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palliative care

Recognizing Physical Signs Associated With Impending Death Can Assist Clinicians, Patients, and Caregivers With Complex Decisions

In a recently published study of patients with advanced cancer whose status was systematically documented twice a day, from the time of admission to a palliative care unit until death or discharge, investigators identified eight physical signs associated with death within 3 days. Taken together...

cns cancers

Having Cancer So Early in Life Gave Me Purpose

I had every classic brain tumor symptom in the book—severe headaches, dizziness, morning nausea—which plagued me for 16 years, starting when I was 8. In college, if I allowed myself to sleep more than 4 hours a night, the morning headaches, which were centered on the top of my head, were so severe, ...

head and neck cancer

The Center of Who We Are

The following essay by Eric M. Genden, 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.   There’s...

Harold Varmus, MD, Steps Down as NCI Director, Douglas Lowy, MD, Named Acting Director

Harold Varmus, MD, who has led the National Cancer Institute (NCI) at the National Institutes of Health (NIH) for nearly 5 years, has announced that he will step down from his post, effective March 31, 2015. “It has been our great fortune to have Dr. Varmus at the helm of the NCI,” said NIH...

breast cancer

Dr. Halsted’s Breast Amputation Specimens, Johns Hopkins Hospital, 1894

A Century of Progress The text and photographs on these pages represent the establishment of oncology as a viable medical specialty during the late 1800s and showcase the early medical advances and treatments in cancer. The images and captions are excerpted from a four-volume series of books titled ...

survivorship
breast cancer

Mobile Patient-Centered App Tracks Breast Cancer Survivors’ Experiences

Patricia Ganz, MD, Director of Cancer Prevention and Control Research at the Jonsson Cancer Center of UCLA, and collaborators Apple and Sage Bionetworks, recently announced the launch of “Share the Journey: Mind, Body and Wellness after Breast Cancer,” a patient-centered mobile application (app)...

issues in oncology

Study Finds Websites That Market Personalized Cancer Care Services Overemphasize Benefits

A recent analysis of 55 Internet websites marketing a broad range of tests and services that promise the ability to personalize cancer treatment has found that the websites often overemphasize their purported benefits and downplay their limitations. In addition, the study results show that the...

integrative oncology

Herbal Supplements: Increasing Problems

In Don Quixote, the 1605 Spanish literary masterpiece by Miguel Cervantes, “Balsam of Fierabras” is mentioned often as a therapeutic panacea. It calls for mixing rosemary, wine, oil, and salt. As the story goes, the knight relied heavily on this herbal preparation to relieve him of pain from the...

gastroesophageal cancer

Clinical Trials Actively Recruiting Patients With Esophageal Cancer

The information contained in this Clinical Trials Resource Guide includes actively recruiting observational, interventional, phase I, phase II, and phase III clinical studies for patients with newly diagnosed or recurrent esophageal cancer. All of the studies are listed on the National Institutes...

breast cancer

Wrestling With the Challenges of Breast Cancer

Bookmark Title: Then Came Life: Living With Courage, Spirit, and Gratitude After Breast CancerAuthor: Geralyn LucasPublisher: Gotham BooksPublication date: October 2, 2014Price: $19.89; hardcover, 240 pages Over the past decade or so, the oncology community has increased its understanding and...

health-care policy
cost of care

Medicine Turned Upside Down

BookmarkTitle: The Patient Will See You Now: The Future of Medicine Is in Your HandsAuthor: Eric Topol, MDPublisher: Basic BooksPublication date: January 2015Price: $28.99; hardcover, 384 pagesMost books about health care center on fixing broken parts of the massive $3 trillion system, as seen with ...

Silvia C. Formenti, MD, Appointed Chair of Radiation Oncology at Weill Cornell and Radiation Oncologist-in-Chief at New York-Presbyterian/Weill Cornell

Silvia C. Formenti, MD, has been appointed Chair of the newly established Department of Radiation Oncology at Weill Cornell Medical College and Radiation Oncologist-in-Chief at NewYork-Presbyterian/Weill Cornell Medical Center, effective April 15. Dr. Formenti, currently the Chair of Radiation...

lymphoma

New Partnership Launches to Empower People Diagnosed With Lymphoma

The Leukemia & Lymphoma Society (LLS), together with the Lymphoma Research Foundation (LRF), CancerCare, the Association of Community Cancer Centers (ACCC), and Genentech announced the launch of a new partnership, the Alliance for Resource Collaboration in Hematology (ARCH). ARCH was developed...

