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The following essay by Michael Feinstein, MD, is excerpted from The Big Casino: America’s Best Cancer Doctors Share Their Most Powerful Stories, which was co-edited by Stan Winokur, MD, and Vincent Coppola and published in May 2014. The book is available on Amazon.com and thebigcasino.org....
The Audacity of Courage
We have toolsWe have ghoulsBut nowhere are there more foolsThan in the rulesfrom those who govern the tools! In the bias That climbs on the shoulders To bring plausibility Through implied causality,Where is ignorance?Where is reality?Where are all the tools of Reason? ...
Integrative Oncology: Mind, Body, and More
Bookmark Title: Integrative Oncology (Second Edition)Editors: Donald I. Abrams, MD, and Andrew T. Weil, MDPublisher: Oxford University PressPublication date: September 3, 2014Price: $65.00; Paperback, 848 pages In 1990, David Eisenberg, MD, from the Harvard School of Public Health, conducted a...
Milk Thistle
The use of dietary supplements by patients with cancer has increased 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...
Researchers at Roswell Park Receive Grants to Study New Anticancer Agent in Lung, Colorectal, and Gastrointestinal Cancers
Researchers at Roswell Park Cancer Institute have been awarded three of four grants by the National Comprehensive Cancer Network (NCCN) Oncology Research Program to evaluate and define the clinical effectiveness of the investigational compound nintedanib. Nintedanib is an investigational...
Clinical Trials Actively Recruiting Patients With Breast Cancer
The information contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies for people with breast cancer. The studies include phase I and II, interventional, and observational trials evaluating new therapies; diagnostic tools; genetic counseling; the association ...
Genetic ‘Hotspot’ Linked to Endometrial Cancer Aggressiveness
Parents of twins often tell them apart through subtle differences such as facial expression, moles, voice tone, and gait. Similarly, physicians treating women with endometrial cancer must be able to distinguish between different versions of this disease form that, on the surface, appear the same....
Lympho-Sarcoma Treated by Radiation, Patient of Francis H. Williams, MD, Boston, 1902
One of the miracles produced by the x-ray was the relatively easy treatment of inoperable or disfiguring tumors. If not a cure, the results frequently gave the patients at least some time to look and feel normal. The young patient shown in these photographs had a remarkable response. Images such as ...
First Photographs of Breast Surgery, New York City, 1886
Antiseptic principles delivered the promise of safe surgery, while asepsis allowed safe major dissections and invasion of body cavities. The physicians who were using these techniques recognized the amazing difference in their surgical results and corresponding mortality rates and proselytized to...
Woman With Ovarian Tumor, Daguerreotype, Wellington, Ohio, June 1851
In June 1851, Philip J. Bruckner, MD, hired a daguerreotypist to photograph this 275-pound, 33-year-old woman, who had borne five children while developing this massive tumor. Dr. Bruckner learned of this patient when Charles Breech, MD, of Wellington, Ohio, presented her case at a medical meeting. ...
100 Years of Progress in Oncology Treatment
In his powerful 2010 best-seller, The Emperor of All Maladies: A Biography of Cancer (Scribner), Siddhartha Mukherjee, MD, chronicles the evolution of cancer from the oldest known description of the disease written on a papyrus from about 1600 BC to the present day’s understanding of the biology of ...
Helping Patients Talk to Their Children About Cancer
Although the focus of an oncologist’s attention is understandably attuned to the needs of the patient, when a patient is a parent, quality oncology care should also include attention to the patient’s role as a parent and to the needs of the patient’s children, according to Paula K. Rauch, MD,...
Now in Its 71st Year, CancerCare Looks to Expand Services to Patients and Caregivers
Eleven days before Patricia J. Goldsmith, joined CancerCare as its CEO last May, she received the unexpected news that she had early-stage colorectal cancer. While the diagnosis was shocking, Ms. Goldsmith said it gave her a unique perspective on what it means to have this serious disease and a...
