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cost of care

Discussing Financial Toxicity With Patients Who Have Cancer

Patient: “Doc, how much are these drugs going to cost me?” Physician: “They are expensive, and you can see our financial counselor to help you understand the costs.”   Cancer care is not a black-and-white endeavor, and costs are considered a distasteful subject to be passed over in tactful silence. ...

Expert Point of View: Cora N. Sternberg, MD, FACP

Cora N. Sternberg, MD, FACP, Chief of Medical Oncology at San Camillo Forlanini Hospital in Rome, Italy, formally discussed CheckMate 025 at the Presidential Session of the 2015 European Cancer Congress as well as findings from the METEOR trial of cabozantinib (Cometriq) in metastatic renal cell...

skin cancer

FDA Approves First Oncolytic Viral Therapy in the United States

The U.S. Food and Drug Administration (FDA) has approved the biologics license application for talimogene laherparepvec (Imlygic), a genetically modified oncolytic viral therapy indicated for the local treatment of unresectable cutaneous, subcutaneous, and nodal lesions in patients with melanoma...

ASH Honors Aaron J. Marcus, MD, Posthumously With Award for Lifetime Achievement in Hematology

The American Society of Hematology (ASH) will recognize the late Aaron J. Marcus, MD, of Weill Cornell Medical College and the Veterans Affairs New York Harbor Healthcare System with the 2015 Wallace H. Coulter Award for Lifetime Achievement in Hematology. Dr. Marcus, who passed away in May 2015,...

breast cancer

Tamoxifen Use and Access to Fertility-Preservation Options Among Premenopausal Women With Breast Cancer

A multivariable analysis of clinical factors associated with tamoxifen use among premenopausal women with hormone receptor–positive breast cancer showed that fertility preservation was a significant factor and “the only predictor of both noninitiation and early cessation” of tamoxifen. “Among...

gynecologic cancers

ASCO-Endorsed ASTRO Guidelines: Searching for Consensus on Radiotherapy for Endometrial Cancer

Endometrial cancer is the most common gynecologic cancer, but there has been little consensus about the appropriate indications for adjuvant therapy. One reason for the lack of consensus is the absence of randomized studies in endometrial cancer that report an overall survival benefit. This may be...

gynecologic cancers

ASCO Endorses ASTRO Guideline on Postoperative Radiation Therapy for Endometrial Cancer

As reported in the Journal of Clinical Oncology by Larissa A. Meyer, MD, MPH, and colleagues, ASCO has endorsed the recently published American Society for Radiation Oncology (ASTRO) guideline on postoperative radiation therapy for endometrial cancer.1 The ASCO clinical practice guideline...

Patient Guides Available Through ASCO University Bookstore

ASCO Answers: Managing the Cost of Cancer Care explains the various costs associated with cancer treatment, including health-care coverage through the Affordable Care Act. It also provides a list of financial resources available to help offset expenses related to care and tips for organizing...

Equanimity

The following essay by S. Vincent Rajkumar, 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. It was...

NCI Names Thomas Kensler, PhD, Outstanding Investigator

Thomas Kensler, PhD, Professor of Pharmacology and Chemical Biology and Co-Leader for the Cancer Epidemiology and Prevention Program at the University of Pittsburgh Cancer Institute (UPCI), was awarded a $6.3 million Outstanding Investigator Award from the National Cancer Institute (NCI). This new...

lymphoma

Answers: Primary Diffuse Large B-Cell Lymphoma of the Central Nervous System

Question 1: What is next best step in the management of this patient? Correct Answer: C. Ophthalmoscopy/slit lamp examination. Expert Perspective Ophthalmic involvement should be sought by noninvasive procedures such as slit lamp examination and ophthalmoscopy and abnormal findings must be...

2015 Oncology Meetings

NOVEMBER Best of ASTRONovember 13-14 • San Diego, California For more information: www.astro.org/Meetings-and-Events/2015-Best-of-ASTRO/Index.aspx 2015 Oncologic Emergency Medicine Conference November 13-14 • Houston, Texas For more information:...

A Chemist Exposes Dangerous Chemicals

Bookmark Title: Pick Your Poison: How Our Mad Dash to Chemical Utopia Is Making Lab Rats of Us All Author:  Monona Rossol Publisher: John Wiley & Sons Publication date: October 2015 Price: E-book, 210 pages Monona Rossol is a chemist and “industrial hygienist” who is a frequent contributor to...

