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issues in oncology

Using Machine Learning to Prompt Serious Illness Conversations

Despite research showing that among patients with cancer, early advance care planning conversations lead to care that is in alliance with patients’ goals and wishes, especially at the end of life,1 most patients die without having discussions about their treatment goals and end-of-life preferences ...

Denial’s Many Faces

The ASCO Post is pleased to reproduce installments of the Art of Oncology as published previously in the Journal of Clinical Oncology. These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer, and they include narratives, topical essays,...

Doctoring in the Digital Age: Modern Stressors, Ancient Strategies to Cope

In my 45 years of practicing hematology/oncology at a major urban academic medical center, I have observed a sea change in daily practice that contributes to physician burnout. Although the emotional stresses of caring for seriously ill people play a part in physician burnout, I find the daily...

issues in oncology

Comparing Prescribing Habits in Academic and Nonacademic Oncology Settings

The art of oncology practice is tailored to the individual patient with cancer, and with the advent of highly personalized targeted therapies, patient outcomes have improved markedly over the past several decades. Although much of oncology practice is guideline- or protocol-driven, chemotherapy...

Seven Haircuts

The ASCO Post is pleased to reproduce installments of the Art of Oncology as published previously in the Journal of Clinical Oncology. These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer, and they include narratives, topical essays,...

leukemia

Selected Abstracts on Novel Therapies for Chronic Myeloid Leukemia

To complement The ASCO Post’s comprehensive coverage of the 2019 American Society of Hematology (ASH) Annual Meeting & Exposition, here are several abstracts selected from the meeting proceedings focusing on novel therapeutic regimens for chronic myeloid leukemia (CML). For full details of...

gastrointestinal cancer

Working to Improve Survival Rates in Pancreatic Cancer

Although pancreatic cancer survival rates have slowly improved over the past few decades for all stages of pancreatic cancer combined, the 1-year rate is 20%, and the 5-year rate is about 9%. There is no single diagnostic test to detect pancreatic cancer, and less than 20% of tumors are confined to ...

An Oncologist’s Thoughtful Examination of Cancer and Personal Loss

“I could not have written this book when I was 30 years old. It is not because of any great discoveries I have made or research papers I have published since. It is because of the experience the intervening decades have given me as I cared for thousands of cancer patients and accompanied many to...

global cancer care

Challenging the Global Community to Deliver Equitable Cancer Care for All

For Her Royal Highness Princess Dina Mired of Jordan, ensuring that every patient with cancer receives high-quality care is not an abstract goal—it is personal. Princess Dina saw firsthand the life-and-death differences that access to state-of-the-art oncology care makes in a patient’s life when...

issues in oncology
hematologic malignancies
leukemia

How Clonal Hematopoiesis of Indeterminate Potential Increases the Risk of Heart Disease and Blood Cancers as People Age

Although stem cells throughout the body acquire genetic mutations over time, usually these alterations do not affect how the stem cells function or cause disease. However, recent research in clonal hematopoiesis and aging has found an association between clonal expansion of hematopoietic cells with ...

lymphoma

Omitting Radiation From Treatment for Early-Stage Hodgkin Lymphoma Increases Risk of Recurrence

Two presentations at the American Society for Radiation Oncology (ASTRO) Annual Meeting offered more evidence that omitting radiation therapy leads to higher rates of recurrence for patients with early-stage Hodgkin lymphoma.1,2 Both studies involve work by the German Hodgkin Study Group among...

The Art of Medicine: Our Role as Patient Advocates

The ASCO Post is pleased to reproduce installments of the Art of Oncology as published previously in the Journal of Clinical Oncology. These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer, and they include narratives, topical essays,...

issues in oncology
palliative care

Is Implicit Bias Contributing to Time Disparities in Goals-of-Care Conversations With Minority Patients?

GUEST EDITOR Addressing the evolving needs of cancer survivors at various stages of their illness and care, Palliative Care in Oncology is guest edited by Jamie H. Von Roenn, MD, FASCO. Dr. Von Roenn is ASCO’s Vice President of Education, Science, and Professional Development. It has been well...

palliative care
issues in oncology

Is Implicit Bias Contributing to Time Disparities in Goals-of-Care Conversations With Minority Patients?

