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issues in oncology
symptom management

Statin Use Associated with Reduced Cancer-related Mortality in Danish Study

Cancer-related mortality among patients in the Danish population receiving a diagnosis of cancer at age ≥ 40 years between 1995 and 2007 was significantly reduced in those who were receiving statin therapy at the time of diagnosis, according to an analysis reported by Nielsen and colleagues in The...

breast cancer

Radiation Therapy Extends Survival in Elderly Women with Early Breast Cancer 

Chronologic age alone should not preclude use of radiation in elderly women with early breast cancer, suggest two studies presented at the 54th Annual Meeting of the American Society for Radiation Oncology (ASTRO). Both studies showed a survival improvement in elderly women with early breast cancer ...

Screening for Ovarian Cancer: A Gynecologic Oncologist’s Perspective

The recent U.S. Preventive Services Task Force (USPSTF) Reaffirmation Recommendation Statement concluded that in the population of asymptomatic women without known genetic mutations that increase risk for ovarian cancer, clinicians should not screen for ovarian cancer using transvaginal ultrasound...

Recognizing and Managing Physician Burnout in Oncology

Although job burnout occurs in all professions, it is more common among physicians, according to a study published recently in Archives of Internal Medicine.1 Physicians on the front line of care, such as those working in emergency rooms or in family medicine, experience the highest rates of...

Expert Point of View: Frederick R. Appelbaum, MD

Commenting on the trial of bone marrow vs peripheral blood stem cell transplants, Frederick R. Appelbaum, MD, at the Fred Hutchinson Cancer Research Center, wrote that the results should change practice. But he added in his editorial, “it will be interesting to see whether it really does.”1...

hematologic malignancies

Bone Marrow Transplants Reduce Risk of Graft-vs-Host Disease Compared to Peripheral Blood

Patients who receive bone marrow transplants are significantly less likely to develop chronic graft-vs-host disease than those who receive peripheral blood stem cell transplants, according to a new, large randomized trial, the first of its kind with unrelated donors. Published recently in The New...

lung cancer

Volume-doubling Time May Help Distinguish Aggressive Cancer from Slow-growing Tumors

Changes in the size of lung tumors over time, as measured by volume-doubling times on low-dose computed tomography, can be used to distinguish aggressive lung cancer from slow-growing or indolent tumors and reduce overdiagnosis that could result in overtreatment and unnecessary morbidity. Results...

breast cancer

Analysis Suggests Screening Mammography Results in Substantial Overdiagnosis with Small Effect on Mortality

An analysis of Surveillance, Epidemiology, and End Results (SEER) data from 1976 through 2008 “suggests that whatever the mortality benefit, breast-cancer screening involved a substantial harm of excess detection of additional early-stage cancers that was not matched by a reduction in late-stage...

gynecologic cancers

Screening and Risk-reduction without Testing Positive for BRCA Mutation

Many women who do not test positive for a BRCA mutation undergo additional ovarian cancer screenings and risk-reducing procedures, despite limited data to determine the effectiveness of these interventions among an average-risk population. Results of an analysis of data from 1,077 women who were...

integrative oncology

Green Tea

The use of dietary supplements by cancer patients has risen significantly over the past 2 decades despite insufficient evidence of safety and effectiveness. Finding reliable sources of information about dietary supplements can be daunting. Patients typically rely on family, friends, and the...

Oncology Meetings

January 2013 Breast-Gynecological International Cancer CongressJanuary 17-18 • Cairo, EgyptFor more information: www.bgicc.eg.net/ Highlights of ASH® San Diego, CA and Toronto, CanadaJanuary 18-19 • San Diego, CA and Toronto, Ontario, CanadaFor more information: www.hematology.org/meetings...

