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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...

palliative care

The Mechanisms Driving Cancer Pain

For over a decade, Patrick W. ­Mantyh, PhD, JD, has been investigating the molecular and cellular mechanisms that are involved in cancer-related pain, especially bone pain caused by advanced breast, prostate, and lung cancers. His early laboratory work using mouse models of bone cancer led to an...

thyroid cancer

Welcome to Multikinase Inhibitors in Radioiodine-Refractory Thyroid Cancer

In the past 2 decades, the incidence of thyroid cancer has risen steeply, with rates now growing by 5.5% annually.1 In 2014, 62,980 new cases of thyroid cancer were diagnosed in the United States. The good news is that, overall, the prognosis of thyroid cancer remains excellent; 97.8% of patients...

breast cancer

Increased Risk of Secondary Bone Marrow Neoplasia After Adjuvant Breast Cancer Treatment: Risk/Benefit Analysis and Biologic Insights

Ever since the early application of adjuvant chemotherapy for breast cancer decades ago, it has been recognized that there is always a price to pay for its success in reducing breast cancer mortality. Most of that “cost” is commonly considered in terms of the potential morbid short- and long-term...

ASCO’s Train the Trainer Program Extends the Reach of Multidisciplinary Cancer Management Education

Multidisciplinary Cancer Management Courses (MCMCs) offered by ASCO International, in collaboration with other organizations, seek to improve cancer care globally through the promotion of interdisciplinary cancer management. Attendees of select MCMCs have the option to attend a 1- to 2-day training ...

cns cancers

Will the PVS-RIPO Poliovirus Be a Game Changer in the Treatment of Recurrent Glioblastoma?

Although the idea of using viruses to target cancer cells dates back more than 100 years, technologic advances in the genetic engineering of viruses are now making it possible to safely test oncolytic virotherapy as a valid strategy against cancer cells. One type of genetically engineered virus...

leukemia

Prognostic Models and Front-Line Treatment Options for Chronic-Phase Chronic Myelogenous Leukemia

The ASCO Post is pleased to present “Hematology Expert Review,” an occasional feature that includes a case report detailing a particular hematologic condition followed by questions. Answers to each question, along with expert commentary, can be found in the sidebar. In this installment, we present...

colorectal cancer
issues in oncology

HPV-Related Anal Cancer on the Rise

More than 7,200 cases of anal cancer were diagnosed in 2014—approximately 2,600 in men and 4,600 in women—representing an increase of more than 4,000 from 8 years ago. In more than 90% of patients, infection with the human papillomavirus (HPV) is the cause, tagging anal cancer as a largely...

breast cancer

Managing Breast Cancer in 2015

Since 1990, we have seen an approximate 35% reduction in breast cancer mortality among women in the United States. Three protagonists can share this clinical success story: prevention, early detection, and better therapies. To shed light on the current state of breast cancer research and therapy,...

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...

myelodysplastic syndromes

Nationally Recognized Leader in Myeloid Malignancies, Alan F. List, MD, Has High Hopes for the Future of Oncology

The Tampa Bay area of Florida is a haven for golfers and fishermen looking to unwind under the warm tropical skies. And the clean highways stretching through the scenic west coast of Florida are also a perfect excuse for weekend motorcycle enthusiasts, such as Alan F. List, MD, the President and...

Pioneer in Combination Chemotherapy, Vincent T. DeVita, Jr, MD, Changed the Face of Modern Oncology

As a young boy growing up in the Bronx, Vincent T. DeVita, Jr, MD, admired the local iceman, a thick-muscled guy known as Nunzi, who used to carry a big block of ice on his shoulder with a set of tongs, and effortlessly slide it into the DeVitas’ icebox. “A friend once asked me what I wanted to be...

issues in oncology
hematologic malignancies
solid tumors

Incidence of Fractures Is ‘Compellingly Higher’ After Hematopoietic Stem Cell Transplantation

The incidence of fractures is “compellingly higher” after receiving hematopoietic stem cell transplantation, according to a retrospective study of patients receiving transplants for treatment of multiple myeloma, other hematologic malignancies, and some solid tumors (mostly breast and ovarian) as...

thyroid cancer
gastroesophageal cancer
lymphoma

Cancer Will Always Be Part of My Life

My first experience with cancer was when I was just 9 years old, and a lump the size of an egg popped out on the right side of my neck. A biopsy of the tumor found that it was Hodgkin lymphoma, and I was given huge doses of external-beam radiotherapy applied to my neck, chest, and underarm lymph...

