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Showing 1901 - 1950The Future of Health Care in America: Which Corridor?
It was mid-morning, and I was walking along one of the long corridors in our hospital, attending to clinical duties. From a distance, I noticed this elderly couple walking in the opposite direction. As we got closer, it became obvious that the elderly gentleman appeared winded and was looking...
How When Breath Becomes Air Is Helping the Public—and Physicians—Confront Their Mortality
It should not come as a surprise to anyone who has read Dr. Paul Kalanithi’s brilliant—and unforgettable—memoir, When Breath Becomes Air (Random House, 2016), that nearly a year after publication, it remains on The New York Times best-seller list, its popularity only increasing with time. Written...
Making Peace With Cancer
Next to me sounds the buzzing of my Lympha Press machine, which substitutes for the constant visits of the physiotherapist who performs the lymph drainage. This gives me more freedom, and we have more privacy at home. I can use the machine whenever I need it, and my 5-year-old daughter, Christina, ...
A Lung Cancer Specialist Talks About Value in Cancer Care
Over the past few years, the term value-based cancer care has become integrated into the vernacular of the oncology community. Value is a subjective term, which is defined largely by its clinical setting. However, value in cancer care is evaluated by the multiple stakeholders involved in the...
How Video Support Tools Help Patients Make Informed Decisions About End-of-Life Care
A relatively recent study by Areej El-Jawahri, MD, and her colleagues is showing how the use of visual media can empower patients with advanced cancer, as well as other life-threatening illnesses, to make more informed decisions about their end-of-life care.1 The aim of Dr. El-Jawahri’s study was ...
Anti–PD-1 Contenders in Advanced Urothelial Cancer
Immunotherapy with anti–PD-1 (programmed cell death protein 1) and anti–PD-L1 (programmed cell death ligand 1) agents continues to advance in metastatic urothelial cancer, with positive showings in two clinical trials presented at the 2016 European Society for Medical Oncology (ESMO) Congress. The...
Clinical Strategies for Improving Endocrine Therapy in Metastatic Breast Cancer
Most women with hormone receptor–positive breast cancer receive endocrine therapy as part of their treatment, but “the reality is that patients who receive antihormone therapy in the metastatic disease setting ultimately develop disease progression, ” William J. Gradishar, MD, stated at the 18th...
Encouraging First Study of Pembrolizumab in Cutaneous T-Cell Lymphoma
Immunotherapy with an anti–programmed cell death protein 1 (PD-1) inhibitor—pembrolizumab (Keytruda)—showed encouraging responses in patients with advanced cutaneous T-cell lymphoma (either mycosis fungoides or Sézary syndrome). Pembrolizumab achieved a 38% overall response rate and responses...
Research Highlights From the 2016 Palliative Care in Oncology Symposium
More than 650 attendees gathered in San Francisco on September 9 and 10 for the 2016 Palliative Care in Oncology Symposium, focusing on the theme of “Patient-Centered Care Across the Cancer Continuum.” Research presented during the Symposium demonstrated how integrating palliative care into cancer...
The Emergence of Philanthropy to Fund High-Risk, High-Reward Cancer Research
Earlier this year, Sean Parker, the cofounder of the music streaming service Napster and an early president of Facebook, joined a growing list of entrepreneurs who are committing large portions of their wealth to funding cancer research. In April, Mr. Parker announced he was donating $250 million...
Memorial Sloan Kettering Long Island Branch Expands Site, Services
The Commack, Long Island–based hospital of Memorial Sloan Kettering (MSK) Cancer Center was opened in 2002, providing personalized cancer care closer to home for individuals living on eastern Long Island. Now, more than 14 years later, MSK is reinforcing its commitment to the local community in...
Recent Progress and Concepts in Pancreatic Cancer
November is National Pancreatic Cancer Awareness Month, the impetus for this article. Pancreatic cancer is a huge health challenge. It's the eighth most common cancer in the United States and the fourth most common cause of cancer deaths but is expected to become the second most common cause of...
Another Step Forward for Genomic Assays in Early-Stage Breast Cancer: Findings With MammaPrint in the MINDACT Trial
Genomic assays have had a powerful influence on the management of early-stage breast cancer, particularly estrogen receptor–positive tumors. The mainstay of adjuvant treatment for early-stage, hormone receptor–positive breast cancer has been endocrine therapy, either with tamoxifen and an...