A Pandemic’s Story of Tragedy and Success

Bookmark Title: AIDS Between Science and Politics Author:  Peter Piot Publisher: Columbia University Press Publication date: May 2015 Price: $29.95; hardcover, 216 pages AIDS is a global phenomenon that recognizes neither national boundaries nor social strata. The AIDS pandemic was one of the...

New Study Indicates Key Differences Between Trial Enrollees and Patients Receiving Treatments

A new article published in the Journal of Oncology Practice evaluates differences between the treatment of patients with metastatic renal cell cancer who participated in clinical trials vs those who received the same therapy in routine clinical practice. Nearly 40% of patients in the real-world...

symptom management

Management of Aromatase Inhibitor–Induced Musculoskeletal Symptoms: A Physiatric Approach

Aromatase inhibitors have demonstrated efficacy in reducing the risk of breast cancer recurrence in hormone receptor–positive patients, but medication compliance can be limited by uncomfortable side effects, including musculoskeletal pain and dysfunction. Musculoskeletal symptoms have been reported ...

geriatric oncology

Geriatric Oncology in Europe: A Commitment to Improving Cancer Care for Older Patients

In Europe, the field of geriatric oncology has a long history of development, and its organization and implementation continue to improve every day. This would not have happened without the strong commitment of national authorities to health policies, a critical success factor. Four Missions In...

skin cancer

Why Melanoma Rates Are Increasing in Adolescents and Young Adults, Especially Among Females

The incidence of melanoma among children, adolescents, and young adults has reached epidemic proportions, increasing more than 250% over the past 4 decades, with young females at highest risk for the deadly cancer, according to a study1 by researchers at Roswell Park Cancer Institute in Buffalo,...

breast cancer

Survival and Bevacizumab in Early Breast Cancer: Time to Reconsider?

In metastatic HER2-negative breast cancer, several trials have shown that the addition of the anti–vascular endothelial growth factor (VEGF) monoclonal antibody bevacizumab (Avastin) to different chemotherapy regimens significantly improved response rates and progression-free survival by various...

breast cancer

Improved Overall Survival With Neoadjuvant Plus Adjuvant Bevacizumab in Early HER2-Negative Breast Cancer

The phase III National Surgical Adjuvant Breast and Bowel Project (NSABP) B-40 (NRG Oncology) trial showed that the addition of bevacizumab (Avastin) to docetaxel + anthracycline-based neoadjuvant chemotherapy improved pathologic complete response rate, the primary endpoint, in patients with early...

solid tumors
lymphoma

ASCO Recommendations for Use of White Blood Cell Growth Factors: What Remains the Same and What Has Been Modified

Neutropenic complications remain the main dose-limiting toxicity of cancer chemotherapy treatment and are associated with considerable morbidity, mortality, and costs.1 Although patients who have experienced a prior neutropenic event are at increased risk of subsequent events, several studies have...

lymphoma
solid tumors

ASCO Clinical Practice Guideline Update: Recommendations for the Use of White Blood Cell Growth Factors

ASCO has issued a clinical practice guideline update on use of hematopoietic colony-stimulating factors, as reported in the Journal of Clinical Oncology by Thomas J. Smith, MD, FACP, FASCO, FAAHMP, and colleagues.1 This update to the ASCO 2006 guideline was based on a systematic review of...

NCCN Unveils Graphic Evidence Blocks to Guide Decision-Making

Treatment decision-making for oncologists and their patients may become simpler through the use of graphic NCCN Evidence Blocks™, which were unveiled at the NCCN 10th Annual Congress: Hematologic Malignancies™ sponsored by the National Comprehensive Cancer Network® (NCCN¨). The first of the NCCN...

issues in oncology

Study Finds Quality of Physician Recommendation to Parents Key to Encourage/Discourage HPV Vaccination of Adolescents

A nationwide online survey of 776 pediatricians and family physicians assessing the quality of their human papillomavirus (HPV) vaccine recommendations to parents has found that approximately 27% of respondents said they do not strongly endorse HPV vaccination; further, 26% and 39% of respondents...

