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health-care policy

Rising Costs in Radiation Oncology Linked to Medicare Coverage

In the ongoing debate over how to control rising cancer care costs, it is vital to identify usage patterns of expensive new technologies. A recent study examined the relationship between Medicare reimbursement and the increasing use of intensity-modulated radiation therapy (IMRT).1 The ASCO Post...

issues in oncology

Options for Preserving Fertility Should Be Considered Early to Maximize the Likelihood of Success

Most cancer survivors prefer to have biologic offspring despite concerns about the possible effects of cancer treatment on the child, the child’s lifetime cancer risk, or their own longevity, according to an ASCO panel that developed guidelines on fertility preservation in patients with cancer.1...

gynecologic cancers
issues in oncology

New Guidelines Recommend Less Frequent Screening for Cervical Cancer, but That Doesn’t Mean Screening Is Less Important

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. In March 2012, the U.S. Preventive...

health-care policy

Letter to the Editor: Patient Protection and Affordable Care Act Reconsidered

I read with interest the front-page interview of Dr. Ezekiel Emanuel by Jo Cavallo in the December 15, 2011, issue of The ASCO Post. Dr. Emanuel may have had some of the most prestigious positions in all of medicine, but his opinion of the Affordable Care Act is completely misguided. This...

kidney cancer

Partial Nephrectomy Can Optimize Survival in Patients with Early-stage Disease

Following recent clinical trial data from the European Organisation for Research and Treatment (EORTC) showing a survival benefit for patients with small kidney cancers treated with radical vs partial nephrectomy, an analysis using linked Surveillance, Epidemiology and End Results (SEER) and...

Conquer Cancer Foundation Board Member Tom Roberts Cites Need to Grow Research Capacity as Opportunity for Discovery Accelerates

Thomas G. Roberts, MD, dedicates a shelf in his home to memories of patients—photographs, notes, expressions of gratitude, traces of lives linked with his through cancer treatment. He looks at it every day, he says, and the memories inform his mission. “In oncology, you become part of people’s...

global cancer care
pain management
palliative care

Untreated Cancer Pain Remains a Significant Global Problem

“Physicians are afraid of morphine … Doctors [in Kenya] are so used to patients dying in pain … they think that this is how you must die. They are suspicious if you don’t die this way — [and feel] that you died prematurely.” —Human Rights Watch interview with Dr. John Weru of Nairobi Hospice,...

global cancer care

Cancer Care in India: Complex Challenges in a Populous Nation

With 1.22 billion people, India is the second most populous country in the world. Experts project that cancer incidence in India will increase by more than two-thirds over the next 20 years, to approximately 1.7 million new cases per year. Due to a range of economic and social issues, most of...

leukemia

Progress in Treating Chronic Lymphocytic Leukemia Has Led to Across-the-board Improvements in Survival

Four decades ago, Kanti R. Rai, MD, was determined to figure out why some of his patients with chronic lymphocytic leukemia (CLL) died within 2 years after their diagnosis, while others lived for 20 or even 30 years. At the time, Dr. Rai was a young scientist doing research in leukemia at...

prostate cancer

Advances in Prostate Cancer Accompanied by Ongoing Debates

Scientific advances have markedly improved prostate cancer survival, but this clinical success story is not without its share of controversy. From screening through treatment, a growing array of options offer an admixture of promise and confusion for clinicians and patients. Moreover, today’s...

issues in oncology
health-care policy

Maintenance of Certification in Medical Oncology

It is said that time is perhaps the most treasured asset we have. If you are a practicing oncologist, everyone wants more and more of your time, and I’m not referring to patients. Rather, there is an increasing proliferation of folks who want to make sure we’re doing a good job, and they are...

FDA-led Research Team Discovers Autoimmune Mechanism for Drug-induced Adverse Reactions

A team of researchers led by the FDA has discovered a new mechanism for identifying and understanding drug-related autoimmune reactions. In an article available online in the journal AIDS, the team reported that in certain at-risk patients, the anti-HIV drug abacavir (Ziagen) causes the immune...

Full Membership: What It Means, What It Offers, and Why It’s Essential

As part of our series explaining the benefits of ASCO’s various membership categories, in this issue we focus on the Full Membership Category Involvement in ASCO—the largest and most inclusive professional organization in oncology—allows those involved in cancer care to chart the very course of the ...

issues in oncology
survivorship

Cancer Survivors Stand Up, Give Thanks, and Give Back

“I have me back,” is how breast cancer survivor Jeanette Daniel of Memphis described her life after being treated on a clinical trial at Vanderbilt-Ingram Cancer Center in Nashville. Being conducted by the Stand Up To Cancer P13K Dream Team, whose leader discovered the PI3K pathway, the trial...

