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lung cancer

Top 10 Lessons Learned So Far About Treating Lung Cancer With Immunotherapy

Immunotherapy agents “really work” in treating lung cancer, but they have unique toxicities, are challenging to combine with other therapies, and questions remain about dose and duration, Roy S. Herbst, MD, PhD, stated at the 2014 Chicago Multidisciplinary Symposium in Thoracic Oncology. “There are ...

breast cancer

Contralateral Prophylactic Mastectomy: Know the Data When Discussing the Option With Patients

Oncologists need a better understanding of why women choose contralateral prophylactic mastectomies without indication, and they need data to counter their patients’ misperceptions about this treatment choice. “Many women who choose [contralateral prophylactic mastectomy] are not at increased risk...

Expert Point of View: Mary L. Disis, MD

Study discussant Mary L. Disis, MD, Professor of Medicine and Associate Dean of Translational Science at the University of Washington, Seattle, commented that the response rate, approaching 20%, is “in the ballpark” of those observed in melanoma, lung cancer, and renal cancer. She pointed out that...

issues in oncology

What Is a Physician? Call a Spade a Spade

Anyone who has awoken from a decades-long amnestic spell can be forgiven for thinking that physicians cannot do anything right nowadays. Compared with decades ago, when physicians did mostly right, we now seem to be nowhere close to correctness. Nearly every malady that befalls the health-care...

multiple myeloma

Carfilzomib-Based Triplet Yields ‘Unprecedented’ Duration of Remission in Relapsed Myeloma

The phase III global ASPIRE trial documented an “unprecedented” duration of remission in relapsed multiple myeloma patients receiving carfilzomib (Kyprolis) plus a standard-of-care doublet, according to Keith Stewart, MB, ChB, Professor of Medicine at the Mayo Clinic in Scottsdale, Arizona, who...

Patients May Voice Concerns About Chemotherapy Effects on the Brain Even If They Have Never Heard of ‘Chemobrain’

The concept of “chemobrain” is underrecognized, noted ­Serena Wong, MD, co-investigator of a clinical trial examining the effects of chemotherapy and hormonal therapy on the brain. Dr. Wong is a medical oncologist at Rutgers Cancer Institute of New Jersey and Assistant Professor of Medicine at...

Cancer Genetics: Looking Back, Looking Ahead

At the 2014 San Antonio Breast Cancer Symposium, The ASCO Post sat down with geneticist Mary-Claire King, PhD, for some personal musings about her career and how she might guide young researchers who want to follow in her footsteps. Dr. King is known for a variety of accomplishments in genetics,...

colorectal cancer

More on Ramucirumab in Metastatic Colorectal Cancer

I am writing in regard to the report and commentary in this issue on the RAISE Trial. To begin, a discussion of this phase III clinical trial presented at the 2015 Gastrointestinal Cancers Symposium (RAISE study) may not be the most appropriate forum to air legitimate views on finances and...

Expect Questions About Atypical Hyperplasia as an Important Risk Factor for Breast Cancer

A special report in The New England Journal of Medicine concluded that atypical hyperplasia of the breast “confers an absolute risk of later breast cancer of 30% at 25 years of follow-up.1” This is higher than previously recognized, and the report’s authors urged “more intensive screening and...

breast cancer

Atypical Hyperplasia as a Predictor of Future Breast Cancer: Focus on Chemoprevention and Screening

Atypical hyperplasia of the breast has “special importance as a predictor of future breast cancer,” according to a special report in The New England Journal of Medicine.1 That special importance is based on the high incidence of atypical hyperplasia—found in around 10% of the 1 million breast...

breast cancer
colorectal cancer
hepatobiliary cancer
lung cancer

Twenty Years After a Diagnosis …  and Counting

In 1995, I was diagnosed with advanced colorectal cancer and given little chance to live. The dire diagnosis came years after being assured by several physicians that the problem I was having with rectal bleeding and anemia was nothing more than the result of an internal hemorrhoid. Busy raising...

lung cancer
issues in oncology
health-care policy

At Long Last: CMS Will Cover Lung Cancer Screening

Few issues in health-care debates are more contentious and polarizing than population screening for the early detection of cancer. After a decades-long battle, lung cancer screening advocates have just received what they have long sought: The Centers for Medicare & Medicaid Services (CMS) has...