Oncology Meetings

February Highlights of ASH® Miami, FL and San Francisco, CAFebruary 1-2 • Miami, Florida, and San Francisco, CaliforniaFor more information: www.hematology.org/meetings Optimizing Outcomes in Colorectal CancerFebruary 7 • Boston, MassachusettsFor more information: www.omedlive.com Interventional...

issues in oncology

Most Patients Do Not Report that Cure Is Highly Unlikely with Chemotherapy for Advanced Cancer  

Chemotherapy for metastatic lung or colorectal cancer can provide palliation and modestly prolong life, but is not curative. In a study recently reported in The New England Journal of Medicine, Jane C. Weeks, MD, of Dana-Farber Cancer Insitute, and colleagues found that the majority of patients...

breast cancer
lung cancer

ASCO Decision Aids Intersect Evidence-based Guidelines, Productive Patient Communication

Imagine this common clinical scenario: A 64-year-old woman presents with a new abnormality on a mammogram. A core needle biopsy and subsequent partial mastectomy reveal a 1.8-cm invasive ductal carcinoma. Sentinel lymph nodes are negative for cancer. The tumor is moderately differentiated and is...

integrative oncology

Turmeric 

The use of dietary supplements by cancer patients has risen significantly over the past 2 decades despite insufficient evidence of safety and effectiveness. Finding reliable sources of information about dietary supplements can be daunting. Patients typically rely on family, friends, and the...

breast cancer

Treatment of HER2-positive Disease in 2013 

From the initial discovery of the HER2 family of receptors in the mid-1980s to the present, a “wealth of riches” has been uncovered in terms of agents that can target pathways relevant to this aggressive breast cancer type, notes Hope S. Rugo, MD, Director of Breast Oncology and Clinical Trials...

prostate cancer

Abiraterone in Patients with Metastatic Castration-resistant Prostate Cancer and No Prior Chemotherapy

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. Indication On December 10, 2012, abiraterone acetate (Zytiga)...

prostate cancer

Abiraterone Benefits Patients with Metastatic Prostate Cancer Who Have Had No Previous Chemotherapy 

The androgen biosynthesis inhibitor abiraterone acetate (Zytiga) has been shown to increase radiographic progression-free survival and delay clinical decline and initiation of chemotherapy in a clinical trial in castration-resistant patients with metastatic prostate cancer who have had no prior...

leukemia

We Need Gemtuzumab Available Again to Treat AML

The word “revival” signifies a renewed use or acceptance after a period of inactivity; similarly, the word “resurrection” refers to the concept of an entity coming back to life after death. In the past year, these terms have been used frequently by us (and others) in articles calling for the return ...

Expert Point of View: Philip Agop Philip, MD and Alan P. Venook, MD

Philip Agop Philip, MD, Head of the Multidisciplinary Team for Gastrointestinal and Neuroendocrine Oncology and Neuroendocrine at Karmanos Cancer Institute at Wayne State University, Detroit, was the formal discussant of the paper at the Gastrointestinal Cancers Symposium. He said the positive...

Expert Point of View: David J. Kuter, MD, PhD

David J. Kuter, MD, PhD, Professor of Medicine, Harvard Medical School, and Director of the Center for Hematology at Massachusetts General Hospital, Boston, commented on the findings for The ASCO Post. “TOPPS is a good attempt to address whether transfusions are helpful as prophylaxis in patients...

issues in oncology

Large Epidemiologic Studies Re-examine Hazards of Smoking

“Smokers lose at least one decade of life expectancy, as compared with those who have never smoked,” and the increased risk of death from cigarettes smoking “are now nearly identical for men and women,” according to two separate studies published online by TheNew England Journal of Medicine. One...

integrative oncology

Fitness: Can Exercise Lengthen Survival in Patients with Cancer? 

Regular physical activity has long been associated with decreased risk of disease, including many types of cancer. Such benefits may translate into increased life expectancy of up to 4.5 years, with even the lowest levels of activity providing some survival advantage.1 Most strikingly, however,...

issues in oncology

Study Shows New Approach Connecting Smokers to Quit Lines Increases Smoking Cessation Treatment Enrollment 

Self-identified smokers directly connected to a tobacco cessation quit line are 13 times more likely to enroll in a treatment program as compared to smokers who are handed a quit line referral card and encouraged to call on their own, according to a new study published online in JAMA Internal...