At More than a Century Old, American Association for Cancer Research Continues to Evolve

Margaret Foti, PhD, MD (hc), has been Chief Executive Officer of the American Association for Cancer Research (AACR) since 1982, and has been instrumental in launching some of the most seminal efforts of the cancer research organization. Over the past 4 years, she has helped spearhead the AACR’s...

breast cancer
multiple myeloma
issues in oncology

Decoding the Genetic Blueprint of Cancer Cells: Findings in Multiple Myeloma and Breast Cancer

Advances in next-generation DNA sequencing technologies are allowing scientists to decipher the whole genome or whole exome (ie, the coding region of the genome) of cancer specimens more quickly and inexpensively than ever before. And the results are revealing genes that had not previously been...

New ASCO President Reflects on Value of Mentorship and Addressing Health-care Disparities

Sandra M. Swain, MD, Medical Director of the Washington Cancer Institute at the MedStar Washington Hospital Center in Washington, DC, and ASCO President for the 2012 to 2013 term, is a leading authority on breast cancer treatment with a global reputation in cutting-edge clinical research. The...

issues in oncology

Medical Ethicists Reflect on Their Personal Cancer Experiences

The recently published book, Malignant: Medical Ethicists Confront Cancer, takes a personal look at the cancer experience from the perspective of seven medical ethicists who were also patients with cancer or cared for spouses with cancer.1 The book’s editor, Rebecca Dresser, JD, MS, who teaches law ...

A Decade of Trusted Cancer Education

May 18 marked the 10th anniversary of Cancer.Net, the patient information website of the American Society of Clinical Oncology (ASCO). This milestone is not only important to the more than 12 million cancer survivors in the United States who have searched for reliable answers to many of the issues...

ASCO’s CancerLinQ: Building a Transformation in Cancer Care

Cancer science and information technology are advancing rapidly, but the way we care for patients today cannot fully capitalize on those advances. The proliferation of scientific results and novel treatments is a growing challenge for all oncology professionals as we enter the era of highly...

breast cancer
global cancer care

Breast Cancer and Noncommunicable Diseases: Where in the World Do We Start?

As the world’s most common cancer among women, and the most likely reason around the globe that a woman will die of cancer, breast cancer affects countries at all economic levels. Despite the common misconception that breast cancer is primarily a problem of high-income countries, the majority of...

Genomics vs Site of Cancer Origin as Basis for Treatment of Cancer Is ‘False Dichotomy’

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. Despite recent news reports...

issues in oncology

Data Liquidity Coalition Takes Shape

A coalition to promote and implement data sharing in cancer by facilitating data ‘liquidity,’ first proposed in February at an Institute of Medicine (IOM) workshop, is taking shape with the formation of a steering committee and action plans that include a demonstration project. For several years,...

A Physician, Who Is Also a Cancer Patient, Talks about Medical Errors

In a whispered but resolute voice, Itzhak Brook, MD, MSc, led off his presentation at the 2012 ASCO Annual Meeting1  by telling the audience his voice is weak because he doesn’t have vocal cords. He spoke with the aid of a tracheoesophageal voice prosthesis. “I have practiced medicine for more than ...

Clinicians to Benefit from New JCO Initiatives

Journal of Clinical Oncology (JCO) has recently launched several new features for readers under the direction of Stephen A. Cannistra, MD, who began his tenure as Editor-in-Chief in June 2011. These initiatives include the creation of two new article types: Rapid Communications (RC) and...

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...

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...

breast cancer

Being Well Informed Helped Me Cope with Breast Cancer

I had been putting off getting a screening mammogram for a few years. When I finally made an appointment in March 2011 and was told that I needed a follow-up sonogram because the test had picked up a suspicious-looking mass in my right breast, I knew I was in trouble. A biopsy of the tumor showed...

supportive care

Getting the Right End-of-life Care: Coming to Terms with the Realities of Advanced Disease and Mortality

“Dying is at once a fact of life and a profound mystery.” That was the opening sentence of a 1997 Institute of Medicine report, Approaching Death: Improving Care at the End of Life, a much-needed jump-start in the national dialogue over identifying the barriers that impede the delivery of...

Genitourinary Cancers Symposium Still Intimate Despite Record Growth

Despite its exponential growth since launching in 2007—from 1,450 attendees then to a record 2,530 last year—the Genitourinary (GU) Cancers Symposium remains an inviting meeting that feels small, accessible, and comfortable. And that’s the perfect blend for networking, said Jeff Michalski, MD,...

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...

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...

breast cancer

Cytotoxic Chemotherapy for Breast Cancer: Are We Done Tweaking It?

While novel targeted agents may grab the headlines in the treatment of breast cancer, oncologists still debate the optimal delivery of conventional cytotoxic chemotherapy, still a vital component of treatment. At the Best of ASCO Boston meeting, Steven J. Isakoff, MD, PhD, of Massachusetts General...

Best of ASCO® Meetings Offer Data, Commentary, and Interaction with the Experts

Three Best of ASCO meetings were held over the summer in Chicago, Boston, and San Diego. The faculty distilled the most interesting and immediately applicable data from the 2012 ASCO Annual Meeting, provided personal perspectives, and interacted with attendees for an educational experience that was ...