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.)...

breast cancer

First National Data on Breast Cancer Subtypes Mark New Era in Biomarker Epidemiology

This year’s Report to the Nation on the Status of Cancer contains the first national combined data set on the incidence of four major breast cancer subtypes by race/ethnicity, poverty level, geography, and other factors. The findings show that “there are unique racial/ethnic-specific incidence...

cns cancers

Whole-Brain Radiation: Risks Outweigh Benefits for Limited Brain Metastases

New data from a phase III ­Alliance trial weighs in on a longstanding debate in the treatment of brain metastases: Should whole-brain radiation therapy be added to stereotactic radiosurgery? The study found that although whole-brain radiation therapy improved local tumor control in patients with...

lymphoma

Carpe Diem

My life as a cancer survivor and an oncologist has taught me the importance of living every day to the fullest. Sometimes we all need a little reminding to appreciate life to the fullest. When I think of my former patient, Marc, that is what comes to mind. When I was a senior in high school, I was...

gynecologic cancers

Hormonal Therapy and Risk of Ovarian Cancer

Ovarian cancer is the second most common gynecologic malignancy in the United States, with an estimated 21,290 new cases expected this year. Ovarian cancer causes 5% of all cancer deaths in women, making it responsible for the highest number of gynecologic cancer deaths.1 Age, family history, and...

issues in oncology

Deciphering the Genetic Variability of Cancer to Advance Precision Oncology Care

In 2014, Memorial Sloan Kettering Cancer Center (MSKCC) in New York opened the Marie-Josée and Henry R. Kravis Center for Molecular Oncology with the sole purpose of expediting the translation of novel molecular discoveries into clinical innovations to turn the goal of precision oncology care into...

cost of care

Cost of Immunotherapy Projected to Top $1 Million per Patient per Year

If new immunotherapy combinations were administered to the half a million Americans dying of cancer each year, the nation’s price tag for treating them—for just 1 year—could top $174 billion, according to projections by Leonard Saltz, MD, Chief of Gastrointestinal Oncology and Chair of the Pharmacy ...

survivorship

Survivors of Childhood Cancer Living Longer, Largely Due to Treatment Improvements

Survivors of childhood cancers can expect longer lives than their peers of 30 years ago. Improvements in the care of children with cancer have reduced the long-term mortality rate, according to an analysis of 34,000 participants in the Childhood Cancer Survivor Study.1 Cumulative all-cause late...

breast cancer

My Faith Helped Me Choose a Way Forward With Cancer

I've been fortunate to be strong and healthy for most of my life. In fact, there is no history of any serious illness in my family, which is why I was so unprepared to hear the words “You have breast cancer” 5 years ago. Not only was the diagnosis foreign to me, I had no idea what chemotherapy and...

integrative oncology

American Ginseng

The use of dietary supplements by patients with cancer has increased significantly over the past 20 years 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 ...

health-care policy
survivorship
legislation

NCCS Advocates for Legislation to Establish Medicare Service for Cancer Survivorship Care Planning

Some years after successful treatment of a childhood cancer, a 16-year-old survivor required surgery to replace both hip joints, which were damaged from therapy containing steroids. An x-ray of the teenager’s destroyed joints is a stark reminder of the serious health challenges faced by cancer...

leukemia
myelodysplastic syndromes

Advancing Classification and Risk Stratification for Leukemia and Myelodysplastic Syndromes

Refinements in the classification and risk stratification for leukemia and myelodysplastic syndromes were reported by three different investigators at the 2015 ASCO Annual Meeting. The first study showed that leukemia stem cell phenotypes are associated with outcomes in acute myeloid leukemia...