GUEST EDITOR Addressing the evolving needs of cancer survivors at various stages of their illness and care, Palliative Care in Oncology is guest edited by Jamie H. Von Roenn, MD, FASCO. Dr. Von Roenn is ASCO’s Vice President of Education, Science, and Professional Development. It has been well...

lung cancer
issues in oncology

Differences By Sex in Lung Cancer Incidence and Mortality: What Is Known, and What Does It Mean?

The finding that women have a higher incidence of lung cancer than men of the same age and with the same smoking history was unexpected when it first emerged from studies in the 1990s. Just as unexpected was a subsequent finding. Even with their higher risk, women have a lower mortality and higher...

immunotherapy

How Ultrahigh-Dose Radiation Therapy, Interferon, and CAR T Cells May Boost Immunotherapy Effectiveness

This past June, the University of Pennsylvania established the Mark Foundation Center for Immunotherapy, Immune Signaling, and Radiation to study the role interferon and pattern recognition receptor signaling transduction pathways play in modulating the immune system’s ability to recognize and...

issues in oncology

Patient-Centered Initiatives at the FDA

OCE Insights is a periodic column developed for The ASCO Post by members of the Oncology Center of Excellence (OCE) at the U.S. Food and Drug Administration (FDA). In this first installment, Vishal Bhatnagar, MD, Acting Associate Director of Patient Outcomes; Bellinda King-Kallimanis, PhD, Senior...

cns cancers
lymphoma

Primary Central Nervous System Lymphoma: Striving for a Curative Therapy

Primary central nervous system (CNS) lymphoma is a rare type of non-Hodgkin lymphoma in which standards of care have not been well established. In light of recent insights into its pathophysiology and the emergence of novel approaches, The ASCO Post asked Tracy T. Batchelor, MD, a specialist in...

head and neck cancer

Maura L. Gillison, MD, PhD, Pioneer in HPV-Related Head and Neck Cancer, Has Often Changed Lanes in Her Career

When The ASCO Post asked physician-scientist Maura L. Gillison, MD, PhD, where she was from, she answered, “North America.” Actually, she was born in Canada, but her father worked for a large international company, so the family moved regularly through Canada, the United States, and Mexico. “I...

breast cancer

Tumor Size and Grade Matter, and Ovarian Ablation by Chemotherapy May Explain Subgroup Anomaly in TAILORx

At the 2019 ASCO Annual Meeting, and simultaneously in The New England Journal of Medicine, we heard the third paper reporting results from TAILORx.1,2 The first, in 2015,3 indicated that women with node-negative breast cancers with Oncotype DX recurrence scores less than 11 did extremely well...

issues in oncology
legislation

Should You Become an Expert Witness in a Legal Proceeding? Here Are the Pros and Cons

Hundreds of oncologists are working “side gigs” as expert witnesses in a wide range of medicolegal settings. With increasing conflict related to liability and insurance coverage, the demand continues to grow for objective physicians who are not involved in a specific case, have no personal...

Out of the Mouths of Babes: A Physician Discusses Her Cancer Diagnosis With Her Two Young Children

  In medical school, I learned a five-step model on how to deliver bad news to a patient. I still fall back on this method, time and again, in my primary care clinic; I have even used it when giving really tough feedback to a learner who is struggling in some aspect of performance. But I honestly...

survivorship

Actively Recruiting Clinical Trials Focused on Survivorship

This Clinical Trials Resource Guide lists actively recruiting clinical research trials that focus on cancer survivorship. The studies here are examining the effects of Web-based platforms, as well as patient navigators and other tools. and the value of improving our understanding of the...

global cancer care

How the ASCO Breakthrough Global Summit Is Bringing Together Innovators to Transform Cancer Care

Earlier this year, ASCO announced plans for its first-ever international meeting, ASCO Breakthrough: A Global Summit for Oncology Innovators, which will be held October 11–13, 2019, in Bangkok, Thailand. The meeting is a joint effort by ASCO and the Thai Society of Clinical Oncology to bring...

immunotherapy
lung cancer

Combination Immunotherapy and Inhibitors of DNA Damage Repair in the Treatment of Small Cell Lung Cancer

Unlike non–small cell lung cancer (NSCLC), which has seen a paradigm shift in treatment modalities with the discovery of genetic signatures (including EGFR mutations) that are responsive to targeted drugs, systemic treatment of small cell lung cancer (SCLC) has remained largely unchanged for over...

prostate cancer

ENZAMET Trial Shows Enzalutamide Improves Overall Survival in Hormone-Sensitive Metastatic Prostate Cancer

Agents that improve survival in metastatic castration-resistant prostate cancer when added to background androgen-deprivation therapy (ADT) are showing success in treating metastatic prostate cancer earlier while it is still hormone-sensitive. These agents include docetaxel (chemotherapy) and...