ASCO’s TAPUR Study Has More Than 100 Participants Receiving Treatment Drugs and 25 New Clinical Trial Sites
More than 100 participants are now enrolled on study drug in ASCO’s Targeted Agent and Profiling Utilization Registry (TAPUR) Study. The trial launched in March 2016 at 37 sites, and in November, it welcomed its newest participating clinical sites: Cancer Treatment Centers of America,...
Living With Metastatic Breast Cancer Is Like Walking a Tightrope
I’ve always had fibrocystic breasts and was steadfast in performing monthly breast self-exams, so I could become familiar with the terrain of my breasts and spot any subtle changes. So, in November 2002, when I felt something in my left breast that seemed different from my usual lumps, I made a...
The Smartest Guys in the Room
The smartest guys in the room were never from the big energy companies, and they’re not running hedge funds on Wall Street or building the next Facebook. For me, the smartest guys in the room are the selfless men and women who’ve transformed cancer from what was all too often a death sentence to...
Resuscitation During Surgery
During the 1890s, aseptic principles were extended only to the operative area of the patient, not the surgeon, although some surgeons did advocate the use of special white or colored uniforms, and hand washing had already been established. In 1895, just 7 years after Arpad Gerster, MD, published...
Talking to Children With Cancer: Sometimes Less Is More
I still remember the day I met Kensie. It was Valentine’s Day. I had sneaked out of the hospital to get my wife a Valentine’s Day card, taking my place among scores of other husbands and boyfriends in front of the rapidly emptying rack of cards. As I started browsing, my beeper sounded. It was the ...
Diagnosing and Managing Chemotherapy-Induced Peripheral Neuropathy
Chemotherapy-induced peripheral neuropathy is a common side effect of cancer treatment—the incidence is reported to be as high as 70% in the first month of chemotherapy1—and can cause significant disability in patients. The extent of the neurotoxicity incurred by patients varies depending on the...
Forging Collaboration Between Children’s and Adult Oncology Groups in Designing Trials for Adolescents and Young Adults
Nonrhabdomyosarcoma soft-tissue sarcomas account for about 5% of all childhood malignancies and are also diagnosed in adolescents and young adults, as well as in older adults, and can require different approaches to treatment based on a patient’s age and stage of disease. These sarcomas comprise...
As More Biosimilars Move Toward U.S. Market, Questions Remain About Cost Savings and Uptake by Physicians and Patients
The U.S. Food and Drug Administration (FDA) approved its first biosimilar drug, filgrastim-sndz (Zarxio), in 2015, allowing it to compete with the granulocyte colony-stimulating factor filgrastim (Neupogen) to treat neutropenia in chemotherapy patients. So far, filgrastim-sndz is the only...
Study Looks for Optimal Dosing of Single-Agent Ipilimumab in Metastatic Melanoma
There has been debate as to the optimal dose of single-agent ipilimumab (Yervoy) in metastatic melanoma. A phase III study presented at the 2016 European Society for Medical Oncology (ESMO) Congress—the first to directly compare these doses—concluded that 10 mg/kg is more effective, but also more...
Is Observation Without Surgery a Viable Strategy for Managing Ductal Carcinoma in Situ?
In a spirited debate, abounding with citations of clinical trials and other evidence, but not without humor and mutual respect, E. Shelley Hwang, MD, MPH, and Armando E. Giuliano, MD, reviewed the data and their clinical experience managing ductal carcinoma in situ and reached opposite...
Introduction
As expensive cancer biologics move off patent, biosimilar products are coming on board. These are highly similar versions of licensed biologics that demonstrate near-fingerprint identity to their reference products in terms of structure and potency. Biosimilars represent a major opportunity for...
Putting Patients First: My Journey in Advocacy
When I lost my only sister to breast cancer in 1986, patients like her had devastatingly few choices. Over the intervening decades, sustained commitment to biomedical research at the National Institutes of Health (NIH) and major technologic advances have led to transformative changes in cancer...
My Catch-22 Predicament
In the spring of 2011, I was feeling so fatigued I needed to rest after walking just a few steps to the kitchen and not doing anything more strenuous than making a cup of coffee. Fortunately, I have a wonderful primary care physician who takes me seriously when I have a complaint about my health,...
