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Showing 12601 - 12650SIDEBAR: How to Reduce Burnout
Although definitive solutions to preventing or overcoming burnout are still being researched, Michael P. Kosty, MD, a member of ASCO’s Workforce Advisory Group and Director of the Scripps Green Cancer Center, said taking regularly scheduled time off and pursuing outside interests may help. “It...
Expert Point of View: Frederick R. Appelbaum, MD
Commenting on the trial of bone marrow vs peripheral blood stem cell transplants, Frederick R. Appelbaum, MD, at the Fred Hutchinson Cancer Research Center, wrote that the results should change practice. But he added in his editorial, “it will be interesting to see whether it really does.”1...
Bone Marrow Transplants Reduce Risk of Graft-vs-Host Disease Compared to Peripheral Blood
Patients who receive bone marrow transplants are significantly less likely to develop chronic graft-vs-host disease than those who receive peripheral blood stem cell transplants, according to a new, large randomized trial, the first of its kind with unrelated donors. Published recently in The New...
Four-plus Cups of Coffee Daily Linked to Lower Risk of Death from Oral/Pharyngeal Cancer
Consuming four or more cups per day of caffeinated coffee could almost halve the risk of dying from oral/pharyngeal cancer compared to drinking no coffee or drinking it only occasionally, researchers reported in the American Journal of Epidemiology. “A dose-related decline in relative risk was...
Chlorambucil, but Not Fludarabine, Confers Significant Benefit in Older Patients with CLL
Among patients aged 70 years and older with chronic lymphocytic leukemia (CLL), “front-line therapy with fludarabine does not improve outcomes” compared to chlorambucil (Leukeran), according to an analysis of patients enrolled in successive front-line Cancer and Leukemia Group B (CALGB) studies...
Volume-doubling Time May Help Distinguish Aggressive Cancer from Slow-growing Tumors
Changes in the size of lung tumors over time, as measured by volume-doubling times on low-dose computed tomography, can be used to distinguish aggressive lung cancer from slow-growing or indolent tumors and reduce overdiagnosis that could result in overtreatment and unnecessary morbidity. Results...
Screening and Risk-reduction without Testing Positive for BRCA Mutation
Many women who do not test positive for a BRCA mutation undergo additional ovarian cancer screenings and risk-reducing procedures, despite limited data to determine the effectiveness of these interventions among an average-risk population. Results of an analysis of data from 1,077 women who were...
SIDEBAR: Expect Questions from Patients
A study finding that a diet high in total carbohydrates can increase the risk of cancer recurrence and mortality doesn’t mean that patients need to totally avoid carbohydrates, any more than previous findings about increased risk from a Western pattern diet means patients can’t eat any red meat....
Patients Treated for Colon Cancer Can Reduce Risk of Recurrence with Balanced Diet and Lower Carbohydrate Intake
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. Patients who have received standard...
Green Tea
The use of dietary supplements by cancer patients has risen significantly over the past 2 decades despite insufficient evidence of safety and effectiveness. Finding reliable sources of information about dietary supplements can be daunting. Patients typically rely on family, friends, and the...
Oncology Meetings
January 2013 Breast-Gynecological International Cancer CongressJanuary 17-18 • Cairo, EgyptFor more information: www.bgicc.eg.net/ Highlights of ASH® San Diego, CA and Toronto, CanadaJanuary 18-19 • San Diego, CA and Toronto, Ontario, CanadaFor more information: www.hematology.org/meetings...
Physician-Scientist Judah Folkman, MD, Faced Years of Skepticism Before His Theory of Angiogenesis Was Proven
That Moses Judah Folkman would buck tradition, breaking his family’s long line of rabbinical succession and pursuing a career in science and medicine instead, was evident from the time he was a young child. Born in Cleveland on February 24, 1933, the first child of Rabbi Jerome and Bessie Folkman,...
Teens and Young Adults with Cancer Want a Voice in End-of-life Care
A top the list of concerns of adolescents and young adults with a life-threatening cancer are these two considerations: being able to choose the kind of medical treatment they want (or do not want) and expressing their wishes to family and friends about how they want to be remembered, according to...
French Investigators Prospectively Test Genomically Driven Treatment in Metastatic Breast Cancer
Whole-genome DNA analysis prospectively identified alterations in metastatic tumors that could be individually targeted with molecular agents, in a study presented at the 2012 European Society for Medical Oncology (ESMO) Congress by Fabrice André, MD, of Institut Gustave-Roussy, Villejuif, France....
Expert Point of View: Ian Smith, MD
Invited discussant Ian Smith, MD, of The Royal Marsden Hospital and Institute of Cancer Research in London, commented at the ESMO meeting that while all three arms of NeoALLTO, especially the arm with dual HER2 blockade, achieved good pathologic complete response rates, “the breast-conserving...
Lumpectomy Rates Inconsistent with Response Rates in Early Breast Cancer
Achieving a pathologic complete response to neoadjuvant chemotherapy does not always reduce the aggressiveness of breast cancer surgery, according to an analysis of the NeoALLTO trial presented at the 2012 European Society for Medical Oncology (ESMO) Congress in Vienna.1 Carmen Criscitiello, MD, of ...