Engage With CENTRA: ASCO’s Center for Research and Analytics

In 2017, ASCO announced the launch of its Center for Research and Analytics (CENTRA). CENTRA’s mission is to conquer cancer by generating, integrating, analyzing, and sharing oncology data to foster innovation in research and patient care. CENTRA aims to make its cancer data available to the...

Arti Hurria, MD, FASCO

The oncology community was deeply saddened by the untimely passing of Arti Hurria, MD, FASCO, a nationally regarded expert and advocate for elderly patients with cancer. Dr. Hurria died on November 7, 2018, in a traffic accident. At the time of her tragic death, Dr. Hurria was Director of the City...

A Career Path Balancing Research, Patient Care, and Everyday Life

In elementary school, Laurie H. Sehn, MD, MPH, dreamed of becoming a teacher. However, as she moved through high school, her passion for science blossomed, as did her desire to have an impact on people’s lives. “I began to seriously consider medicine because it provided the dual opportunity to...

pain management
health-care policy

Debating the Role of Opioids in the Management of Chronic Cancer Pain

Despite the increasing public awareness of the danger of the overuse of prescription opioids, drug overdose deaths continue to rise in the United States. According to the Centers for Disease Control and Prevention (CDC), from 1999 to 2017, nearly 400,000 people died of an overdose involving...

issues in oncology
gynecologic cancers
global cancer care

Barriers to Cervical Cancer Screening Among HIV-Infected Women in Tanzania

Population screening programs and the advent of human papillomavirus (HPV) vaccination have made cervical cancer largely a preventable disease. Despite these advances, ­cervical cancer remains a leading cause of cancer death for ­women in low- and middle-income countries. A recent study identified...

global cancer care

Measuring the Burden of Global Cancer as a Tool for Policymakers

The Global Burden of Disease Study was initiated in 1990, commissioned by the World Bank. At that time, the study was conducted mainly by researchers at Harvard and the World Health Organization (WHO). Since then the study has gone through many iterations to its present structure, which is a...

global cancer care
issues in oncology

St. Jude Children’s Research Hospital and WHO Join Forces to Improve Childhood Cancer Survival Worldwide

A report by the International Agency for Research on Cancer (IARC) based on data from more than 100 cancer registries in 68 countries shows that from 2001 to 2010, the occurrence of childhood cancer worldwide was 13% more common than in the 1980s.1 In addition, the report’s findings showcase stark...

issues in oncology
immunotherapy

NCCN Roundtable Tackles Issues With Innovative Immunotherapies

Immunotherapies are radically changing outcomes, but while helping patients, they are creating complexities surrounding their cost. At the 2019 Annual Conference of the National Comprehensive Cancer Network® (NCCN®), a roundtable of experts, including clinicians and payers, discussed how chimeric...

hematologic malignancies

Prolonged Exposure to Ibrutinib May Increase Effectiveness of CAR T-Cell Therapy in Patients With CLL

Chimeric antigen receptor (CAR) T-cell therapy has shown remarkable efficacy in the treatment of certain hematologic malignancies, including several types of large B-cell non-Hodgkin lymphomas (NHLs) and acute lymphoblastic leukemia (ALL). The U.S. Food and Drug Administration (FDA) has approved...

Expert Point of View: Irene Ghobrial, MD, and Monica M. Bertagnolli, MD, FACS, FASCO

Irene Ghobrial, MD, of Dana-Farber Cancer Institute and Harvard Medical School, Boston, who has conducted seminal trials in smoldering myeloma, commented on the phase III E3A06 study. Asked by The ASCO Post whether E3A06 settles the issue of treating smoldering disease, Dr. Ghobrial responded,...

cns cancers
solid tumors
leukemia
multiple myeloma
sarcoma

FDA Pipeline: Designations in Myeloma, Adenoid Cystic Carcinoma, and Kaposi Sarcoma, Plus ODAC Votes

This week, the U.S. Food and Drug Administration granted designations in relapsed or refractory multiple myeloma, adenoid cystic carcinoma, and Kaposi sarcoma; and the FDA’s Oncologic Drugs Advisory Committee (ODAC) held votes on treatments for tenosynovial giant cell tumor and acute...

solid tumors
kidney cancer

Hope and Fear Are Two Constants in the Lives of Patients With Cancer

A year and a half ago, when I was 33, the thought of having a life-threatening disease was unimaginable. In hindsight, the weight loss I began experiencing in the fall of 2017 should have raised concern because I’ve always had to be mindful of my diet if I wanted to lose weight. But denial can be a ...

breast cancer
cost of care

Does Oncotype DX–Guided Treatment Reduce Initial Costs of Breast Cancer Care?