A Cancer Diagnosis Brings Two Sisters Back Together
Elizabeth Lesser is an award-winning writer and co-founder of the Omega Institute, the largest adult education center in the United States focusing on health, wellness, spirituality, and creativity. She is the author of several acclaimed books including Broken Open: How Difficult Times Can Help...
Quality Improvement Project Results in Timelier Hospice Referrals
A quality improvement project conducted within the OhioHealth system showed that oncologists can change their behavior and refer patients earlier to hospice care. After a relatively minor intervention, 18 medical oncologists in private practice doubled the mean length of stay in hospice care for...
Dexamethasone Mouth Rinse Should Be Routine Part of Everolimus Treatment
Dexamethasone mouth rinse should be given prophylactically to prevent stomatitis associated with everolimus (Afinitor)/exemestane in metastatic breast cancer, according to Hope S. Rugo, MD, principal investigator of the SWISH trial and Director of Breast Oncology and Clinical Trials Education at...
New NCCN Patient Resources Assist Decision-Making for Patients With Stomach Cancer
According to the American Cancer Society, it is estimated that more than 26,000 people will be diagnosed with stomach cancer in the United States this year, with nearly 1 million new cases diagnosed worldwide each year, according to the World Health Organization. Because there are no early symptoms ...
Using Pharmacogenetics to Predict Cancer Prognosis, Response to Treatment, and Toxicity
Although clinical trials are helpful in determining the effectiveness of a specific drug across a patient population, they are not as reliable at pinpointing how well a particular patient will respond to the drug or dosing regimen or how the drug may impact the patient’s quality of life from...
Rise in Oropharyngeal Cancer Incidence in the UK Not Solely Driven by HPV
The rise in the incidence of oropharyngeal squamous cell carcinoma in the United Kingdom from 2002 to 2011 was not solely attributable to a rise in the incidence of human papillomavirus (HPV)-positive disease, according to a study published in Cancer Research,1 which reported that the proportion of ...
When Breath Becomes Air: Dr. Lucy Kalanithi Reflects on Dr. Paul Kalanithi’s Life and Writing
Perhaps more than any other book in recent memory, When Breath Becomes Air has struck a chord among readers, both inside the medical community and among the public, desiring an honest and philosophical consideration of death. The autobiographical account of Paul Kalanithi, MD, a physician diagnosed ...
What We Know and What We Need to Know About Neoadjuvant Chemotherapy in Advanced Ovarian Cancer
Ever since the landmark studies of Griffiths and colleagues in the 1970s,1 primary cytoreductive surgery followed by chemotherapy with the objective of achieving minimal residual disease has been the standard approach for women with advanced-stage epithelial ovarian cancer. However, what is...
Expert Point of View: Olivier Michielin, MS, MD, PhD
The paper’s invited discussant was Olivier Michielin, MS, MD, PhD, Head of Personalized Analytical Oncology and the Melanoma Clinic at Lausanne University Hospital in Switzerland. He called the findings of the European Organisation for Research and Treatment (EORTC) 18071 trial a “new landmark in...
With Changing Strategies for Laryngeal Cancer, Multidisciplinary Team Approach Is Key
The treatment of cancer of the larynx has changed dramatically in recent years. With organ preservation now possible in many cases, it is more important than ever for patients to receive guidance from every corner of the field. In a recent article in the Journal of Oncology Practice (JOP),1 a...
Consensus on Defining and Measuring Lymphedema Is Needed to Advance Efforts to Intervene Early and Prevent Progression
“Early intervention might prevent lymphedema progression,” Alphonse Taghian, MD, PhD, said at the 18th Annual Lynn Sage Breast Cancer Symposium in Chicago, but the lack of a universal definition of lymphedema and agreement on how to optimally measure it impedes phase III studies to test that...
ESMO 2016: Clinical Benefit Demonstrated With Everolimus and Pasireotide LAR Alone or in Combination in Advanced Lung and Thymic Carcinoids
In patients with advanced lung or thymus carcinoid receiving everolimus, pasireotide LAR, or the combination of the two drugs, statistically significant positive impact was seen on proportion of patients’ progression-free rate at 9 months (primary endpoint) in all three arms, more relevant in ...