Jane Cooke Wright, MD, ASCO Cofounder, Dies at 93 

The practice of oncology advances incrementally; each step forward, no matter how painfully small at times, leads to the next. The oncology community readily offers tribute to predecessors in the field who took those first steps into the uncharted regions of cancer care, without which today’s...

solid tumors
colorectal cancer

Colorectal Cancer: A Decade of Progress 

The 2013 Gastrointestinal Cancers Symposium marked the 10th anniversary of the meeting. Richard M. Goldberg, MD, the Klotz Family Chair in Cancer Research, Professor of Medicine, and James Cancer Hospital Physician-in-Chief at The Ohio State University, looked back over the decade to highlight the...

colorectal cancer

Bevacizumab plus Capecitabine Has Robust Effect in Elderly Patients with Colorectal Cancer

In elderly patients with treatment-naive metastatic colorectal cancer, a trend toward a survival benefit was observed for bevacizumab (Avastin) plus capecitabine (Xeloda) in the international phase III AVEX trial, which was presented at the 2013 Gastrointestinal Cancers Symposium by David...

lung cancer

Modified and Updated Risk-prediction Model Is More Efficient in Identifying Persons for Lung Cancer Screening

An updated and modified lung-cancer risk-prediction model developed from the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial “was more sensitive” for lung cancer detection than criteria from the National Lung Cancer Screening Trial (NLST), according to a study in TheNew...

prostate cancer

Recently Reported Long-term Outcomes Could Motivate More Men with Prostate Cancer to Consider Active Surveillance 

Fifteen years after being treated with radical prostatectomy or external-beam radiation for localized prostate cancer, “the prevalence of erectile dysfunction was nearly universal,” among men enrolled in a long-term functional outcomes analysis of the Prostate Cancer Outcomes Study (PCOS). There...

breast cancer
integrative oncology

Qigong Practice Associated with Quality-of-life Benefits in Women Undergoing Radiation Therapy for Breast Cancer 

Qigong (“qi” or “chi” = energy flow, “gong” = skill or achievement) is an integrated mind-body exercise and meditative practice that involves rhythmic breathing coordinated with repetition of fluid movements and calm focus on the body. A study reported in Cancer by Zhen Chen, MD, and colleagues...

palliative care

New Partnership Will Harness Technology to Foster Improved Palliative Care in Oncology

ASCO and the American Academy of Hospice and Palliative Care Medicine (AAHPM) have announced a joint initiative to support delivery of high-quality palliative care in medical oncology. The initiative, funded by the Agency for Health Care Research & Quality, aims to address the complex care...

leukemia

Gene Transfer Therapy Is Producing Prolonged Remissions in Patients with Advanced Leukemia 

In August 2011, researchers from the University of Pennsylvania published their breakthrough findings of a pilot study showing sustained remissions of up to 1 year in a small number of patients with advanced chronic lymphocytic leukemia (CLL) who had been treated with genetically engineered...

prostate cancer

Similar Outcomes for 18 vs 36 Months of Androgen Blockade in High-risk Prostate Cancer Treated with Radiation 

Eighteen months of hormone therapy appears to be as safe and effective as 36 months when combined with radiation for patients with high-risk prostate cancer.1 Patients who received the shorter course of hormone therapy plus radiation had survival rates similar to those who received 36 months of...

colorectal cancer

CT Colonography Reconsidered

The parallel SIGGAR trials recently published in Lancet add to the growing body of literature regarding the utility of computed tomographic (CT) colonography in the detection of colorectal polyps and cancers. These papers reinforce the results seen in other large multicenter trials1-3 and echo the...

lung cancer

The Risk of Death From Smoking Now Nearly Identical for Men and Women 

Researchers from multiple organizations, including the American Cancer Society (ACS), studied the smoking trends among men and women over the last 50 years and found that women’s smoking habits in that time have significantly increased their risk of dying from lung cancer and chronic obstructive...

lung cancer

Study Shows Lung Cancer CT Screening Could Save 12,000 Lives Annually 

Screening all current and former heavy smokers could prevent over 12,000 lung cancer deaths a year, according to a new study published in Cancer.1 The study, funded by the American Cancer Society, arrived at that number based on data from the National Lung Screening Trial (NLST),2 which found that...

breast cancer

Ado-Trastuzumab Emtansine in Metastatic Breast Cancer 

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.  Indication On February 22, 2013, ado-trastuzumab emtansine...

prostate cancer

Similar 15-year Functional Outcomes after Prostatectomy or Radiotherapy for Localized Prostate Cancer 

Comparative longer-term functional outcomes of radical prostatectomy and external-beam radiation therapy for localized prostate cancer remain undefined. In a study recently reported in The New England Journal of Medicine,1 Matthew J. Resnick, MD, and colleagues at Vanderbilt University, Nashville,...

colorectal cancer

Is Aspirin Protective against Colorectal Cancer? 

