over the same period. The...

palliative care

Overcoming Physician Bias in Recommending Palliative Care

In 2010, Jennifer S. Temel, MD, published her landmark study in The New England Journal of Medicine showing that the introduction of palliative care early after a diagnosis of metastatic non–small cell lung cancer, along with cancer therapy, not only provided patients with a better quality of life...

breast cancer

Targeting Cancer Stem Cells in Breast Cancer: A Potential Clinical Strategy

Preclinical models have suggested that cancer stem cells play a role in tumor recurrence and metastasis following adjuvant therapy, and Max S. Wicha, MD, and his research team are deciphering the mechanisms by which this might happen. A true understanding of cancer stem cells will have important...

survivorship

Detecting Accelerated Aging in Adult Survivors of Childhood Cancer

Last fall, Kirsten K. Ness, PhD, published her study1 on the prevalence of frailty as a sign of accelerated aging in adult survivors of childhood cancer, and the results are startling. Among the 1,922 participants in the study, the prevalence of prefrailty was 31.5% among women and 12.9% among men; ...

prostate cancer

Long-Term Complications of Prostate Cancer Treatment May Have Been Underappreciated

The recent study by Nam et al in The Lancet Oncology—reviewed in this issue of The ASCO Post—provides a fresh perspective on complications other than incontinence or erectile dysfunction that commonly arise after primary treatment of localized prostate cancer.1 The authors conducted a...

prostate cancer

Prostatectomy vs Radiotherapy: A Study for Cautious Interpretation

Men with newly diagnosed localized prostate cancer face a decision between prostatectomy and radiotherapy, treatments deemed similarly effective but with well-established trade-offs in terms of treatment-related morbidity. Numerous clinical trials and other prospective studies, from both academic...

breast cancer

Overdiagnosis of Breast Cancer: New Research Directions

Currently, one of the most challenging problems in oncology is to accurately predict whether neoplastic lesions detected by screening tests will progress. The focus on developing ever-more sensitive cancer screening tests has produced the clinical dilemma of overdiagnosis. Overdiagnosis occurs when ...

breast cancer

The Canadian National Breast Screening Trial Had So Many Flaws That Its Results Should Not Be Used to Guide Screening Recommendations

If a randomized, controlled trial of therapy for breast cancer was submitted for publication in which 1. The drug being tested was old and ineffective, and 2. prior to randomization, the women underwent a clinical breast examination and the study coordinators knew who had the largest cancers, and...

lymphoma

‘Double-Hit’ Lymphomas a Challenge for the Oncologist

"Double-hit” lymphomas remain challenging tumors, and the best means of treatment remains somewhat elusive, according to studies presented at the 2013 American Society of Hematology (ASH) Annual Meeting in New Orleans, and experts who commented on these findings. “We still don’t have a standard of...

lymphoma

Better Options Emerging for Salvage Therapy in Hodgkin Lymphoma

Emerging effective treatment options for salvage therapy in Hodgkin lymphoma were described by Anas Younes, MD, Chief of the Lymphoma Service at Memorial Sloan Kettering Cancer Center, New York, at the 2014 Highlights of ASH in North America meeting in Miami. “This is an exciting time in Hodgkin...

prostate cancer

Georgetown Researchers Study Nonsurgical, Minimally Invasive Approach to Benign Prostatic Hyperplasia

Physicians at MedStar Georgetown University Hospital and Georgetown University Medical Center, Washington, DC, are studying the safety and effectiveness of prostate artery embolization in men with enlarged prostate glands and urinary obstruction. According to the National Institutes of Health,...

bladder cancer

Bladder Cancer Patient With Rare Genetic Mutations Shows Exceptional Response to Everolimus/Pazopanib Combination

A patient with advanced bladder cancer experienced a complete response for 14 months to the drug combination everolimus (Afinitor) and pazopanib (Votrient) in a phase I trial, and genomic profiling of his tumor revealed two alterations that may have caused this exceptional response, according to a...

kidney cancer

A Conversation With Arie Belldegrun, MD, FACS, and Allan Pantuck, MD, MS, FACS

Cancer Immunotherapy What is the role of immunotherapy in the treatment of metastatic renal cell carcinoma? The harnessing of the immune system as an effective treatment for cancer was recently selected by the journal Science as the top scientific Breakthrough of the Year for 2013.1 With this...

kidney cancer

A Conversation With David I. Quinn, MBBS, PhD, FRACP

First-Line Therapy Please describe current medical oncology approaches to first-line therapy for metastatic renal cell carcinoma. The current first-line therapy for most patients with good- to intermediate-risk metastatic renal cell carcinoma is a vascular endothelial growth factor (VEGF) receptor...

health-care policy

ASCO Releases Its First-Ever Report on the State of Cancer Care in America

On March 11, ASCO released its first-ever comprehensive assessment of the daunting challenges facing America’s ability to continue to deliver high-quality care to all patients with cancer. ASCO President Clifford A. Hudis, MD, FACP, introduced the assessment at a Congressional news briefing in...

health-care policy

The Outlook on Cancer Research in This Era of Leaner Federal Funding

In the March 1, 2014, issue of The ASCO Post we talked with Francis S. Collins, MD, PhD, Director of the National Institutes of Health (NIH), about the future of biomedical research at the NIH during this time of constrained federal funding. We continue that conversation here with our interview of...

breast cancer

SSO-ASTRO Margin Guideline: Why Now and What Does It Mean?

Although breast-conserving therapy has been a standard practice for more than 20 years, controversy still exists over what constitutes the appropriate margin of normal breast tissue around a tumor that minimizes local recurrence while maintaining a good cosmetic outcome. Surveys of surgeons1 and...

breast cancer

SSO-ASTRO Consensus Guideline on Margins for Breast-Conserving Surgery in Stage I/II Invasive Breast Cancer

The Society of Surgical Oncology (SSO) and American Society for Radiation Oncology (ASTRO) formed a multidisciplinary expert panel in 2013 to examine the relationship between surgical margin width and ipsilateral breast tumor recurrence and develop guidelines on margins for breast-conserving...

gynecologic cancers

Desensitization Protocols May Allow Reintroduction of Chemotherapeutic Agents After Hypersensitivity Reactions

Hypersensitivity reactions to chemotherapeutic agents used to treat ovarian cancer are “increasingly common and can greatly limit their use,” according to an article published in the Journal of the National Comprehensive Cancer Network. “Drug desensitization has emerged as a safe and effective way...

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