Book Review: Breast Cancer, Break the Silence
This date has a special place in my heart, as well as the hearts of my children, my family and my loved ones. It was the day when my life—and my priorities—took a whole new direction.” So begins Breast Cancer, Break the Silence, a slim yet powerful and highly revealing booklet by Saudi Arabian...
Breaking the Silence About Breast Cancer in the Arab World
In 1974, First Lady Betty Ford spoke publicly about her breast cancer diagnosis and treatment. Remarkably, at the time of her action, public discussion of breast cancer in the United States was seen as off limits. Four decades later, cultural barriers to women’s health still exist, particularly in...
On Being A Mentee and the Value of the Conquer Cancer Foundation’s Career Development Award
At the ASCO Annual Meeting in June, the Conquer Cancer Foundation presented the 2014 recipients of prestigious grants and awards, including the Young Investigator Award, Career Development Award, and the Advanced Clinical Research Award in Breast Cancer. In announcing the awards, Charles W. Penley, ...
The Value of Lifelong Mentorship in Career Development
While the development of mentorship relationships is critical in launching and nurturing the academic careers of young investigators, it is also an essential component for continued success throughout their careers, according to Jennifer R. Brown, MD, PhD. Dr. Brown, Director of the CLL Center at...
IARC Calls on Countries With High Stomach Cancer Burden to Act to Prevent the Disease
A new report from the International Agency for Research on Cancer (IARC), an agency of the World Health Organization, urges health authorities of countries with high stomach cancer burden to include stomach cancer in their national cancer control programs and allocate more resources to control the...
Treating Sarcomas in 2014
In 2014, about 15,000 people in the United States will be diagnosed with some form of sarcoma, and of those, approximately 5,000 adults and children are expected to die of the disease. Sarcomas are a heterogeneous group of mesenchymal malignancies that have historically been difficult to diagnose...
Enzalutamide in Metastatic Castration-Resistant Prostate Cancer
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. On September 10, 2014, the androgen receptor inhibitor...
Improving Treatment of Depression in Patients With Cancer: The SMaRT Oncology-2 Trial
Clinical depression is highly prevalent, associated with significant morbidity, often underrecognized, and inadequately treated in cancer patients. Professor Michael Sharpe and Jane Walker, PhD, and their colleagues’ seminal work on enhancing treatment of depression in cancer patients using a...
Integrated Collaborative Care Program Highly Successful in Treating Major Depression in Patients With Cancer
In the Scottish SMaRT Oncology-2 study reported in The Lancet, Michael Sharpe, MD, and Jane Walker, PhD, of University of Oxford, United Kingdom, and colleagues found that an integrated collaborative treatment program for depression (“depression care for people with cancer”) was associated with...
ASCO, AACR Urge FDA to Regulate All Tobacco Products—Including E-Cigarettes
ASCO and the American Association for Cancer Research (AACR) sent a joint letter to the U.S. Food and Drug Administration (FDA) urging the agency to regulate electronic cigarettes, cigars, and all other tobacco products and to strengthen the proposed regulations for newly deemed products. The...
The Latest Information for Patients From ASCO’s Symposia
The 2014 ASCO Quality Care Symposium is taking place this week, from October 17 to 18, and the new Palliative Care in Oncology Symposium is next week, from October 24 to 25. Direct your patients to www.cancer.net/blog to learn what the research announced prior to the symposia means and how it...
New Series Features Interviews With Authors of JCO and JOP Research
Journal of Clinical Oncology (JCO) and Journal of Oncology Practice (JOP) “Exclusive Coverage” summaries, available on ASCO.org and ASCO Connection, are designed to provide quick insight and additional author perspectives on select recently published studies. Based on interviews conducted with the...
Fellows’ Expectations of Work-Life Balance Not in Line With Realities of Practice
Oncology fellows just years away from entering the profession full time may have unrealistic expectations of their future career, according to data published recently in the Journal of Clinical Oncology. The study by Tait D. Shanafelt, MD, of the Mayo Clinic, Rochester, Minnesota, and colleagues...