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 ...
Call for Abstracts: 2013 ASCO Annual Meeting
Groundbreaking research in cancer care is the cornerstone of ASCO’s Annual Meeting, and the deadline for submitting abstracts to be considered for presentation or publication at this year’s Meeting is fast approaching. The submission deadline is February 5 at 11:59 PM (EST). Late-Breaking Abstracts ...
Gene Profiling Directs Site-specific Therapy for Carcinoma of Unknown Primary Site
Patients with carcinoma of unknown primary site usually receive empiric therapy (eg, with taxane/platinum or gemcitabine/platinum regimens), resulting in a median overall survival of approximately 9 months. As reported recently in Journal of Clinical Oncology, Hainsworth and colleagues have shown...
Accountable Care Organizations: The New Normal?
The accountable care organization was introduced into our lexicon during a public meeting of the Medicare Payment Advisory Commission in 2006, and the term became ubiquitous when it was specified in the Patient Protection and Affordable Care Act of 2010. After the November 6 election, accountable...
Management of Brain Metastases
Pearls in Neuro-oncology is guest edited by Tracy Batchelor, MD, Director, Division of Neuro-Oncology, Massachusetts General Hospital Cancer Center, and Professor of Neurology, Harvard Medical School, Boston. The series is intended to provide the practicing oncologist with guidance in managing...
Omacetaxine for Chronic or Accelerated Phase CML Patients with Resistance/Intolerance to Tyrosine Kinase Inhibitors
In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. Indication On October 26, 2012, the FDA granted accelerated...
Fixed-dose Apixaban Reduces Risk of Recurrent Venous Thromboembolism
Venous thromboembolism is a frequent problem in cancer patients, and approximately 20% of all patients who develop the disease have a recurrence. Extending treatment with two fixed doses of the investigational agent apixaban, a factor Xa inhibitor without laboratory monitoring, may provide a...
Tumor Grade Is Associated with Risk for Venous Thromboembolism
Recent data suggest that risk for venous thromboembolism is associated with biologic aggressiveness of cancer. Findings in the Vienna Cancer and Thrombosis Study, recently reported by Ahlbrecht and colleagues in Journal of Clinical Oncology, indicate that patients with higher-grade tumors are at...
Developing Cancer Care Pathways for the New Environment
As community practices and the insurance industry seek cost-effective ways to adapt to the Patient Protection and Affordable Care Act, the evolving concept of cancer care pathways is emerging as a strategy that may help control oncology costs and add value to care. At ASCO’s recent Quality Care...
Measuring and Improving Quality in Oncology Practices
The seed for ASCO’s Quality Oncology Practice Initiative (QOPI®) was planted a decade ago by Joseph Simone, MD, when he contemplated the feasibility of studying a volunteer group of oncologists to measure the quality of care they provide and share those results with their colleagues. Dr. Simone’s...
Expert Point of View: Claire Dearden, MD
Patients are very excited about this new, well tolerated drug for chronic lymphocytic leukemia (CLL). Ibrutinib is available orally and is not chemotherapy. It produces excellent responses. This is particularly important for elderly [ie, age 65 and older] patients who are not always fit enough to...
Umbilical Cord Blood Transplant: Two Units are No Better Than One in Children with Hematologic Malignancies
Use of two partially HLA-matched units of umbilical cord blood were not superior to a single unit if it contained an adequate number of hematopoietic stem cells, according to a randomized study by the Blood and Marrow Clinical Trials Network. Results were reported at the 54th Annual Meeting of the...
Oral Proteasome Inhibitor May Be a Game-changer in Myeloma
An investigational oral proteasome inhibitor currently known as MLN9708 could make the treatment of multiple myeloma much more convenient and possibly less neurotoxic, according to the results of a phase I/II study of treatment-naive multiple myeloma patients presented at the 54th Annual Meeting of ...
Overall Survival Benefit Achieved with Pomalidomide in Advanced Myeloma
Support for the oral immunomodulatory agent pomalidomide for multiple myeloma took a step forward when the phase III MM-003 trial showed a survival advantage in patients with advanced disease, in addition to a doubling in progression-free survival, when pomalidomide was given with low-dose...
Are We Winning the War on Cancer?
On December 23, 1971, President Richard Nixon signed the U.S. National Cancer Act. This date is widely considered to mark the beginning of the so-called “War on Cancer,” although that phrase was introduced only later on. Over recent decades, journalists have from time to time questioned whether we...
Expert Point of View: Peter Ravdin, MD and Sandra M. Swain, MD, FACP
Putting these results in perspective, Peter Ravdin, MD, moderator of a San Antonio Breast Cancer Symposium press conference where ATLAS findings were discussed, said that in the United States, there is currently a different strategy for pre- and postmenopausal women. Tamoxifen is used as primary...
More Thoughts on Rationing Cancer Care
I read the article about “The Ethics of Rationing Cancer Care” with interest (The ASCO Post, Dec 15, 2012). The issue of rationing (or rational) care has likely been debated since Hippocrates. Yet the topic has become a focus of acute interest with the current fiscal crises facing countries around...