A new study suggests that Oncotype DX–guided treatment could reduce the cost for the first year of breast cancer care in the United States by about $50 million (about 2% of the overall costs in the first year). These findings were published by Mariotto et al in the Journal of the...

issues in oncology

Knowing Gender Identity and Sexual Orientation of Patients Is a Vital Aspect of Medical Care

A survey of oncologists from National Cancer Institute (NCI)-designated Comprehensive Cancer Centers found that 95.3% of oncologists who responded are comfortable with treating lesbian, gay, and bisexual patients with cancer, and 82.5% are comfortable treating transgender patients with cancer.1...

palliative care
supportive care

Sweet Surrender

The ASCO Post is pleased to reproduce installments of the Art of Oncology as published previously in the Journal of Clinical Oncology. These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer, and they include narratives, topical essays,...

issues in oncology
global cancer care

Who I Am and What I Will Do

I am a radiation oncologist from Zambia, where we only have one cancer center offering radiotherapy—and I will beat cancer. This bold statement often evokes a look of surprise. However, if the conversation is allowed to go on, I’ll say cancer is beatable even where resources are thin. I am...

issues in oncology
survivorship

How to Improve Care for Young Sexual and Gender Minority Cancer Survivors

IN 2017, ASCO issued its recommendations for addressing the oncology care needs of sexual and gender minority cancer survivors and the unique challenges they face.1 There are myriad reasons for cancer disparities in this population compared to heterosexual cisgender cancer survivors, including...

immunotherapy

How Turning ‘Cold’ Tumors Into ‘Hot’ Ones May Improve Response to Immunotherapy

The proliferation of immunotherapeutics in the treatment of cancer over the past decade has revolutionized the way many cancers are treated, especially lung cancer and melanoma, as well as some blood cancers, including leukemia and lymphoma, drastically improving outcomes for many patients with...

solid tumors

Impact of Stereotactic Ablative Radiotherapy on Survival for Patients With Advanced Cancers

The first report from a phase II, multicenter clinical trial has found that a newer, more aggressive form of radiation therapy—stereotactic ablative radiation—can extend long-term survival for some patients with stage IV cancers, while maintaining their quality of life. The study was...

Oncology Pioneer V. Shanta, MD, Has Long Championed Access to Quality Cancer Care

In this installment of the Living a Full Life series, guest editor Jame Abraham, MD, interviewed V. Shanta, MD, an internationally renowned oncologist and Chairperson of the Cancer Institute in Adyar, Chennai, India. Dr. Shanta has been with the Institute since 1955, holding several positions...

leukemia

BEAT AML Umbrella Trial: Bringing Personalized Medicine to Acute Myeloid Leukemia

THE MULTIARM, multicollaborative BEAT AML umbrella trial demonstrated the feasibility of using next-generation sequencing to assign treatment tailored to individual genomics of elderly patients with acute myeloid leukemia (AML) within 7 days. This may prove to be a major advance, since typically...

A Tribute to Arti Hurria, MD, FASCO, a Leader in Geriatric Oncology

The oncology community is deeply saddened by the untimely passing of Arti Hurria, MD, FASCO, a nationally regarded expert and advocate for elderly patients with cancer. Dr. Hurria died on November 7, 2018, in a traffic accident. At the time of her tragic death, Dr. Hurria was Director of the City...

Should I Have Lied?

The ASCO Post is pleased to reproduce installments of the Art of Oncology as published previously in the Journal of Clinical Oncology. These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer, and they include narratives, topical essays,...

immunotherapy
skin cancer

Optimal Duration of Checkpoint Inhibition in Melanoma Is No More Than 2 Years

For patients with advanced melanoma, the concept of treating to disease progression does not always apply. With many patients responding to checkpoint inhibition for years, when can treatment be safely discontinued? This important clinical question was addressed at the European Society for Medical...

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