American Psychosocial Oncology Society Provides Helpline for Counseling Services

The American Psychosocial Oncology Society (APOS) offers a toll-free national Helpline as a resource to help people with cancer and their caregivers find counseling services in their own communities. Patients with cancer, caregivers, and advocacy organizations may obtain referrals for local...

issues in oncology

Tweeting at ASCO Annual Meetings Can Enhance the Experience

Tweeting at concerts or plays may earn you scornful looks or even stern warnings from ushers, but tweeting at the ASCO Annual Meeting may enhance the meeting experience for you and others. In a study comparing trends in Twitter use by physicians during the 2010 and 2011 ASCO Annual Meetings, some...

supportive care
pain management

SIDEBAR: Don’t Expect Direct Questions from Patients about Pain

Just asking patients “Is there something else you want to address in the visit,” rather than “Is there anything else you want to address in the visit today,” dramatically reduced patients’ unmet concerns during a primary care visit, according to a 2007 study.1 That learning can be applied to...

multiple myeloma

Novel Drug Combinations Present New Hope for Effective Treatments in Multiple Myeloma

Developing early-phase clinical trials that incorporate combinations of novel agents targeting different pathways in the hematologic cancer multiple myeloma is a leading focus of the work of Sagar Lonial, MD, Professor of Hematology and Vice Chair of Clinical Affairs in the Department of Hematology ...

Karnofsky Award Winner Honors Mentors through Gift to Conquer Cancer Foundation

Kanti R. Rai, MD, and his wife Susan have been loyal donors to the Conquer Cancer Foundation for the past 9 years, but in 2012, a momentous occasion in his career inspired Dr. Rai to make a unique gift. A Moment of Reflection In the spring of 2012, Dr. Rai, an internationally recognized expert on ...

issues in oncology

Challenging Times: A Day in the Life of a Community Oncologist

Community oncologists man the front line of cancer care, treating upward of 85% of our nation’s patients. Over the past 2 decades, regulatory and economic changes have left many practices in a state of flux and uncertainty, some struggling to keep their doors open. To shed light on the community...

Nobel Laureate E. Donnall Thomas, MD, Dies at 92

In his 1990 Nobel Prize Lecture, Eduard Donnall Thomas, MD, with characteristic humility, acknowledged that the success he celebrated “was made possible by the work of many others in this and related fields.” Dr. Thomas, whose groundbreaking work in bone marrow transplantation marked a new era in...

breast cancer

Surrounded by Breast Cancer

Nine women on my mother’s side of the family have been diagnosed with breast cancer, and nearly half have died from their disease, including my mother. With odds like these, I was determined to do what I could to stay ahead of this dreaded monster I thought was surely coming for me. First Tests...

The Nuts and Bolts of Getting into an Oncology Fellowship

Oncology continues to be one of the most sought-after specialties. Because of a shortage of oncologists and the accelerating pace of developments in the diagnosis and treatment of cancer, oncology has become an increasingly competitive field. Accreditation Council for Graduate Medical Education...

Delivering Affordable Cancer Care: Is It Possible and What Will It Entail?

Many experts agree that at 18% of gross domestic product, health care (to paraphrase Shakespeare) is eating the country out of house and home. “The average cost of treating the most common cancers has increased, and as more expensive targeted therapies and other new technologies become the...

Options Shifting for First-line Treatment of Renal Cell Carcinoma

Trials with pazopanib (Votrient) have “provided significant efficacy, toxicity, and tolerability data for pazopanib to be established as a first-line standard of care” for renal cell carcinoma,” Tim Eisen, PhD, of the University of Cambridge, United Kingdom, stated at the 11th International Kidney...

MSKCC’s Decision Not to Purchase New Cancer Drug Sparks Editorial and Unprecedented Actions

“At Memorial Sloan-Kettering Cancer Center, we recently made a decision that should have been a no-brainer: we are not going to give a phenomenally expensive new cancer drug to our patients.” That was the opening sentence of a New York Times op-ed piece written by three physicians from Memorial...

solid tumors

I Am Not a Victim

Six years ago, at age 62, I was feeling in great shape. The year before, I had taken over custody of my 2- and 3-year-old great-grandchildren and decided to change the course of my career from motivational speaker to motivational coach to be home more often with the kids. It was during one of our...

solid tumors
prostate cancer

Expert Point of View: Jeffrey Bradley, MD

Commenting on both radiotherapy studies and the use of proton-beam therapy in general, Jeffrey Bradley, MD, of Washington University in St Louis, agreed with both presenters that a randomized prospective trial is needed to justify the use of proton-beam therapy in prostate cancer. Washington...

Surgical Resection for Colorectal Cancer Liver Metastases: Who, When, How?

Many patients with colorectal liver metastases can undergo surgical resection with curative intent. Who are these patients and how are they best managed? In an interview with The ASCO Post, Steven A. Curley, MD, Professor of Surgical Oncology at The University of Texas MD Anderson Cancer Center,...

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