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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.)...

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...

cost of care

Clinical Trials, Drug Costs, and Restoring the Primacy of the Patient Volunteer

“What’s past is prologue.” —William Shakespeare Today, a cancer drug under study in a clinical trial is commonly provided for a finite period of time after the study closes to accrual. If that drug were not yet U.S. Food and Drug Administration (FDA)-approved when the study began, the complimentary ...

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...

Expert Point of View: Lynn Schuchter, MD, and Vernon Sondak, MD

Lynn Schuchter, MD, of the University of Pennsylvania, Philadelphia, a designated ASCO expert, commented at the press briefing that the results might apply to a select group of patients concerned about lymphedema but not yet to the broader population. “I would say that this is a really important...

cost of care

ASCO Releases Details of Its Conceptual Framework for Assessing Value in Cancer Care

Defining and ensuring the delivery of high-value oncology care has been one of ASCO’s major goals for more than a decade. In 2007, ASCO formed the Task Force on the Cost of Cancer Care, now called the Value in Cancer Care Task Force, to identify the drivers of the increasing costs of oncology care...

Expert Point of View: Hisham Mehanna, PhD

Formal discussant Hisham Mehanna, PhD, Chief of Head and Neck Surgery and Director of Head and Neck Studies and Education at the University of Birmingham, United Kingdom, congratulated Dr. D’Cruz on conducting an ambitious and difficult trial. “Like all studies, it has flaws, but the study has...

Expert Point of View: Anees B. ­Chagpar, MD

“This is an important study. We’ve known for some time that the aromatase inhibitors tend to be better than tamoxifen for postmenopausal women with hormonally sensitive invasive breast cancer. The NSABP B-35 trial asked the same question in ductal carcinoma in situ. These data, which now follow...

Expect Questions About Preventing Melanoma

A recent report from the Centers for Disease Control and Prevention (CDC) stated that the incidence of melanoma “doubled between 1982 and 2011, but comprehensive skin cancer prevention programs could prevent 20% of new cases between 2020 and 2030.”1,2 That report should serve to increase interest...

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...

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

Past President of ASCO Takes on New Role at Memorial Sloan Kettering Cancer Center to Improve Patient Care and Public Health

In June, Memorial Sloan Kettering Cancer Center (Memorial) in New York announced it had appointed ­Clifford A. Hudis, MD, FACP, Chief of Breast Medicine Service, to a newly created position of Vice President for Government Relations and Chief Advocacy Officer. In addition to his new role, Dr. Hudis ...

issues in oncology

Value: What Do We Mean, Who Should Decide?

Oscar Wilde famously defined a cynic as “a man who knows the price of everything and the value of nothing.” I do not think that oncologists need to be as cynical as this, but it was very appropriate that a major theme of this year’s ASCO Annual Meeting was the concept of “value.” It is clear that...

Expert Point of View: Peter B. Bach, MD, MAPP, and Leonard Saltz, MD

Peter B. Bach, MD, MAPP, Director of the Center for Health Policy and Outcomes at Memorial Sloan Kettering Cancer Center (Memorial), New York, discussed Dr. Schrag’s study at the ASCO Health Services Research and Quality of Care session. “Dr. Schrag’s analysis could have been ‘back of the...

issues in oncology

Johnson & Johnson Creates Independent Bioethics Panel to Evaluate Compassionate Drug Use Requests

In May 2015, Johnson & Johnson announced its partnership with New York University (NYU) School of Medicine in New York to create a first-of-its kind independent bioethics panel to review requests made to the company for compassionate use of an investigational drug and determine how the company...

cost of care

Calculating the Value of Cancer Drugs

For nearly a decade, Peter B. Bach, MD, MAPP, Director of the Center for Health Policy and Outcomes at Memorial Sloan Kettering Cancer Center in New York, has been a leading voice in sounding the alarm over the escalating cost of cancer drugs and in seeking a solution to the problem. In 2012, Dr....

health-care policy

‘Right to Try’ Laws: Helpful or Harmful?