Seattle Children’s Names Jeff Sperring, MD, New Chief Executive Officer

Seattle Children’s Hospital announced that the Board of Trustees has named Jeff Sperring, MD, Chief Executive Officer, effective early in May. Dr. Sperring, who currently serves as President and Chief Executive Officer of Riley Hospital for Children at Indiana University Health, will continue to...

multiple myeloma

Five Questions Can Guide the Treatment of Relapsed Myeloma

Joseph Mikhael, MD, MEd, myeloma expert at the Mayo Clinic in Arizona, Scottsdale, and Associate Dean of the Mayo School of Graduate Medical Education, considers five questions when selecting treatment for patients with multiple myeloma who relapse. “With prolonged survival, which approaches 10...

issues in oncology

Avoiding Burnout and Maintaining Well-Being While Caring for Seriously Ill Patients

A variety of studies, including one published this past year in the Journal of Clinical Oncology,1 have showed that clinicians who care for seriously ill patients are at high risk for diminished personal well-being, including high rates of burnout; moral distress, defined as the inability to act in ...

ASCO Expresses Concern Over New Oncology Care Model

While commending the Centers for Medicare & Medicaid Services (CMS) for seeking new approaches to physician payment, ASCO expressed concerns over the model’s limited scope. “We are disappointed [CMS has] chosen to pursue only one model—and one that continues to rely on a broken fee-for-service...

health-care policy

New Oncology Care Model: Encouraging Better Coordination for Cancer Care

On February 12, 2015, the U.S. Department of Health and Human Services (HHS) announced its new Oncology Care Model, a multipayer payment and care delivery model intended to support better coordination for cancer care. The initiative will include 24-hour access to practitioners for beneficiaries...

palliative care

Helping Patients Understand Palliative Care

The booklet Palliative Care: Improving Quality of Life for Patients and Families is one of the latest additions to the ASCO Answers collection of patient education materials developed by ASCO for people with cancer and their caregivers. These materials provide oncologist-approved information in a...

Beating the Odds in The Big Casino

More than 35 ASCO members contributed personal essays to a recently published collection of stories about humanism in medicine, including ASCO Past Presidents Paul A. Bunn, Jr, MD, FASCO, and Emil J. Freireich, MD, FASCO, and current President-Elect Julie M. Vose, MD, MBA, FASCO. The Big Casino:...

ASCO Supports FDA’s Proposed Regulation of Laboratory Developed Tests

In comments submitted to the U.S. Food and Drug Administration (FDA), ASCO expressed its support for the agency’s draft guidance, “Framework for Regulatory Oversight of Laboratory Developed Tests (LDTs).” ASCO also strongly recommends that the agency proceed with regulatory authority in a way that...

2015 Pre–Annual Meeting Seminars Feature Important Topics for Modern Cancer Care Providers

ASCO will once again be offering a series of Pre–Annual Meeting Seminars ahead of its 2015 Annual Meeting in Chicago. First offered in 2012, the Pre–Annual Meeting Seminars are a series of in-depth educational opportunities dedicated to topics of interest in the oncology community. The seminars are ...

multiple myeloma

Panobinostat in Combination With Bortezomib‑Dexamethasone in Previously Treated Multiple Myeloma

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 February 23, 2015, panobinostat (Farydak) was granted...

issues in oncology

Development and Approval of Biosimilar Products

INSIDE THE BLACK BOX is an occasional column providing insight into the U.S. Food and Drug Administration (FDA) and its policies and procedures. In this installment, Leah Christl, PhD, and Albert Deisseroth, MD, PhD, answer questions about biosimilar products. Dr. Christl is the Associate Director...

issues in oncology

New Lurie Cancer Center Program Combines Oncology  With Genomics to Provide More Personalized Cancer Care

The Robert H. Lurie Comprehensive Cancer Center of Northwestern University, in collaboration with the Northwestern Medicine Developmental Therapeutics Institute and Northwestern Memorial Hospital, has launched a new research program, Northwestern Onco-SET (Sequence, Evaluate, Treat). The program’s...

multiple myeloma

Lenalidomide in Combination With Dexamethasone in Newly Diagnosed Multiple Myeloma

