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colorectal cancer

FDA Approves Colon-cleansing Drug for Prep Prior to Colonoscopy

The FDA has approved sodium picosulfate, magnesium oxide, and citric acid (Prepopik) to help cleanse the colon in adults preparing for colonoscopy, Ferring Pharmaceuticals announced. The new solution is a low-volume, dual-acting stimulant and osmotic laxative. The FDA approval is based on data from ...

health-care policy

Maintenance of Certification: One Size Should Not Fit All

After a conference call and having returned several phone calls, I again opened my ASCO Medical Oncology Self Evaluation Program (SEP) book hoping to steal an hour to reread the chapter on multiple myeloma, and begin digging deeper into head and neck cancer. It was March 2011, and my Maintenance of ...

prostate cancer
issues in oncology

Rethinking the Role of PSA Screening in Public Health

Population screening to identify preclinical disease is considered a central factor in the decades-long decrease in mortality seen in certain cancers. However, hope in the face of deadly disease can sometimes blind us to the scientific evidence. According to the recent U.S. Preventive Services Task ...

Expert Point of View: James O. Armitage, MD

In an accompanying editorial entitled “Who Benefits From Surveillance Imaging?” James O. Armitage, MD, University of Nebraska Medical Center, Omaha, noted that data on surveillance imaging (CT or PET/CT) indicate a general absence of survival benefit in adults with lymphomas, while pointing out...

lymphoma

Study Shows Routine CT Surveillance Overused in Pediatric Hodgkin Lymphoma

The value of routine CT surveillance monitoring of pediatric patients for recurrence of Hodgkin lymphoma has been unclear. A study of CT surveillance recently reported by Stephan D. Voss, MD, PhD, and colleagues from the Children’s Oncology Group (COG) in the Journal of Clinical Oncology showed...

SIDEBAR: Dating among Adolescents and Young Adults with Cancer

How do you tell somebody you are dating that you have cancer or that you may not be able to have children? These are among the issues explored in “Dating and Disclosure for the Cancer Patient,” part of a new book, Sexuality and Cancer, scheduled for release in the fall by Springer, New York. “The...

SIDEBAR: Don’t Expect Questions: Be Proactive with Younger Patients

It is unrealistic to expect adolescents and young adults with cancer to initiate questions about disease-related or or treatment-related issues that are troubling them, according to Bradley Zebrack, PhD, MSW, MPH, Associate Professor of Social Work at the University of Michigan, Ann Arbor....

supportive care

Adolescent and Young Adult Patients Report Unmet Needs for Cancer Information and Psychosocial Support Services

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. Psychosocial care needs are not...

Kidney Transplant Recipients Switching to Sirolimus Had Lower Risk of Secondary Squamous Cell Carcinomas

Kidney transplant recipients with at least one previous cutaneous squamous cell carcinoma decreased their risk of developing new cutaneous squamous cell carcinomas by switching from calcineurin inhibitors (cyclosporine or tacrolimus) to sirolimus (Rapamune) in a multicenter phase III study. New...

ASCO Expert Panel Concludes Evidence Supports Physician Discussion of PSA Testing for Men with Longer Life Expectancies

ASCO has issued a new evidence-based provisional clinical opinion (PCO) on the use of prostate-specific antigen (PSA) testing for prostate cancer screening. To facilitate informed decisions, ASCO also released a new, detailed decision aid to help men and their physicians understand the risks and...

The Problem of Monitoring Remission

How wonderful it is that we now have to concern ourselves with survivorship issues! The ever-increasing success of cancer therapy means that more and more patients can look to a life beyond cancer diagnosis and treatment. But living with cancer creates its own problems. While treatment often may be ...