Stereotactic Radiosurgery Achieves Better Quality of Life and Improved Cognition Than Whole-Brain Radiotherapy
Two separate randomized trials presented at the 58th Annual Meeting of the American Society of Radiation Oncology (ASTRO) affirmed the value of stereotactic radiosurgery as an option for postoperative treatment of the surgical cavity of resected brain metastases, potentially avoiding the cognitive...
Study Shows Strong Evidence Supporting Radiation Boost to Tumor Bed in Ductal Carcinoma in Situ
A radiation boost to the local tumor bed following treatment with breast-conserving therapy (ie, local excision followed by whole-breast radiation therapy) improves local control for patients with ductal carcinoma in situ, according to a study of pooled data from 10 academic centers,1 presented at...
Combination of Ribociclib and Letrozole Improved Progression-Free Survival in Hormone Receptor–Positive Advanced Breast Cancer
The combination of the selective CDK4/6 inhibitor ribociclib plus letrozole significantly improved progression-free survival in hormone receptor–positive advanced breast cancer. When ribociclib was added to letrozole, progression-free survival improved by 44% compared with letrozole alone,...
ESMO 2016: Niraparib Significantly Improves Outcomes in Platinum-Sensitive Recurrent Ovarian Cancer
The PARP inhibitor niraparib significantly improves the outcome of platinum-sensitive recurrent ovarian cancer, according to full data from the ENGOT-OV16/NOVA trial presented by Mirza et al at the 2016 European Society for Medical Oncology (ESMO) Congress in Copenhagen (Abstract LBA3_PR), and...
A Space to Heal
We pass them every day on our way to the hospital, the street dwellers of our town in India. Their home consists of a plastic sheet suspended between four poles on the pavement. One day, two women sat under the plastic sheet in happy conversation. It had rained heavily the previous night, and I...
Friendship
Mr. C is almost 90 now, but every summer the boxes of squash, pumpkins, tomatoes, and other vegetables from his truck farm still arrive like clockwork at our door. The cancer that required treatment 17 years ago has never recurred. He’s now struggling with a new problem, recovering from a broken...
Are You Ready for MACRA? ASCO Offers Educational Resources and Events to Help Practices Prepare
There are only a few months to go before program changes go into effect under the Medicare Access and CHIP Reauthorization Act (MACRA) on January 1, 2017. MACRA was enacted more than a year ago to replace the Sustainable Growth Rate formula for updates to the Medicare physician fee schedule, and it ...
Why Curing Cancer Will Take Decades
This past summer, Eric S. Lander, PhD, President of the Broad Institute of the Massachusetts Institute of Technology and Harvard in Cambridge, Massachusetts, and Co-Chair of the President’s Council of Advisors on Science and Technology, raised a few eyebrows at the Aspen Ideas Festival when he...
Blood Biomarkers in Abiraterone- or Enzalutamide-Resistant Prostate Cancer Tumor Cells
While searching for a noninvasive way to detect prostate cancer cells circulating in blood, Duke Cancer Institute researchers have identified some blood markers associated with tumor resistance to two common hormone therapies. In a study published by Gupta et al in Clinical Cancer Research, a team...
Nobel Laureate Roger Y. Tsien, PhD, Dies
In 2008, Roger Y. Tsien, PhD, shared the Nobel Prize in chemistry with Drs. Osamu Shimomura and Martin Chalfie for helping turn green fluorescent protein from a jellyfish into a research tool that could tag cancer cells or track the advance of Alzheimer’s disease. “Our work is often described as...
Pioneer in Chemoradiation Robert B. Livingston, MD, Dies
Over the past couple of decades, chemoradiation for several cancers, such as lung and breast, has advanced in efficacy and side-effect tolerance, prolonging survival and quality of life for patients. One of the pioneers in chemoradiation, Robert B. Livingston, MD, died on September 8, 2016. Dr....
Breaking the ‘Conspiracy of Silence’
A new study1 showing that just 1 in 20 terminally ill patients with cancer has sufficient understanding about the prognosis or purpose of treatment is highlighting the need for improvements in both the way oncologists communicate prognosis with their patients and in the development of educational...