Mount Sinai Honors James F. Holland, MD, FASCO, on the Occasion of His 90th Birthday

On May 14, 2015, over 160 colleagues, family members, friends, and patients of James F. ­Holland, MD, FASCO, gathered in the Goldwurm Auditorium in the Icahn School of Medicine at Mount Sinai Hospital in New York to honor Dr. Holland for the contributions he has made during his remarkable career in ...

issues in oncology

Cost vs Our Values in Cancer Care

An 80-year-old patient with metastatic prostate cancer asked me to discontinue his treatments, which were costing him more than $1,000 every 3 months. Although he had Medicare, he did not have secondary insurance. I told him that I would seek compassionate-care payment from the pharmaceutical...

palliative care

The Importance of Including Adolescents and Young Adults With Cancer in Their Advance Care Planning

Three years ago, a study of adolescents and young adults aged 16 to 28 with metastatic or recurrent cancer or HIV/AIDS compared the usefulness of two previously developed advance care planning guides—one prepared specifically for adolescents and young adults and one specifically for adults. The...

Community Oncologist Stephen Grubbs, MD, to Lead ASCO’s New Clinical Affairs Department

Stephen S. Grubbs, MD, a community oncologist and managing partner at Medical Oncology Hematology Consultants, PA, in Newark, Delaware, has been named the Senior Director of ASCO’s new Clinical Affairs department. Dr. Grubbs is a longtime ASCO member and volunteer and the Principal Investigator of...

The Human Heart: Tales of Science and Mystery

BOOKMARK Title: The Man Who Touched His Own Heart: True Tales of Science, Surgery, and Mystery Author: Rob Dunn Publisher: Little, Brown and Company Publication date: February 3, 2015 Price: $27.00; hardcover, 384 pages No part of the human anatomy has been as mythologized, analogized, and...

issues in oncology
palliative care

Using Gene Analytics to Identify Patients at Risk for Treatment Toxicity

Genomic applications are now an accepted part of oncologic science and practice. Differences in gene expression have been used to understand and predict tumor behaviors and response to treatment. And now it seems likely that genomics may also play a pivotal role in guiding treatment preferences by...

geriatric oncology

Geriatric Oncology: A Geriatrician’s Perspective

“The management of older individuals, including older cancer patients, involves a wisdom developed over a lifetime, thanks to time-consuming listening and painstaking collection and interpretation of clinical details.” —Lodovico Balducci, MD It is not simple to be a geriatrician in a world of...

supportive care
pain management
palliative care
symptom management

Managing Cancer Pain at the End of Life

Cancer-related pain does not exist in a vacuum. To effectively treat it, clinicians should understand the contributing factors. Proper assessment and management of cancer pain at the end of life can significantly alleviate patient suffering, according to Eduardo Bruera, MD, FAAHPM, Department Chair ...

breast cancer
survivorship

‘Share the Journey’ Mobile App Aims to Understand the Different Experiences of Breast Cancer Survivors

In March 2015, Sage Bionetworks and Apple released “Share the Journey: Mind, Body, and Wellness After Breast Cancer,” a patient-centered iPhone app that tracks five common consequences of breast cancer treatment, including fatigue, cognitive function, sleep disturbances, mood changes, and a...

Never Say Never

The following essay by Grace Wang, 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. D.K. came to me ...

The Flipped Classroom: Swapping the Traditional Lecture Hall for an Online Version

Despite enormous advances in modern medicine and the explosion of biomedical information over the past century, the way medical education is taught in the United States is stuck in a format that does not optimize learning, according to Charles Prober, MD, Senior Associate Dean for Medical Education ...

lung cancer

Roswell Park Cancer Institute Partners With Cuban Scientists to Develop Lung Cancer Vaccine

Just 4 months after President Barack Obama’s announcement in December 2014 that there would be an easing of the trade embargo between the United States and Cuba, a deal was struck between Roswell Park Cancer Institute in Buffalo, New York, and the Center for Molecular Immunology (CIM) in Havana,...

issues in oncology

Our Patients Are the True Heroes of Cancer Research

A few weeks ago, I read an op-ed1 in The New York Times written by Stan Collender, a patient with Merkel cell carcinoma, a rare and aggressive type of skin cancer. In his article, he described his participation in a clinical trial for a new drug he is hoping will stem progression of his cancer and...