The Science of Resilience: Exploring the Process of Grieving from a New Perspective

How human beings cope with bereavement, loss, extreme adversity, and life-threatening illness has dominated the research interests of George A. Bonanno, PhD, Professor of Clinical Psychology, Teachers College at Columbia University, New York, for more than 20 years. In his book, The Other Side of...

prostate cancer

Letter to the Editor: More Thoughts on PSA

An article that appeared in the August 15 issue of The ASCO Post (“Rethinking the Role of PSA Screening in Public Health”) contains false statements about the discovery of prostate-specific antigen (PSA) and its effectiveness as a test for early detection of prostate cancer. Contrary to what’s...

colorectal cancer

Patients with Unresectable Metastases Can Be Spared Noncurative Resection of Intact Primary Tumor

Patients with surgically unresectable metastatic colon cancer and an asymptomatic intact primary tumor can be spared initial noncurative resection of their intact primary tumor, National Surgical Adjuvant Breast and Bowel Project (NSABP) C-10 trial investigators reported in the Journal of Clinical...

colorectal cancer

Cetuximab Dose Escalation May Increase Responses among Patients with Mild or No Initial Skin Reactions

Escalating the dose of cetuximab (Erbitux) among patients with metastatic colorectal cancer who developed no or mild skin reactions on standard-dose cetuximab plus irinotecan “seemed to lead to an increase in response rate” as well as in the disease-control rate, according to a phase I/II study...

prostate cancer

Enzalutamide Significantly Prolonged Survival in Men with Castrate-resistant Metastatic Prostate Cancer

“Enzalutamide significantly prolonged the survival of men with metastatic castration-resistant prostate cancer after chemotherapy” in an international phase III, double-blind, placebo-controlled trial, investigators reported in The New England Journal of Medicine. Median overall survival, the...

SIDEBAR: Unique Considerations for Radiation Exposure in Children

There are three “unique considerations” for radiation exposure in children, according to Radiation Risks and Pediatric Computed Tomography (CT): A Guide for Health Care Providers, an educational leaflet for health-care providers that was developed by the NCI: Children are considerably more...

SIDEBAR: Expect Questions from Parents

Results of a study finding that exposure to radiation from multiple CT scans in childhood can triple the risk of leukemia and brain tumors may cause some parents to question the overall benefit of CT scans and to directly question physicians. “The three key questions that parents can ask are: (1)...

leukemia

CT Scans in Childhood Can Triple Risk of Leukemia and Brain Cancer Later in Life, Study Finds

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. Computed tomography scans with...

Researchers Awarded NCI Grants to Address ‘Provocative Questions’

Two scientists are among the first recipients of grants geared to answer “Provocative Questions” in cancer research, a new project funded by the National Cancer Institute (NCI), part of the National Institutes of Health (NIH).  Cynthia Sears, MD, and Peter Searson, PhD, both of Johns Hopkins, will...

prostate cancer

FDA Grants Priority Review to Supplemental New Drug Application for Abiraterone Acetate in Metastatic Castration-resistant Prostate Cancer

Janssen Research & Development, LLC, announced that the FDA has granted Priority Review to the supplemental New Drug Application (sNDA) for abiraterone acetate (Zytiga) administered in combination with prednisone for the treatment of patients with metastatic castration-resistant prostate cancer ...

Inaugural Quality Care Symposium Will Detail How to Pioneer Successful Quality Initiatives in Your Practice

Over the past 10 years, Wilshire Oncology Medical Group of La Verne, California, has reengineered itself so that all processes—from front-desk operations at all eight locations to the 10 oncologists’ interactions with patients and payers—capture quality data that can be used for robust benchmarking ...

Evolutionary Pathways in BRCA1-associated Breast Tumors

BRCA1 germline mutations are associated with elevated risk of breast and ovarian cancers, and somatic loss of the wild-type BRCA1 allele has been thought to be a rate-limiting initiating step in tumor development. BRCA1-associated breast tumors acquire additional somatic alterations during...

breast cancer

Lack of Sleep Found to Be Risk Factor for Aggressive Breast Cancers

Lack of sleep is linked to more aggressive breast cancers, according to new findings published in the August issue of Breast Cancer Research and Treatment by physician-scientists from University Hospitals Case Medical Center’s Seidman Cancer Center and Case Comprehensive Cancer Center at Case...

supportive care
palliative care

Dying Patients with Cancer Who Avoid Aggressive Care but Stay Connected with an Oncologist Have Better Quality of Life

Dying patients with cancer who avoided hospitalizations and life-prolonging measures, who worried less, prayed or meditated, were visited by a pastor, and maintained a therapeutic alliance with their oncologist had the highest quality of life at the end of life, according to a study recently...

breast cancer

Physical Activity Benefits Breast Cancer Survivors, but Role in Reducing Breast Cancer Risk Is Less Clear

Breast cancer survivors who engage in moderate to high levels of physical activity have reduced mortality and improved quality of life, according to recent studies. In addition, exercise may play a role in lowering the risk of breast cancer. “Physical activity can hasten recovery from the immediate ...