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 February 18, 2015, the indication for lenalidomide (Revlimid)...

issues in oncology
health-care policy

Ongoing Controversies in Allocating Our Health‑Care Resources

Disparities of care that result in poorer outcomes among certain populations have long been an issue addressed by the cancer community and its major organizations such as ASCO. While ethnicity and race play key roles in this ongoing debate over equitable allocation of our precious health-care...

breast cancer
gastrointestinal cancer

Gastric, Breast Cancer Risk in Carriers of CDH1 Gene Mutations

In a new study,1 more precise estimates of age-associated risks of gastric and breast cancer were derived for carriers of the CDH1 gene mutation, a cancer-predisposing gene that is abnormal in families meeting criteria for clinically defined hereditary diffuse gastric cancer (HDGC). David G....

issues in oncology

Physician-Controlled Decisions in Cancer Care Linked to Lower Quality Rating

Patients who described physician-controlled decisions about their cancer care vs shared decision-making were less likely to report receiving excellent quality of care, according to a study published by JAMA Oncology.1 The Institute of Medicine has called for shared decision-making and accommodation ...

breast cancer

SOFT Trial Results Inconclusive: Further Study Needed

The results of the SOFT trial—presented at the 2014 San Antonio Breast Cancer Symposium, reported recently by Francis et al in The New England Journal of Medicine,1 and reviewed in this issue of The ASCO Post—were not as conclusive as we had hoped. In essence, the study enrolled women with resected ...

breast cancer
survivorship
thyroid cancer

New Analysis Reports Increased Risk of Thyroid Cancer After Breast Cancer Diagnosis

Breast cancer survivors are at increased risk of developing thyroid cancer, especially within 5 years of their breast cancer diagnosis, according to a new analysis of a large national database. The study results were presented at the Endocrine Society’s 97th Annual Meeting.1 “Recognition of this...

breast cancer

Increasing the Use of Hypofractionated Radiation in Early-Stage Breast Cancer: The Way Forward

Bekelman and colleagues are to be congratulated on the publication of an important paper—reviewed in this issue of The ASCO Post—alerting us all to the underutilization of hypofractionated whole-breast irradiation in the treatment of early-stage breast cancer.1 As background, recent randomized...

breast cancer

Hypofractionated Whole-Breast Irradiation After Breast-Conserving Surgery Used in Up to One-Third of Eligible Patients

In a study reported in JAMA, Justin E. Bekelman, MD, of the University of Pennsylvania Perelman School of Medicine, and colleagues found that approximately two-thirds of patients with early-stage breast cancer for whom hypofractionated whole-breast irradiation (for 3–5 weeks) was endorsed received...

Expert Point of View: Nancy Kemeny, MD

Nancy Kemeny, MD, Attending Physician at Memorial Sloan Kettering Cancer Center and Professor of Medicine at Weill Cornell Medical College, New York, discussed the study at the session and noted several limitations: The data could be outdated (chemotherapy and surgery could be better now), some...

supportive care

Many Cancer Patients at Risk for Hepatitis B Virus Reactivation

In 2015, no cancer patients should be cured of their malignancy only to die of reactivation of hepatitis B virus (HBV),” according to Anna S. Lok, MD, the Alice Lohrman Andrews Research Professor in Hepatology and Director of Clinical Hepatology at the University of Michigan, Ann Arbor. “I...

Winship Cancer Institute of Emory University Names  New Chief Medical Officer and Chief Quality Officer

Sagar Lonial, MD, has been named Chief Medical Officer at Winship Cancer Institute of Emory University and Charles A. Staley, MD, has been named Chief Quality Officer, according to an announcement recently released by the Cancer Institute. Both physicians join Winship’s senior leadership team and...

AACR Names Nancy E. Davidson, MD, President-Elect for 2015–2016

The American Association for Cancer Research (AACR) has announced the election of Nancy E. Davidson, MD, Director of the University of Pittsburgh Cancer Institute and UPMC CancerCenter in Pittsburgh, as its President-Elect for 2015–2016. Dr. Davidson will officially become President-Elect at the...