Expert Point of View: William J. Gradishar, MD, FASCO

Discussant of the Neoadjuvant Breast Symphony Trial data, William J. Gradishar, MD, FASCO, Betsy Bramsen Professor of Breast Oncology at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University in Chicago, underscored the importance of identifying patients in a more precise and...

lung cancer

Antibody-Drug Conjugate Makes Strong Showing in Small Cell Lung Cancer

The antibody-drug conjugate rovalpituzumab tesirine has shown strong clinical activity as second- and third-line treatment for small cell lung cancer in a phase I/Ib multicenter study,1 especially in the subset with high expression of the delta-like protein 3 (DLL3), which the drug targets. This...

Expert Point of View: Martin Reck, MD, PhD

Martin Reck, MD, PhD, Head of the Department of Thoracic Oncology at the Lung Clinic Grosshansdorf in Germany, discussed the study at the Presidential Session, calling it “very important work.” This study shows that, with more sensitive assays, T790M mutations are much more frequent than previously ...

lung cancer

Combined EGFR and VEGF Inhibition Ameliorates the Impact of  the EGFR T790M Mutation in NSCLC

Treatment with erlotinib and bevacizumab (Avastin) may help overcome the poor prognosis associated with T790M mutations present at diagnosis in advanced non–small cell lung cancer (NSCLC), according to the results of the phase II BELIEF trial.1 At the 2015 European Cancer Congress, Rolf A. Stahel,...

Expert Point of View: Fabrice André, MD, PhD, and Peter Naredi, MD, PhD

In discussing the findings of this study on genetic sequencing of breast cancer tissue, Fabrice André, MD, PhD, of the Gustave Roussy Institute, in Villejuif, France, questioned whether all the genes that were found to be enriched in the relapsed samples were driving the relapse and whether any...

breast cancer

Primary vs Metastatic Breast Cancer: The Genetic Landscape Varies

Breast tumors that recur appear to have a different genetic profile than those that do not, and they often demonstrate targetable mutations, according to the largest study of genetic sequencing of breast cancer tissue to date.1 This finding was presented at the 2015 European Cancer Congress. “We...

solid tumors
bladder cancer
skin cancer

PD-1/PD-L1 Inhibitors Show Promise in Additional Tumor Types

While inhibitors of programmed cell death protein 1 (PD-1) or its ligand (PD-L1) are becoming established in melanoma, non–small cell lung cancer, and renal cell carcinoma, their efficacy is also being evaluated in numerous other tumor types, with promising results, according to studies presented...

Expert Point of View: Bertrand Tombal, MD, PhD

We have made major progress by moving docetaxel forward, and now the largest pool of patients who become hormone resistant have received local therapy and then progressed. We have a lot of drugs for castration-resistant prostate cancer, and we are studying them earlier in the course of disease, but ...

prostate cancer

Update on Clinical Trials in Metastatic Prostate Cancer

Despite the proliferation of new drugs to treat prostate cancer, further progress is proving somewhat elusive, according to three trials presented at the 2015 European Cancer Congress. One study had positive results with orteronel maintenance therapy in patients with metastatic castration-resistant ...

Expert Point of View: Ronald de Wit, MD, PhD

Ronald de Wit, MD, PhD, of Erasmus Medical Center, Rotterdam, Netherlands, called the use of docetaxel in addition to androgen-deprivation therapy “the latest paradigm shift” in the treatment of prostate cancer. The data showing a 10% absolute improvement in survival in the metastatic setting “are...

prostate cancer

Meta-analysis Evaluates Benefit of Docetaxel and Bisphosphonates in Hormone-Sensitive Prostate Cancer

The results of a meta-analysis conducted in the United Kingdom may guide clinicians in the use of docetaxel and bisphosphonates in patients with hormone-sensitive prostate cancer.1 Claire L. Vale, PhD, Senior Research Scientist at the Medical Research Council Clinical Trials Unit at University...

cns cancers

Cooperative Group Study Finds Radiation May Benefit Patients With Atypical Meningiomas

Management of the vast majority of meningiomas is straightforward, but treatment of atypical meningiomas has been controversial. Should radiation be part of therapy or not has been the question. The first analysis of Radiation Therapy Oncology Group (RTOG) 0539 suggested that patients will have...

issues in oncology
legislation

Debate Over Physician-Assisted Suicide Continues, State by State

In 1997, after surviving a storm of high-court legal challenges, Oregon’s Death With Dignity Act went into effect, making Oregon the first American state to legalize physician-assisted suicide. The Supreme Court ruled that there was no right to assisted suicide in the Constitution but implied that...

issues in oncology

Is Health Care in the United States a Basic Human Right or an Entitlement?