A growing body of evidence provides biologic and clinical evidence that nonsteroidal anti-inflammatory agents are protective against colorectal cancer. “It is fascinating for me as a medical oncologist and epidemiologist to see how the worlds of colorectal cancer treatment and epidemiology are...

skin cancer

Sentinel Node Biopsy in Melanoma: Essential or Optional? 

Is sentinel node biopsy in melanoma an essential component of care? Despite a large multinational trial and recently published or updated guidelines, the question is still a thorny one according to experts who debated the issue at the recent meeting of the Society of Surgical Oncology in...

integrative oncology

Symptom Management with Complementary Therapies for Patients Receiving Radiation Therapy

The supportive care of patients with cancer receiving radiotherapy is an important responsibility for the radiation oncologist, and complementary therapies are an integral component of many patients’ treatment strategy.A recent prospective study suggests that 54% of patients with breast cancer...

leukemia

Drug Approvals in Acute Myeloid Leukemia: Can We Do Better? 

Forty years ago, President Richard Nixon announced a “war on cancer.” Some of that war’s first battles were won in the field of acute myeloid leukemia (AML) with two agents, cytarabine and daunorubicin, receiving U.S. Food and Drug Administration (FDA) approval based on their ability to produce...

gynecologic cancers

Lynch Syndrome: A Multitude of Predispositions 

The current uncertainty regarding the relative frequencies of cancers of various anatomic sites in Lynch syndrome poses a difficulty in commenting on the syndrome’s overall cancer spectrum. It is even more vexing to address the order in which these cancers are prone to occur. What we do know is...

breast cancer

Novel Regimen Produces High Pathologic Complete Response Rates in Triple-negative Breast Cancer 

Interim results from a small neoadjuvant study of patients with triple-negative breast cancer has found high rates of pathologic complete response with the combination of nab-paclitaxel (Abraxane), carboplatin, and bevacizumab (Avastin).1 The study was presented at the 18th Annual Conference of the ...

lung cancer

Lessons of 2 Decades' Experience with CHESS

Our work on an Internet-based intervention for lung cancer confirmed what many other studies have shown about technologic interventions for health-care consumers—that such interventions can improve quality of life for caregivers and patients.1 We expected this result in part because of the...

breast cancer
issues in oncology
survivorship

Breakthroughs in Targeted Therapies for Breast Cancer Are Improving Patient Survival Rates 

For more than 20 years, José Baselga, MD, PhD, has devoted his medical and scientific career to caring for breast cancer patients and the development of novel molecular targeted agents to treat the disease. From 1996 to 2010, he was Head of the Oncology Department of Vall d’Hebron University...

breast cancer

Reducing Incidental Cardiac Irradiation during Breast Radiotherapy  

In the treatment of breast cancer, a wealth of data from prospective clinical trials and meta-analyses has documented the benefits of radiation to prevent local-regional recurrence and improve survival. Accordingly, important quality indicators in breast cancer care include: (1) receipt of...

SIDEBAR: Left-sided Adjuvant Breast Radiotherapy: A Change of Heart? 

Darby and colleagues are to be congratulated for an ambitious population-based case-control study that demonstrates the impact of postoperative adjuvant ionizing radiation for early-stage breast cancer on ischemic heart disease.1 The study examined roughly 1,000 cases and 1,000 controls in Sweden...

SIDEBAR: Critical Information on Radiation's Heart Effects  

The paper by Darby et al provides extremely important information on quantitative estimates of the effect of radiotherapy on coronary events in women with breast cancer.1 The authors have determined a direct relationship between radiation dose and effects on the heart and provide strong evidence...

breast cancer

Risk for Ischemic Heart Disease after Radiotherapy for Breast Cancer 

A population-based case-control study reported by Sarah C. Darby, PhD, Professor of Medical Statistics in the Clinical Trial Service Unit and Epidemiologic Studies Unit at the University of Oxford, and colleagues in The New England Journal of Medicine indicates that incidental exposure of the heart ...

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