Since 2014, “Right to Try” legislation has been sweeping the nation. Created to enable terminally ill patients to gain access to experimental drugs, biologics, and devices by sidestepping the approval process of the U.S. Food and Drug Administration (FDA), at press time, 22 states have enacted...

breast cancer
pain management

Increased Interest in Simple Injection to Treat Women With Postmastectomy Pain

After presenting results of a study showing that injecting a standard analgesic combination into trigger points of pain along the inframammary fold relieved postmastectomy pain, Laura J. Esserman, MD, MBA, Director of the Carol Franc Buck Breast Care Center and Co-Leader of the Breast Oncology...

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 ...

Charting a New Course: From Clinical Investigator to University President

What first intrigued Fadlo R. Khuri, MD, FACP, about the prospect of becoming the 16th President of the American University of Beirut (AUB) in Lebanon was the chance to give back to an institution and a country that had given him so much. Born in Boston, Massachusetts, in 1963, Dr. Khuri was raised ...

cost of care

Making Their Voices Heard: 118 Oncologists Speak Out About Stemming the High Cost of Cancer Drugs

In a bold move to shed light on the ramifications of the ever-increasing cost of cancer drugs for patients with cancer and for the health-care system, 118 prominent oncologists came together to write a commentary in Mayo Clinic Proceedings detailing their concerns.1 To learn more about these...

issues in oncology

Our Children’s Future Is Our Responsibility

Cancer prevention is a child-care issue. With many of cancer’s instigators planting their seeds during childhood, we—as a profession and as a nation—must seize this important window of opportunity to protect the health and well-being of future generations. Current estimates suggest that up to...

global cancer care

Measuring Global Health Issues, Seven Billion Times

BOOKMARK Title: Epic Measures: One Doctor. Seven Billion PatientsAuthor: Jeremy N. SmithPublisher: Harper WavePublication date: April 7, 2015Price: $26.99; hardcover, 352 pages Health measures are essential tools in assessing public health and safety. Collecting large amounts of data is a laborious ...

breast cancer

Varied Reactions to Study Finding That Preventing Ipsilateral Recurrence Did Not Prevent Death From Breast Cancer

Women diagnosed with ductal carcinoma in situ have a low risk of dying of breast cancer, according to an observational study looking at data from 108,196 women diagnosed with ductal carcinoma in situ between 1988 and 2011.1 The breast cancer–specific mortality rate for these women was 1.1% at 10...

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 ...

supportive care
survivorship

Patient and Survivor Care Studies Yield Useful Results to Improve Quality of Life

Recent studies have yielded useful results that clinicians can put into practice, some right now, to help improve the quality of life for patients with cancer. Concerns addressed included cachexia, pain, “chemobrain,” and fertility preservation. At the Best of ASCO®/Chicago meeting, Arif ­Kamal,...

Expert Point of View: Martin Reck, MD, PhD

Martin Reck, MD, PhD, of the Department of Thoracic Oncology at the Lung Clinic Grosshansdorf in Germany, discussed the studies. In pretreated patients, he said, “We have seen confirmed efficacy” [for AZD9291] and “impressive activity.” In the first-line setting, its efficacy is still being...

lung cancer

EGFR Gene Copy Number as Biomarker for Antibody Treatment in Squamous Cell NSCLC

Two studies presented at the 16th World Conference on Lung Cancer suggest that high expression of the epidermal growth factor receptor (EGFR), or gene copy number, may indicate potential benefit from EGFR antibodies in squamous cell non–small cell lung cancer (NSCLC). The studies were presented by...

What Do You Say When She Is No Longer Living With Cancer?

The ASCO Post is pleased to reproduce installments of the “Art of Oncology” as published previously in the Journal of Clinical Oncology (JCO). These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer, and they include narratives, topical essays,...

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