Mercy Killers is a one-man show that details the consequences of a medical health-care catastrophe (breast cancer) in a family.1 This disturbing fictional account is actually a daily event in cancer centers: losing insurance for technicalities, losing a home because of an inability to pay the...

Expert Point of View: Brian D. Kavanagh, MD, MPH, FASTRO

At a press conference held during the ASTRO Annual Meeting, ASTRO President-Elect Brian D. Kavanagh, MD, MPH, FASTRO, interim Chair of Radiation Oncology at the University of Colorado, Anschutz Medical Campus, Denver, said, “This study provides an important lesson for the field. We are lucky to...

lung cancer

Intensity-Modulated Radiotherapy Gains Ground for Treatment of Stage III Non–Small Cell Lung Cancer

Intensity-modulated radiation therapy appears to be preferable to three-dimensional (3D) conformal radiation therapy as part of treatment for patients with locally advanced (stage III) non–small cell lung cancer (NSCLC). Compared with 3D conformal radiotherapy, intensity-modulated radiotherapy...

hematologic malignancies

William Dameshek, MD, Helped Take Hematology From a Minor Medical Discipline to a Major Scientific Field

Although William Dameshek, MD, is renowned for his work in hematology, especially in advancing the understanding of myeloproliferative disorders and their interrelatedness, his early interest in medicine was instead focused on such diverse diseases as hyperthyroidism and typhus fever. Born on May...

issues in oncology

Increased Lifetime Risk of Developing Cancer in Patients With HIV

The effectiveness of antiretroviral therapy has enabled patients with HIV to live long enough to have high lifetime risks for several types of cancer. The finding has important clinical implications for cancer screening, as well as primary prevention, according to the results of a study funded by...

issues in oncology

Falls Experienced by Older Patients Are Often Not Recorded or Responded to by Oncology Providers

A study comparing self-reported falls by older patients with cancer with the history and physical and/or clinic notes completed by their oncology providers “found that oncology providers rarely recorded or responded to falls in their older patients.” There was minimal evidence of documentation of...

prostate cancer
palliative care

Aggressive End-of-Life Care More Frequent Among Black Men With End-Stage Prostate Cancer

A study to examine end-of-life care among black and white patients dying of prostate cancer found that “significant racial disparities in end-of-life care” do exist. “Although diagnostic and therapeutic interventions are less frequent in black patients with end-stage prostate cancer, the rate of...

Expect Questions About Updated Breast Cancer Screening Guidelines

As Chair of the American Cancer Society (ACS) panel that issued an updated guideline for breast cancer screening, Kevin C. Oeffinger, MD, has answered questions and offered perspective on the updated guideline and its development for The New York Times, USA Today, and other major media outlets. As...

breast cancer
issues in oncology

Updated ACS Breast Cancer Screening Guideline Recognizes Greater Role for Individual’s Values and Preferences

The reactions to the updated breast cancer screening guideline from the American Cancer Society (ACS) have been many, varied, and not consistently favorable but not surprising to Kevin C. Oeffinger, MD, who chaired the ACS panel that issued the guideline. Breast cancer screening “is an area that...

2015 Oncology Meetings

DECEMBER Markers in Cancer 2015December 1-2 • Brussels, Belgium For more information: http://markersincancer.org 9th European Colorectal Congress (ECC)December 1-4 • St.Gallen, Switzerland For more information: www.colorectalsurgery.eu Advances in Cancer ImmunotherapyTMDecember 4 • New Orleans,...

ASH Selects Medical Students and Residents for HONORS Award

The American Society of Hematology (ASH) has announced the names of 18 medical students and 10 residents selected to receive a 2015 ASH HONORS Award. The ASH HONORS Award aims to support hematology research projects for North American medical students and residents who are interested in hematology...

Patient Guides Available Through ASCO University Bookstore

ASCO Answers: Managing the Cost of Cancer Care explains the various costs associated with cancer treatment, including health-care coverage through the Affordable Care Act. It also provides a list of financial resources available to help offset expenses related to care and tips for organizing...

multiple myeloma

CAR T-Cell Immunotherapy Saved My Life

I have always prided myself on being healthy and fit, so when I started experiencing a chronic cough, difficulty breathing, and pain in my ribs and back, I thought they were the inevitable symptoms of a severe cold. At 42 and the mother of three children, it was inconceivable to me that I could...

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