issues in oncology

Pharmacokinetics and Exposure Response in Drug Development

INSIDE THE BLACK BOX is an occasional column offering insight into the U.S. Food and Drug Administration (FDA) and its policies and procedures. In this installment, former clinical pharmacology team leader Julie Bullock, PharmD, and current team leader Nitin Mehrotra, PhD, discuss how...

issues in oncology

How Changes to ACGME’s Accreditation Standards Are Affecting Fellowship Training

Two years ago, the Accreditation Council for Graduate Medical Education (ACGME), the nonprofit organization that evaluates and accredits more than 9,000 medical residency programs in the United States, began phasing in implementation of its Next Accreditation System for graduate medical education,...

colorectal cancer

ASCO Endorsement of ESMO Guidelines on Hereditary Colorectal Cancer Syndromes

In a recent issue of the Journal of Clinical Oncology,1 and as reviewed in this issue of The ASCO Post, an ASCO expert endorsement panel reviewed and endorsed, with minor qualifications, the European Society for Medical Oncology (ESMO) clinical practice guidelines for management of familial/genetic ...

survivorship
gynecologic cancers

Cancer Was My Wake-Up Call to a Healthier Life

I come from strong physical stock and inherited a sort of “tough it out mentality” when it comes to coping with the usual aches and pains that creep up as you age. So by the time I realized that my legs had become so swollen and my breathing so labored it was difficult for me to walk, I could...

The Journey From Book to Film

Soon after publication of The Emperor of All Maladies: A Biography of Cancer (Scribner) in 2010, the book’s author Siddhartha Mukherjee, MD, PhD, received a call from Laura Ziskin, a film producer and cofounder of Stand Up To Cancer, who was interested in obtaining the film rights to Dr....

issues in oncology

Highlights From the 2014 ASCO Quality Care Symposium

The 2014 ASCO Quality Care Symposium was held October 17 to 18 in Boston and featured research on combating disparities, improving end-of-life care, and finding opportunities for cost reduction. These highlights have been adapted from ASCO Quality Care Symposium Daily News  (quality.asco.org/dn)....

Expert Point of View: Jaffer A. Ajani, MD

Jaffer A. Ajani, MD, Professor of Gastrointestinal Medical Oncology at The University of Texas MD Anderson Cancer Center, Houston, discussed the two studies. He emphasized the impressive cytoreductive activity of AMG 337. “Granted, it was only 13 patients, but in 13 patients, 8 [responders] is a...

palliative care

Caregivers May Want to Know About a Patient’s Impending Death but May Be Afraid to Ask

The likelihood of impending death of patients with advanced cancer “is one of those questions that many people want to know about, but they are too afraid to ask,” David Hui, MD, MSc, said in an interview with The ASCO Post. Dr. Hui is lead author of a study, published in Cancer, on clinical signs...

palliative care

Recognizing Physical Signs Associated With Impending Death Can Assist Clinicians, Patients, and Caregivers With Complex Decisions

In a recently published study of patients with advanced cancer whose status was systematically documented twice a day, from the time of admission to a palliative care unit until death or discharge, investigators identified eight physical signs associated with death within 3 days. Taken together...

cns cancers

Having Cancer So Early in Life Gave Me Purpose

I had every classic brain tumor symptom in the book—severe headaches, dizziness, morning nausea—which plagued me for 16 years, starting when I was 8. In college, if I allowed myself to sleep more than 4 hours a night, the morning headaches, which were centered on the top of my head, were so severe, ...

head and neck cancer

The Center of Who We Are

The following essay by Eric M. Genden, MD, is adapted from The Big Casino: America’s Best Cancer Doctors Share Their Most Powerful Stories, which was coedited by Stan Winokur, MD, and Vincent Coppola and published in May 2014. The book is available on Amazon.com and thebigcasino.org.   There’s...

survivorship
breast cancer

Mobile Patient-Centered App Tracks Breast Cancer Survivors’ Experiences

Patricia Ganz, MD, Director of Cancer Prevention and Control Research at the Jonsson Cancer Center of UCLA, and collaborators Apple and Sage Bionetworks, recently announced the launch of “Share the Journey: Mind, Body and Wellness after Breast Cancer,” a patient-centered mobile application (app)...

issues in oncology

Avoiding Burnout and Maintaining Well-Being While Caring for Seriously Ill Patients

A variety of studies, including one published this past year in the Journal of Clinical Oncology,1 have showed that clinicians who care for seriously ill patients are at high risk for diminished personal well-being, including high rates of burnout; moral distress, defined as the inability to act in ...