Expert Point of View: Michael Krychman, MD

Like female cancer survivors, men experience high rates of sexual dysfunction following a cancer diagnosis and treatment, especially for prostate cancer, with as many as 90% of men reporting erectile dysfunction after radical prostatectomy and nearly as many suffering with the problem following...

breast cancer
supportive care

Sexual Dysfunction in Female Cancer Survivors Is Prevalent

Although medical experts put the proportion of female survivors facing some form of sexual dysfunction following a cancer diagnosis and treatment at nearly 100%, very few women raise sexual health concerns with their oncologist. In a study of 261 patients with gynecologic or breast cancer published ...

Anticancer Effect of Diabetes Drug Metformin

Retrospective analyses have indicated that the antidiabetic agent metformin may be associated with a quite substantial reduction in risk of cancers. There is evidence that the anticancer effects of metformin are related to inhibition of the growth of certain cancers via activation of AMP kinase...

issues in oncology

FDA Issues New Safety Alert on Reumofan Plus and Reumofan Plus Premium

In August 21, the FDA issued a new warning to consumers about the potential health risks of two products marketed as natural dietary supplements for treating arthritis, muscle pain, osteoporosis, bone cancer, and other conditions. The products, Reumofan Plus and Reumofan Plus Premium, contain...

Expert Point of View: Timothy Wilt, MD, MPH

PIVOT is the largest and longest randomized trial conducted in men with early-stage prostate cancer detected during the era of widespread PSA testing. The trial enrolled 731 men and followed them for up to 15 years after randomization. PIVOT results demonstrate that compared to observation, radical ...

prostate cancer
issues in oncology

No Survival Benefit of Radical Prostatectomy vs Observation for Localized Prostate Cancer Detected by PSA Testing

The relative benefits of surgery or observation in men with prostate cancer detected by prostate-specific antigen (PSA) testing have not been defined. Randomized trials comparing radical prostatectomy with observation were conducted before widespread use of PSA testing and an observational study...

Predictors and Treatment for Transformed Lymphoma: Current Paradigms

At the recent Pan Pacific Lymphoma Conference, held in Maui, Hawaii, Richard I. Fisher, MD, Chairman of the SWOG Lymphoma Committee and Vice-President for Strategic and Program Development at the University of Rochester Medical Center in New York, gave a presentation on the characteristics and...

skin cancer

Importance of Dermatologic Care for Patients with Cancer

I first became interested in treating skin issues associated with cancer about 10 years ago, during my dermatology residency training at the University of Chicago. Many of the agents under clinical development at the time, such as cetuximab (Erbitux) or sorafenib (Nexavar), were causing...

Expert Point of View: Dan L. Longo, MD

The term “abscopal” is from Greek roots that mean “away from the target.” Coined by R.H. Mole in 1953, it was used to label observed effects of radiation at a distance from the volume irradiated. Mounting evidence suggests an immunologic basis for the effect, but it should also be remembered that...

Contagious Cancer and an Unexplained Phenomenon Might Inspire Future Therapies

A deadly contagious cancer known as devil facial tumor disease is pushing the world’s largest carnivorous marsupial, the Tasmanian devil (Sarcophilius harrisii), to the brink of extinction. The loss of an interesting creature aside, the plight of the Tasmanian devil raises provocative questions...

Faculty Q&A Discussion: Brentuximab Vedotin

 Dr. Armitage: It is no surprise that brentuximab vedotin is really an exciting agent, and it gives us a new opportunity in treating classical Hodgkin lymphoma. What if this person Dr. Engert just presented was at the same point with nodular lymphocyte-predominant lymphoma and no CD30 positivity....

Faculty Q&A Discussion: Communicating with Patients

 Dr. Armitage: As oncologists, we face many challenges. I think the most difficult is when you say to a patient with a disease everybody expects will be cured, and every patient expects to be cured, “It is not worth trying to do that. It is time to worry about keeping you as well as possible for as ...

lymphoma

Management of a Patient with Hodgkin Lymphoma following Failure of Autologous Stem Cell Transplant

Case Summaries presented by Joseph M. Connors, MD, Clinical Director, Centre for Lymphoid Cancer, British Columbia Cancer Agency, University of British Columbia, Vancouver, British Columbia, Canada When considering the management of a patient whose Hodgkin lymphoma has relapsed despite high dose...