Expert Point of View: Matthew I. Milowsky, MD

Commenting on the study presented by Galsky et al at the Genitourinary Cancers Symposium, Matthew I. Milowsky, MD, Section Chief, Genitourinary Cancer, at the Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, agreed with Dr. Galsky that it is unlikely that we will...

bladder cancer

Adjuvant Chemotherapy Favored in Locally Advanced Bladder Cancer Not Treated With Neoadjuvant Therapy

A large observational study presented at the 2015 Genitourinary Cancers Symposium in Orlando, Florida, found that adjuvant chemotherapy extended the likelihood of survival in locally advanced bladder cancer compared with observation alone.1 Using three different approaches to propensity scores...

bladder cancer

Antiangiogenesis Plus Chemotherapy Pursued in Advanced Bladder Cancer

Two separate phase II studies lend support to the concept of antiangiogenesis in advanced bladder cancer. The combination of an antiangiogenic agent and chemotherapy may fulfill an unmet need in this disease, the studies suggest. Both studies were presented at the 2015 Genitourinary Cancers...

Expert Point of View: Andrew Loblaw, MD

Commenting on this study, formal discussant D. Andrew Loblaw, MD, a radiation oncologist at the Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Canada, said: “The trial showed that after a median follow-up of 7.0 years, there were no differences in overall survival between the two ...

prostate cancer

High-Dose Radiotherapy Provides Meaningful Improvements in Localized Prostate Cancer—But Not Increased Survival Yet

High-dose radiotherapy failed to improve overall survival at 7 years compared with standard-dose radiotherapy in men with stage II localized prostate cancer. However, the high-dose schedule had several advantages, including improved rates of local tumor control and distant metastasis, according to...

Expert Point of View: Eric J. Small, MD

GETUG-AFU 15 sought to improve outcomes in metastatic hormone-naive prostate cancer, but the study failed its primary objective,” noted formal discussant Eric J. Small, MD, of the University of California, San Francisco. In the overall analysis of this previously published trial, with no...

triple-negative

Our Aging Population: Challenges in Caring for Older Patients With Cancer

Managing older-aged cancer patients represents one of the major challenges to our health-care system. Caring for older cancer patients, with their frequent multiple morbidities and a variable health status, requires special integration of an oncologic and geriatric approach. Moreover, our aging...

issues in oncology
health-care policy

Health-Care Fraud and Abuse: Implications for Oncology

Health-care fraud is a long-standing problem in the United States, accounting for $75 billion in government expenses per year,1 while total spending on government health-care programs is over $1 trillion. Two decades ago, the Department of Justice increased its efforts to combat health-care fraud....

prostate cancer

Intensified Immunotherapy Encouraging in Chemotherapy-Naive Metastatic Prostate Cancer

Emerging evidence suggests that immunotherapy may play an important role in treating prostate cancer. In particular, preliminary results have shown that combining a new vaccine with ipilimumab ­(Yervoy) boosts overall survival in men with castration-resistant prostate cancer.1 A study comparing...

Remembering Neurosurgeon and Writer Paul Kalanithi, MD

What initially drew me to read the eloquent essay by Paul Kalanithi, MD, in The New York Times—“How Long Have I Got Left?”—was its provocative title.1 What kept me there was the moving description of his quick transition from healthy physician with a brilliant career in neurosurgery to terminally...

prostate cancer

Targeted MR/Ultrasound Fusion–Guided Biopsy Increased Detection of  High-Risk Prostate Cancer

Among men undergoing biopsy for suspected prostate cancer, targeted magnetic resonance (MR)/ultrasound fusion–guided biopsy was associated with an increased rate of detection of high-risk prostate cancer and a decreased rate of detection of low-risk prostate cancer than was standard...

breast cancer

Are Physicians Choosing Wisely When Imaging for Distant Metastases in Early-Stage Breast Cancer?

Patients with early-stage breast cancer still undergo imaging for distant metastases despite evidence-based local, national, and international guidelines—and a recommendation from ASCO—to avoid such imaging, according to a retrospective review of staging imaging for distant metastases in patients...

colorectal cancer

Use of Minimally Invasive Colorectal Cancer Surgery Increases at NCCN Centers, but Wide Variation Exists

“Laparoscopic colectomy has been shown to have equivalent oncologic outcomes to open colectomy for the management of colon cancer, but its adoption nationally has been slow,” Heather Yeo, MD, of Memorial Sloan-Kettering Cancer Center in New York, and colleagues noted in reporting on a study...

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