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Showing 1251 - 1300Dartmouth Study Finds Lung Cancer Screening With Low-Dose CT Could Be Cost-Effective
Dartmouth researchers say lung cancer computed tomographic (CT) screening in the National Lung Screening Trial (NLST) meets a commonly accepted standard for cost-effectiveness as reported recently in The New England Journal of Medicine.1 The screening test uses annual low-dose CT scans to spot lung ...
Dying in America: Ensuring High-Quality Care at the End of Life
In September, the Institute of Medicine (IOM) released its report Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life. The report argues that the U.S. health-care system subjects patients to too many—and often futile—interventions near the end of life, often ...
Key Solutions to Sexual Concerns in Cancer Survivor
Evaluating a Patient’s Sexual Health—The National Cancer Institute suggests designating and training a member of the oncology team, such as an oncology nurse or social worker, as the expert on sexual health issues. When assessing general quality-of-life concerns, relationship and sexuality should...
Expert Point of View: Andrés Cervantes, MD, PhD
During a special session at the European Society for Medical Oncology (ESMO) 2014 Congress, additional analyses from the FIRE-3 and Cancer and Leukemia Group B (CALGB)/SWOG 80405 trial were presented, and an expert panel was charged with putting the findings into context. Role of Subsequent...
Young Adults With Cancer: Unique Issues Highlight Importance of Patient-Centered Care
Suleika Jaouad, a journalist, was 22 and had just gotten her first chance to cover a major news story—the revolution underway in Tunisia—when she was diagnosed with myelodysplastic syndrome that had evolved into acute myeloid leukemia (AML). Months into her treatment, she began to write again, but...
For Selected Patients With Metastatic Colorectal Cancer, Taking a Break From Combination Chemotherapy Might Be Appropriate and Appreciated
Two phase III studies presented at the Best of ASCO meeting in Chicago shed more light on the role of maintenance therapy in patients with metastatic colorectal cancer undergoing first-line treatment with oxaliplatin-based chemotherapy. The two studies compared maintenance therapy with bevacizumab...
Choosing Wildly: A Patient’s Perspective on Overtreatment and Quality Care
Over the past decade, there has been growing concern in the oncology community about overdiagnosis and overtreatment of cancers that prove to be indolent and nonlethal, resulting in unnecessary and sometimes harmful procedures. At this year’s ASCO Quality Care Symposium in Boston, this important...
Why I Think Dr. Ezekiel Emanuel Is Wrong About Aging
The image of aging that Ezekiel Emanuel, MD, PhD, expresses in his essay, “Why I Hope to Die at 75,” in the October issue of The Atlantic,1 is bleak indeed and one that has contributed mightily to the negative views of aging imbedded in our society. But I refute his description of growing older as...
Striving for Quality, Not Quantity, of Life
Advances in science and medicine have led to humans living longer than at any other time in history. According to a new report1 on mortality from the Centers for Disease Control and Prevention’s National Center for Health Statistics, life expectancy in the United States is at an all-time high of...
South Korean Study Sparks Warnings About the Hazards of Overscreening
An “epidemic of diagnosis” of thyroid cancer is occurring in South Korea and “absolutely could happen here,” according to H. Gilbert Welch, MD, MPH, Professor of Medicine at the Dartmouth Institute for Health Policy and Clinical Practice, Hanover, New Hampshire. Dr. Welch is coauthor of an article...
Discussing Cessation of Medications Near the End of Life
Discussions with patients and families about stopping non–cancer-related medications near the end of life are thorny but necessary, according to Arif H. Kamal, MD, of Duke Cancer Institute, at the Best of ASCO meeting in Seattle. “What’s happening now is that a lot of hospices are having a...
How the Earlier Introduction of Palliative Care Improves Quality of Life for Patients With Advanced Cancer
A 4-year study1 involving 461 patients with advanced stages of lung, gastrointestinal, genitourinary, breast, and gynecologic cancers has found that providing early outpatient palliative care vs standard oncology care alone improved quality of life and patient satisfaction. The study participants...
Checklists: Simple Tools That Enhance Quality
Evidence indicates that the use of surgical safety checklists results in marked improvements in patient outcomes. Unfortunately, their adoption in the field of medicine has largely been limited to equipment operations or parts of specific treatment algorithms. Yet they have tremendous potential to...
Top 10 Articles From The ASCO Post in 2014
The following list presents those articles published in 2014 that were observed most often by visitors to ASCOPost.com, as measured by the number of views.a To view the full version of the articles listed below, visit ASCOPost.com and enter the URL provided below each entry. 1. Continuous...
Debate Over Legalizing Physician-Assisted Death for the Terminally Ill
On November 1, 2014, 29-year-old Brittany Maynard ended her life through physician-assisted death, reigniting the controversy surrounding Death With Dignity laws, which allow physicians to prescribe life-ending drugs to terminally ill patients. Diagnosed with glioblastoma multiforme in January, Ms. ...
ASCO Expert Statement on Cancer Survivorship Care Planning: Timing Is Everything
As the saying goes, “Timing is everything.” And so it is with the recently released ASCO Clinical Expert Statement on survivorship care planning.1 Although there has been extensive discussion and debate about the use of survivorship care plans since the publication of the 2005 Institute of Medicine ...
Revisiting Successes in Advanced NSCLC to Test Value in Earlier-Stage Disease
Some pretty good evidence suggests that chemotherapy that works in advanced disease probably works even better in early-stage disease,” said Fadlo R. Khuri, MD, Chair, Department of Hematology and Medical Oncology at Winship Cancer Institute in Atlanta, in summarizing results from trials of...
Transplants for AML in First Remission: A Great Leap Forward, Sideways, or Backward?
“All great truths begin as blasphemies.” —George Bernard Shaw (Annajanksa, 1918) Until about 15 years ago, persons with acute myelogenous leukemia (AML) were considered candidates to receive a blood cell or bone marrow allotransplant in first remission only if they had had an HLA-identical...
Citing Guidelines May Reassure Patients
Whether deviations from treatment guidelines are warranted to provide optimal personalized care, or should be financially penalized for straying from evidence-based care, has raised questions among insurers and physicians and caused a stir in the press. In general, however, patients with cancer are ...
Life Is Like Riding a Bicycle
The following essay by Bruce D. Cheson, 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. The ride...
Incorporating Physical Medicine and Rehabilitation Into Palliative Care
Although cancer rehabilitation has been a part of oncology clinical practice for several decades, it has largely gone unrecognized as an integral part of palliative medicine and survivorship care. Now, the role of physical medicine and rehabilitation in oncology care may increase as patients with...
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 ...
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...
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...
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,...
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...
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...
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...
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...
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...
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,...
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 ...
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....
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...
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...
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...
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, ...
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...
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)...
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...
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...