Beating the Odds in The Big Casino

More than 35 ASCO members contributed personal essays to a recently published collection of stories about humanism in medicine, including ASCO Past Presidents Paul A. Bunn, Jr, MD, FASCO, and Emil J. Freireich, MD, FASCO, and current President-Elect Julie M. Vose, MD, MBA, FASCO. The Big Casino:...

Remembering Neurosurgeon and Writer Paul Kalanithi, MD

What initially drew me to read the eloquent essay by Paul Kalanithi, MD, in The New York Times—“How Long Have I Got Left?”—was its provocative title.1 What kept me there was the moving description of his quick transition from healthy physician with a brilliant career in neurosurgery to terminally...

lung cancer

I Refuse to Capitulate to Cancer

Editor’s note: We regret to announce that Paul Kalanithi, MD, passed away on March 9, 2015. Dr. Kalanithi was Chief Resident in Neurological Surgery at Stanford University when he shared his story, reprinted here, with The ASCO Post just over 1 year ago, in March 2014. We extend our deepest...

A Surgeon Cuts to the Chase

BookmarkTitle: The Cost of Cutting: A Surgeon Reveals the Truth Behind a Multibillion-Dollar IndustryAuthor: Paul A. Ruggieri, MDPublisher: Berkley BooksPublication date: September 2014Price: $16.00; paperback, 320 pages The woman seated on the exam table was lean and fit and seemed perfectly at...

issues in oncology
lung cancer

The Ongoing Struggle Against Tobacco: Past Accomplishments, Future Steps

In 1913, 10 doctors and 5 laypersons in New York founded the American Cancer Society (ACS). At that time, a cancer diagnosis was almost always fatal and was rarely discussed in public. The Society’s original charter was to raise awareness about cancer, and although that mission has remained firm,...

issues in oncology

Clinical Trial Participation: ‘Is It All Worth It?’

Clinical trials have become increasingly complex over the past several years, and unfortunately, this has resulted in the typical scenario described below. We are fortunate that there are so many promising agents available for patients, and we want to encourage their participation in clinical...

Expect Questions About Cold Caps to Spare Hair During Chemotherapy

For patients who have confronted a diagnosis of cancer, then endured weeks of chemotherapy, it would seem that losing their hair would not be a big concern. But for many patients, it can be. “You have to spend a year either putting on wigs or announcing to the world that you’ve had chemotherapy,”...

geriatric oncology

Preparing for the ‘Silver Tsunami’ and the Impact of an Aging Population on Cancer Care

“Older adults constitute the only increasing natural resource in the entire world.” —Linda Fried, PhD, Columbia School of Public Health The good and bad news about our changing demographic world is that the population of older adults is increasing in the United States and worldwide. While it is...

issues in oncology
cost of care

In Search of ‘Just’ Prices: Questioning the High Cost of New Cancer Drugs

As the oncology community begins the slow and often difficult-to-define transition from volume to value in the delivery of cancer care, the relationship between the price and value of certain high-priced cancer drugs is getting more scrutiny. We generally correlate the efficacy of a new drug and...

issues in oncology
global cancer care

Noncommunicable Diseases Are the Leading Cause of Death in Low- and Middle-Income Countries

The greatest health threat to people living in low- and middle-income countries is no longer infectious diseases like HIV/AIDS, which has seen a 33% decline in the global rate of new infections since 2001.1 It is the rise of noncommunicable diseases (including cancer, cardiovascular disease, and...

issues in oncology

Just Engaging in ‘Some’ Leisure Time Physical Activity Reduces Overall and Cancer-Specific Mortality

There’s good news for those who recognize the benefits of exercise but feel they have neither the time nor energy for frequent workouts: A recent study reported in JAMA Internal Medicine1 has found that just performing “some” leisure time physical activity, even below the recommended minimum level, ...

Remembering Multiple Myeloma Patient Advocate Michael S. Katz, MBA

I first met Michael Katz, MBA, in 2004, 3 years after my brother, Dom, was diagnosed with multiple myeloma, and we were at a crossroads in his care and needed advice. Although an experimental regimen of thalidomide (Thalomid) and dexamethasone had successfully put Dom in remission for a year (the...

Learning to Communicate Science More Effectively

Alan Alda’s passion and appreciation for science extend nearly as far back to his early life as his love of acting. The son of actor Robert Alda, Mr. Alda began his acting career at the age of 16. Although he has appeared in such widely acclaimed films as The Seduction of Joe Tynan, Crimes and...