Cancer Survivors Face Lasting Financial Struggles Long After Treatment Ends, New Study Reports
The majority (62%) of America’s middle-income cancer survivors say they were not financially prepared for cancer diagnosis and treatment, according to a new study released by the Washington National Institute for Wellness Solutions (IWS). The study, “Insights from Survivors: Managing the Personal,...
ECOG E4402/RESORT Trial: When ‘Black and White’ Results Are Actually Gray
The results of the ECOG E4402/RESORT trial recently reported by Kahl and colleagues,1 and reviewed in this issue of The ASCO Post, provide interesting new information on the use of maintenance rituximab (Rituxan) vs retreatment with rituximab at progression in patients with low–tumor burden...
Time to Treatment Failure Similar With Rituximab Retreatment vs Maintenance in Low–Tumor Burden Follicular Lymphoma
Maintenance rituximab (Rituxan) has been shown to improve progression-free survival vs observation in low–tumor burden follicular lymphoma. In the Eastern Cooperative Oncology Group (ECOG) E4402 Trial (RESORT), reported in the Journal of Clinical Oncology, Brad S. Kahl, MD, of the University of...
Early Study Reports Modified Vitamin D Has Potential in Treatment for Pancreatic Cancer
Researchers at the Salk Institute have reported on a synthetic derivative of vitamin D able to collapse the barrier of cells shielding pancreatic tumors, making this challenging cancer more susceptible to therapeutic drugs. The discovery has led to human trials for pancreatic cancer, even in...
Colonoscopic Polypectomy and Predicting Cancer Risk: A Work in Progress
Colon cancer screening using colonoscopy has significantly decreased the incidence and mortality of colorectal cancer in the United States. In the National Polyp Study (NPS), colorectal cancer was prevented by removal of adenomatous polyps.1 A more recent study looking at long-term follow-up from...
Advanced Robotic Technology Used to Remove Kidney Tumor in First-Time Outpatient Procedure
Keck Medical Center of the University of Southern California (USC) has become the first medical center in the world to use a new robotic technology in an outpatient procedure for a patient with kidney cancer. Urologic surgeons at the USC Institute of Urology, part of Keck Medicine of USC, used a...
First Approval of PD-1 Inhibitor: Pembrolizumab in Unresectable or Metastatic Melanoma
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. On September 4, 2014, pembrolizumab (Keytruda) was granted...
Exceptional Responders to Cancer Therapy Study Begins
The National Cancer Institute (NCI) recently launched “The Exceptional Responders Initiative,” a study to investigate the molecular factors of tumors associated with exceptional treatment responses of patients with cancer to drug therapies. Scientists will attempt to identify the molecular features ...
Despite Growing Awareness, the Global Crisis of Untreated Cancer Pain Persists
Each day, millions of patients with cancer around the world suffer unrelieved pain because they are denied morphine, the gold standard of cancer pain control. The World Health Organization has called access to morphine a human rights issue. Not surprisingly, the crisis in unrelieved cancer pain is...
Life-Threatening Dermatologic Toxicity
A variety of life-threatening dermatologic adverse events may occur in association with cancer drug therapies. Here, we discuss the recognition and management of three types of such toxicities: type I hypersensitivity/anaphylaxis, Stevens-Johnson syndrome/toxic epidermal necrolysis, and drug rash...
Women at Higher Risk for Breast Cancer to Benefit From Hereditary Risk Assessment Program in Tucson Center
Approximately 12% of women in the United States will develop breast cancer, according to the American Cancer Society. That’s more than 30,000 in Tucson alone, 2,500 of whom are estimated to have a genetic risk factor for cancer. In response to this growing concern, The Breast Center at Carondelet...
Attaining the Goal of Preventing Ovarian Cancer
Fifteen years ago, David Fishman, MD, launched the National Ovarian Cancer Early Detection Program as part of the National Cancer Institute’s Early Detection Research Network. The goal of the research effort was to develop methods to accurately detect ovarian cancer while it was still confined to...
Guidelines and Care: What Comes Next?