E-mail Reminders to Providers May Improve Documentation of Code Status in Patients with Advanced Disease
E-mail reminders to providers at the start of each new chemotherapy regimen may improve the rate and timing of code status documentation for patients with advanced lung cancer, according to a study in the Journal of Clinical Oncology. Jennifer S. Temel, MD, and colleagues from Massachusetts General ...
No Difference in Toxicity with Proton Radiotherapy vs Less Costly Intensity-modulated Radiotherapy
A national sample of Medicare beneficiaries treated for prostate cancer with intensity-modulated radiation therapy or proton radiotherapy found that proton radiotherapy “was rare and expensive and associated with only a modest and transient reduction in genitourinary toxicity,” reported James B....
Adding Temsirolimus to Letrozole Did Not Improve Survival but Might Benefit Patients under 65
Adding temsirolimus (Torisel) to letrozole did not improve progression-free survival in patients with aromatase inhibitor–naive, estrogen receptor (ER)-positive advanced breast cancer, but exploratory analysis indicated the combination could benefit postmenopausal patients ≤ 65. In their Journal of ...
'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....
Oncology Meetings
February Highlights of ASH® Miami, FL and San Francisco, CAFebruary 1-2 • Miami, Florida, and San Francisco, CaliforniaFor more information: www.hematology.org/meetings Optimizing Outcomes in Colorectal CancerFebruary 7 • Boston, MassachusettsFor more information: www.omedlive.com Interventional...
Helping Patients Prepare for Cancer Treatment Decisions
Under the stress of a cancer diagnosis and overwhelmed with the influx of information, patients often report that they feel unprepared to engage fully in the discussion with their health-care provider around a critical treatment decision. Consequently, the Cancer Support Community—an international...
Expert Point of View: Eduardo Bruera, MD, FAAHPM
The study by Weeks and colleagues is an important one that shows quite unexpected results. There are three main possible reasons for the very low rate of accurate reporting by the patients: (1) Physicians are not communicating prognosis adequately. (2) Patients are unable to understand the...
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...
Patients Receiving Higher-intensity Chemotherapy for ALL Are at Greater Risk for Cognitive Deficits, Researchers Report
Omitting cranial irradiation from the treatment regimen for acute lymphoblastic leukemia (ALL) may help preserve global cognitive abilities. “Treatment with chemotherapy alone is not without risks,” however, noted researchers from St. Jude Children’s Research Hospital in Memphis. “The St. Jude...
Health Insurance Issues for Young Cancer Survivors
The latest addition to Cancer.Net’s video series for young adults, Moving Forward: Perspectives from Survivors and Doctors, deals with the health insurance issues young adult cancer survivors may face. This video series is a collaboration between Cancer.Net and LIVESTRONG. Each set of videos in the ...
ASCO Decision Aids Intersect Evidence-based Guidelines, Productive Patient Communication
Imagine this common clinical scenario: A 64-year-old woman presents with a new abnormality on a mammogram. A core needle biopsy and subsequent partial mastectomy reveal a 1.8-cm invasive ductal carcinoma. Sentinel lymph nodes are negative for cancer. The tumor is moderately differentiated and is...
New England Journal of Medicine Article Reports Inferior Outcome in Using Alternative Treatments to Counter Mechlorethamine Shortage
ASCO Immediate Past President Michael P. Link, MD, recently coauthored a perspectives piece in The New England Journal of Medicine on the impact of drug shortages on children with cancer. The paper, “The Impact of Drug Shortages on Children with Cancer — The Example of Mechlorethamine,” describes...
Dune Medical Devices Receives FDA Approval for the MarginProbe System
Dune Medical Devices, Inc, announced that the FDA has granted Premarket Approval to the MarginProbe System, the company’s breakthrough intraoperative tissue assessment tool for early-stage breast cancer surgery. The technology significantly improves surgeons’ ability to intraoperatively identify...
Primary Endpoint Not Met for Eribulin vs Capecitabine in Breast Cancer
While a global phase III trial failed to meet its primary endpoint in showing an overall or progression-free survival benefit for eribulin (Halavan) in metastatic breast cancer, a trend toward greater efficacy than capecitabine (Xeloda) was observed, researchers reported at the 2012 San Antonio...
Somatic HER2 Mutations That Drive Cancer Found in HER2-negative Breast Cancer
A proportion of patients with breast cancer whose tumors test HER2-negative for gene amplification on fluorescence in situ hybridization or immunohistochemistry harbor HER2 mutations that are amenable to treatment with anti-HER2–targeted therapy, according to a gene-sequencing study presented at...
Key Pathways Identified in Triple-negative Breast Cancer
Five key biologic pathways have become evident in triple-negative breast cancer tumors, and these pathways may be targetable with agents that are currently available or in development, results from an international genetic analysis revealed at the 2012 San Antonio Breast Cancer Symposium. Justin M. ...
Cost of Cancer Drugs: What Price for What Benefit?
In 2011, national health-care spending in the United States was about $2.7 trillion, larger than the entire French national budget.1 U.S. national health-care spending is about 17% of the national gross domestic product. Total Medicare expenditures in 2011 were $549 million.2 In the debate about...