Internationally Acclaimed Cancer Researcher, Gianni Bonadonna, MD, Dies at 81

Gianni Bonadonna, MD, was considered the “Father of Italian Oncology,” but his scientific contributions to the field and his generous collegial spirit extended far beyond the shores of his native land. Dr. Bonadonna was at the forefront in the battle to convince the surgical establishment that...

NCI Awards Huntsman Cancer Institute, University of New Mexico Cancer Center Comprehensive Cancer Center Designations

The National Cancer Institute (NCI) recently awarded Huntsman Cancer Institute (HCI) at the University of Utah and The UNM Cancer Center (UNMCC) at the University of New Mexico Comprehensive Cancer Center status. An NCI-Designated Comprehensive Cancer Center must demonstrate depth and breadth of...

palliative care

One Doctor’s Road to Palliative Care Services in the Inner City

St. Barnabas Hospital is located in the heart of Bronx, New York, and as such, it has a culturally diverse, largely poor, patient population. The backbone of successful palliative care services is the doctor-patient communication bonding process. However, many of the patients with late-stage cancer ...

A Practical Guide to Surviving Breast Cancer and Its Treatments

BOOKMARK Title: Bald Is Better With Earrings: A Survivor’s Guide to Getting Through Breast CancerAuthor: Andrea HuttonPublisher: Harper CollinsPublication date: July 7, 2015Price: $17.99; paperback, 224 pages There are a plethora of books written by breast cancer survivors, and there are sure to...

solid tumors

Extraordinary Medical Advances and the Conundrum They Pose

BOOKMARK Title: Ordinary Medicine: Extraordinary Treatments, Longer Lives, and Where to Draw the LineAuthor: Sharon R. KaufmanPublisher: Duke University PressPublication date: May 29, 2015Price: $26.95 paperback, 336 pages Medicine has changed radically over the past 15 years. Who doesn’t welcome...

Todd Demmy, MD, FACS, FCCP, Joins Rutgers Cancer Institute of New Jersey

Rutgers Cancer Institute of New Jersey has named Todd Demmy, MD, FACS, FCCP, as its new Chief of Thoracic Oncology and Associate Chief of the Division of Surgical Oncology. Dr. Demmy, who is leading Rutgers Cancer Institute’s Thoracic Oncology Program, is an international leader in minimally...

issues in oncology

A Cancer Care Model for Rural Areas

Rural cancer patients have long had to adjust to difficult geographic and financial barriers to access high-quality cancer care. These problems are exacerbated by today’s fiscal challenges, which have disrupted many of the small community practices that once served rural communities. In 2006, the...

pain management

The Need for a Multidisciplinary Approach to Combating Cancer-Related Pain

The statistics are staggering. Despite the development of novel analgesics and the increasing awareness of the importance of adequately controlling pain from cancer or its treatment, up to 50% of patients undergoing treatment and between 70% and 90% of patients with advanced disease experience some ...

breast cancer

Male Breast Cancer: An Understudied Disease and Clinical Challenge

Male breast cancer is an uncommon disease, although the incidence has increased over the past couple of decades. As with many other “orphan” diseases, male breast cancer is understudied, especially in randomized controlled trials. Although it shares similarities with female breast cancer, some...

issues in oncology

Better Definitions and Biomarkers Needed to Reduce Cancer Overdiagnosis

At the third annual Preventing Overdiagnosis Conference, speakers described the prevalence and consequences of overdiagnosis in several medical specialties, including cancer. The Conference, which had the theme “Winding Back the Harms of Too Much Medicine,” was co-sponsored by the National Cancer...

lung cancer

Lung Cancer Rates Doubling Among Nonsmokers

Lung cancer is becoming an equal-opportunity malignancy—with rates rising among never-smokers, especially females, according to studies presented at the 16th World Conference on Lung Cancer in Denver. British investigators reported that in one large tertiary medical center, the proportion of...

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