The goal of clinical, translational, and basic research is, in the end, the betterment of life on earth. Advances in basic and clinical science ultimately should lead to information that, in turn, enables clinicians to make better treatment decisions for individual patients in order to improve...
ASCO Clinical Practice Guideline: Chemotherapy and Targeted Therapy in Advanced HER2-Negative or HER2 Status–Unknown Breast Cancer
The American Society of Clinical Oncology has released a new clinical practice guideline on chemotherapy and targeted therapy for women with advanced HER2-negative or HER2 status–unknown breast cancer. The guideline is published in the Journal of Clinical Oncology.1 In formulating the consensus...
REVEL: Winning a Questionable Race
The investigators and sponsors of the phase III REVEL trial should be congratulated and probably commiserated. In this large study, reported by Garon and colleagues in The Lancet and reviewed in this issue of The ASCO Post, 1,253 patients with advanced non–small cell lung cancer (NSCLC) were...
Significant Improvement in Overall Survival With Second-Line Addition of Ramucirumab to Docetaxel in Stage IV NSCLC
In the phase III REVEL trial reported in Lancet, Edward B. Garon, MD, of the David Geffen School of Medicine at UCLA/Translational Research in Oncology–US Network, Los Angeles, and colleagues found that the addition of the antiangiogenic vascular endothelial growth factor receptor (VEGFR)-2...
Early Study Finds BRCA-Mutated Pancreatic Cancer Responds to PARP Inhibition Trio
Two-thirds of patients with advanced pancreatic adenocarcinoma who harbored BRCA mutations responded to the combination of veliparib, cisplatin, and gemcitabine in a phase IB trial that is paving the way for future studies of novel poly(ADP-ribose) polymerases (PARP) inhibitors in this challenging...
CTNeoBC Analysis: Response to Neoadjuvant Chemotherapy Varies by Breast Tumor Subtype
Women who achieve a pathologic complete response (pCR) to neoadjuvant chemotherapy rarely have local or regional recurrence of breast cancer, but this largely depends on tumor subtype, which remained an independent predictor of locoregional recurrence when pathologic response was taken into account ...
Fertility Preservation Suggested With Triptorelin in Long-Term Study
Young women with early breast cancer may be more likely to resume menses and become pregnant when treated with a luteinizing hormone–releasing hormone (LH-RH) analog (also known as a gonadotropin-releasing hormone [GnRH] analog) along with chemotherapy, according to the final follow-up of...
With Breast-Conserving Surgery, Margin Status Not a Factor in Recurrence
In a chart review of 754 early-stage breast cancer patients undergoing breast-conserving surgery, margin status did not impact risk of locoregional recurrence or breast cancer-specific survival, though it did predict for overall survival, as did numerous other factors. Tumor biology remained the...
Expert Point of View: Harold Burstein, MD
Harold Burstein, MD, Associate Professor of Medicine at Dana-Farber Cancer Institute, Boston, spoke to The ASCO Post about the multidisciplinary discussion of margin assessment during the 2014 Breast Cancer Symposium. Should Oncologists Be Concerned? “There is a real art to being a good...
How Accurate Is the Pathologic Assessment of the Partial Mastectomy Specimen?
The pathologic evaluation of lumpectomy margins is “fraught with problems and pitfalls,” said Stuart J. Schnitt, MD, Director of Anatomic Pathology at Beth Israel Deaconess Medical Center and Professor of Pathology at Harvard Medical School, Boston, who was part of a multidisciplinary discussion of ...
Pathologic Complete Response: Understanding the Subtleties
In the neoadjuvant treatment of breast cancer, the importance of achieving a pathologic complete response (pCR) varies substantially by breast cancer subtype. Patients are increasingly interested in this outcome, but it means different things to different patients, according to two breast cancer...
Managing Resistance to Targeted Agents: The Future of NSCLC Therapy
The bane of treating non–small cell lung cancer (NSCLC) patients with druggable mutations has been the development of resistance to targeted agents. New compounds are meeting the challenge of treating resistant disease, according to Fadlo R. Khuri, MD, FACP, Professor and Chair of Hematology and...