SIDEBAR: Melanoma Treatment Options Exploding, but Old Standbys Should Remain

New drugs are rapidly changing the treatment paradigm for stage IV melanoma, but there is still validity to some of the old standbys, according to Michael Sabel, MD, of the University of Michigan, Ann Arbor, who described the shifting landscape of melanoma treatment at the Best of ASCO Boston...

skin cancer

Exciting New Agents Offer Further Treatment Options for Metastatic Melanoma

“This is a very exciting time in melanoma,” said Michael Sabel, MD, of the University of Michigan, Ann Arbor. “For years, we chugged along with few options for systemic therapy. Then in 2010 and 2011, we saw melanoma data presented at ASCO plenary sessions. At ASCO 2012, we expanded in these areas...

solid tumors
kidney cancer

Another Tyrosine Kinase Inhibitor Joins the Lineup in Renal Cell Carcinoma

The novel tyrosine kinase inhibitor tivozanib was superior to sorafenib (Nexavar) for the treatment of advanced renal cell carcinoma in the phase III TIVO-1 trial.1 Tivozanib is a potent, selective inhibitor of vascular endothelial growth factor receptors 1, 2, and 3, with a long half-life that is...

SIDEBAR: A Closer Look at Radium-223

William Oh, MD, of Mount Sinai School of Medicine, New York, posed some questions about the first-in-class alpha emitter radium-223 chloride. “Is this an anticancer drug or a bone-targeted drug?” he said. “With abiraterone acetate (Zytiga) and enzalutamide (Xtandi), we see declines in PSA—an...

prostate cancer

Novel Drugs Enhance—but Complicate—Prostate Cancer Treatment

Three emerging agents for castration-resistant prostate cancer are extending lives and defining their roles in the treatment scenario, according to William Oh, MD, of Mount Sinai School of Medicine, New York, who commented on new data at the Best of ASCO Boston meeting. “We are talking about...

SIDEBAR: Is Microsatellite Instability Status also Predictive in Stage II Disease?

“Microsatellite instability status is a validated prognostic marker in stage II colorectal cancer. It is the strongest prognostic marker we have in that group,” Dr. Overman commented. “The fact is that we should be getting this [test] consistently to help us make this discussion [of prognosis]...

Encouraging Data Presented for Monoclonal Antibodies and Novel Oral Agent in Lymphocytic Leukemias

Novel agents may transform the outcomes of lymphocytic leukemias. In acute lymphocytic leukemia (ALL), encouraging data were presented for two monoclonal antibodies, and in chronic lymphocytic leukemia (CLL), a completely novel class of agents produced surprisingly robust results, said Attaya...

SIDEBAR: Maximizing Tyrosine Kinase Inhibitor Therapy in CML

Second-generation tyrosine kinase inhibitors as initial therapy in chronic myeloid leukemia (CML) continue to prove their worth by demonstrating protection against disease progression and by producing increasingly “higher quality” remissions, said Attaya Suvannasankha, MD, of Indiana University...

leukemia

New Agents Are Achieving Deeper Responses in CML

As tyrosinse kinase inhibitors become increasingly effective in treating chronic myeloid leukemia (CML), major molecular responses (≥ 3-log reduction in BCR-ABL transcripts) are being achieved for a growing percentage of patients. “In the new era of tyrosinse kinase inhibitors, we are learning how...

lymphoma

ABVD and BEACOPP Yield Equivalent Survival in Hodgkin Lymphoma

In the EORTC 20012 randomized phase III trial comparing eight cycles of ABVD vs eight cycles of BEACOPP, Hodgkin lymphoma patients achieved equivalent overall survival with either regimen, but BEACOPP was more toxic.1 “Our approach, and that of most U.S. centers, is to use ABVD,” Michael E....

SIDEBAR: Is Watch and Wait the Best Strategy for Indolent NHL in the Rituximab Era?

Data from the RESORT and its planned subanalysis can guide oncologists in optimizing treatment for indolent non-Hodgkin lymphoma (NHL) with low–tumor burden advanced-stage disease, according to Michael E. Williams, MD, of the University of Virginia Cancer Center in Charlottesville. The phase III...

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