Courage Under Fire

The following essay by Kishore K. Dass, MD, is adapted from The Big Casino: America’s Best Cancer Doctors Share Their Most Powerful Stories, which was coedited by Stan Winokur, MD, and Vincent Coppola and published in May 2014. The book is available on Amazon.com and thebigcasino.org. Born in...

issues in oncology

8 Steps to Help Children Cope With Cancer and Its Treatment

Here are several steps for helping pediatric and adolescent patients to cope with cancer and its treatment. Give young patients control whenever possible, suggests Shawna Grissom, MS, CCLS, CEIM, Director of the Child Life Program at St. Jude Children’s Research Hospital, and offer them realistic...

issues in oncology

Taking the Trauma Out of Cancer Care for Children and Adolescents

Getting a cancer diagnosis and going through treatment are difficult for patients of any age, but the experience can be especially traumatizing for the nearly 16,000 infants, children, and adolescents diagnosed each year with cancer,1 especially during the early days of treatment. Young cancer...

Taking the Next Step in a Storied Career

On March 31, 2015, Harold Varmus, MD, left his position as Director of the National Cancer Institute (NCI) to join the faculty of Weill Cornell Medical College in New York as its Lewis Thomas University Professor of Medicine. Dr. Varmus was also named Senior Associate Core Member of the New York...

Exploring the History and Psychology of Pain: Beyond the Clinical Setting

BOOKMARKTitle: The Story of Pain: From Prayer to PainkillersAuthor: Joanna BourkePublisher: Oxford University PressPublication date: 2014Price: $34.95: hardcover, 416 page   “Pain may even kill. It may overwhelm the nervous system by its mere magnitude & duration.” —Peter Mere Latham, 1871...

Expert Point of View: D. Ross Camidge, MD, PhD

PD-L1 is an imperfect biomarker, according to formal discussant of this paper, D. Ross Camidge, MD, PhD, of the University of Colorado Comprehensive Cancer Center, Denver. “The importance of a good predictive assay in this field [of immunotherapy] is so great that it is impossible to ascribe any...

lung cancer

Pembrolizumab Safe and Effective in Patients With NSCLC, Especially in Those With Tumors Showing High Levels of PD-L1 Expression

Add lung cancer to the growing list of cancers that may derive benefit from immunotherapy. The KEYNOTE-001 trial found that pembrolizumab (Keytruda) achieved durable responses in a proportion of patients with non–small cell lung cancer (NSCLC) and high levels of expression of the protein PD-L1...

issues in oncology

Illumination and Innovation: Transforming Data Into Learning

The ASCO Annual Meeting is our Society’s premier event and without a doubt one that is highly anticipated by the oncology world. The success of the meeting stems from the desire to share with each other our data and the knowledge we have gleaned from those data over the course of the past year. The ...

A Tribute to James F. Holland, MD, in Celebration of His 90th Birthday

Far and away the best prize that life has to offer is the chance to work hard at work worth doing. —Theodore Roosevelt   Longevity, in and of itself, is not an accomplishment. Luck and good genes are just human lottery tickets. Most people fortunate enough to live long lives have a productive sweet ...

lymphoma

Wyndham H. Wilson, MD, PhD: Shedding Light on the Complexity of Lymphoma Through a Lifetime of Illuminating Research

Dear Dr. Wilson: I am writing to express our family’s deepest and heartfelt appreciation for the lifesaving care you and your team provided for our son, Patrick…. I don’t know how widely it is known that you save lives at the National Cancer Institute—offering hope to people like Patrick, who have...

‘Father of Geriatric Oncology’ Lodovico Balducci, MD, Unearthed a New Understanding of Aging’s Effect on Cancer Treatment

At the 2007 ASCO Annual Meeting, Lodovico Balducci, MD, received the inaugural B.J. Kennedy Award and Lecture for Scientific Excellence in Geriatric Oncology. Called the “patriarch of geriatric oncology,” Dr. Balducci is widely known in the oncology community for his warm humor and thick Italian...

Fulfilling NCI’s Commitment to Supporting the Best Science

On April 1, 2015, Douglas R. Lowy, MD, became Acting Director of the National Cancer Institute (NCI), succeeding ­Harold Varmus, MD, who left NCI to join the faculty of Weill Cornell Medical College in New York. (See “The Next Step in a Storied Career,” in the May 25, 2015 issue of The ASCO Post.)...

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