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cost of care

Cost of Care: A Multidisciplinary Responsibility

I read the interview with Dr. Ezekiel Emanuel (The ASCO Post, December 15, 2011) with much interest, as the health-care policy problems that America is currently experiencing have plagued other countries for some time. Despite proactive measures and attempts to amend those situations elsewhere,...

issues in oncology
health-care policy

Drug Shortages Hit Oncology Hard: Experts Weigh in on Challenges and Solutions

Periodic drug shortages are an unavoidable reality in our complicated pharmaceutical supply chain; however, over the past several years, drug shortages have expanded to crisis levels, putting vulnerable patients at risk. In 2010, there were 178 drug shortages reported to the FDA, 132 of which were...

breast cancer

Facing the Future without Fear of Breast Cancer Recurrence

A year ago, I was living my dream. Married to a wonderful man, Danny, and with two young children to raise, Karl, 7, and Marcus, 4, I had given up a career in accounting to be a stay-at-home mom. At age 34, I was enjoying life, helping my children with their homework and going to their soccer and...

SIDEBAR: Expect Questions from Your Patients

The possibility of reexcision after breast-conservation surgery should be discussed with patients before the initial surgery, advised Laurence E. McCahill, MD, lead investigator of the JAMA study on reexcision following breast-conservation surgery, which showed wide variability in reexcision...

breast cancer

Reexcision Rates Following Breast-conservation Surgery Vary Widely

In the News focuses on media reports that your patients may have questions about at their next visit. This continuing column will provide summaries of articles in the popular press that may prompt such questions, as well as comments from colleagues in the field. Reexcision rates for women with...

head and neck cancer

Challenges, Progress, and Future Directions in Head and Neck Cancer

Although head and neck cancer remains a major therapeutic challenge, significant advances have been made over the past few decades. The ASCO Post recently spoke with Marshall R. Posner, MD, Medical Director of the Head and Neck Oncology Program, Mount Sinai Medical Center, New York, about the...

Career Development Award Recipient Susan K. Parsons, MD, Supports Next Generation of Researchers

Like all pediatric oncologists, Susan K. Parsons, MD, MRP, knows that when a child is diagnosed with cancer, it happens to the whole family. Siblings must cope with everything from disruption of routine to reduced parental attention, to the often-new possibility of mortality. Parents must navigate...

breast cancer

Genomics Projects Plumb Breast Cancer’s Inner Workings

Two large collaborative genomics projects are producing new and sometimes surprising findings about what makes breast cancers tick—information that may ultimately be applied to improve clinical outcomes. In a special session titled “Genome Data for the Masses: Presentation of TCGA and ICGC Breast...

gastrointestinal cancer

What Were the Take-home Messages from the 2012 Gastrointestinal Cancers Symposium?

Richard M. Goldberg, MD, of The Ohio State University Medical Center, chaired the steering committee of the 2012 Gastrointestinal Cancers Symposium in San Francisco, which attracted approximately 4,000 registrants who viewed data from some 700 scientific abstracts. The ASCO Post asked Dr. Goldberg...

global cancer care
pain management

Inefficient Markets Impede Cancer Pain Relief

The potent analgesic property of morphine was first isolated in 1804, and after more than 2 centuries morphine is still the gold standard for moderate to severe pain. It is relatively easy to produce, and compared to most pharmaceuticals, morphine is dirt-cheap. Therein lies the cruel conundrum:...

health-care policy

A Visionary Call for the ‘Creative Destruction’ of Medicine

According to nationally regarded cardiologist and geneticist Eric Topol, MD, Chief Academic Officer of Scripps Health, the next frontier of the digital revolution can create exponentially better health care. Dr. Topol, who is also Director of the Scripps Translational Science Institute and...

breast cancer

Surviving Cancer Means Making Many Difficult Decisions

The best advice I received after getting a diagnosis of stage I invasive lobular carcinoma in my left breast was from my radiologist, who told me, “Remember, be your own best advocate.” Those words have stayed with me through my 6-year struggle with breast cancer and its aftermath. Extraordinary...

SIDEBAR: Should ‘AYA’ Be an Oncology Subspecialty?

The lag in improvement in survival rates for adolescents and young adults (AYAs) with cancer and a greater awareness of the unique issues they face has prompted discussion about whether “AYA” should become a new oncology subspecialty.1 “Yes and no,” according to Archie Bleyer, MD. “I am going to...

issues in oncology

Adolescents and Young Adults with Cancer: A Distinct Population of Patients Who Need to Be Treated Differently

In the News focuses on media reports that your patients may have questions about at their next visit. This continuing column will provide summaries of articles in the popular press that may prompt such questions, as well as comments from colleagues in the field. Cancer among adolescents and young...

integrative oncology

Some Patients Using Complementary and Alternative Therapies May Be Receiving ‘Parallel’ Rather Than Integrative Care

Most patients with cancer receiving complementary and alternative medicine do so not as part of integrative care, but rather as “parallel care,” according to Lynda Balneaves, RN, PhD, Associate Professor, University of British Columbia, School of Nursing in Vancouver. Dr. Balneaves is lead...

breast cancer

Context May Affect Benefit of Adjuvant Clodronate in Breast Cancer

A benefit of the oral bisphosphonate clodronate when used as adjuvant therapy for early breast cancer may depend on factors such as the endpoint assessed and patient age, suggests the randomized B-34 trial conducted by the National Surgical Adjuvant Breast and Bowel Project (NSABP). The trial,...

multiple myeloma

Maintenance with Lenalidomide or Bortezomib Prolongs Remission in Elderly Patients with Multiple Myeloma

The benefit of maintenance therapy in newly diagnosed multiple myeloma patients ineligible for stem cell transplant, such as the elderly, is still debated, though value appears to be emerging, according to studies presented at the 2011 American Society of Hematology (ASH) Annual Meeting....

issues in oncology

FDA Acts to Bolster Supply of Critically Needed Cancer Drugs

The FDA has announced a series of steps to increase the supply of critically needed cancer drugs and build on President Obama’s Executive Order to help prevent future drug shortages. The President’s order, issued last October 31, directed the FDA to take action to help further prevent and reduce...

ASCO Launches Community Research Forum to Tackle Top Research Conundrums

Just how many research-focused staff members is it optimal to have when conducting clinical trials in a community-practice setting? To properly gauge that, should the practice look closely at how many studies it’s working on? The complexity of those studies? The number of patients enrolled? Some...

issues in oncology
health-care policy

Searching for Quality in an Increasingly Complex Health-care Environment

With the Presidential election just around the corner, the health-care debate will undoubtedly heat up. The ASCO Post spoke with Sean R. Tunis, MD, MSc, Founder and Director, Center for Medical Technology Policy, and former Chief Medical Officer for the Centers for Medicare & Medicaid Services, ...

issues in oncology

Options for Preserving Fertility Should Be Considered Early to Maximize the Likelihood of Success

Most cancer survivors prefer to have biologic offspring despite concerns about the possible effects of cancer treatment on the child, the child’s lifetime cancer risk, or their own longevity, according to an ASCO panel that developed guidelines on fertility preservation in patients with cancer.1...

colorectal cancer

Cancer Does Not Have to Be a Death Sentence

When I found a large amount of blood on my toilet tissue just before Thanksgiving in 2010, I wasn’t too concerned. At just 45 years old, I was in excellent health, and other than the bloody stool I had no other symptoms signaling that something was seriously wrong. My primary care physician thought ...

AACR Inducts Frank McCormick, PhD, FRS, DSc (hon) as President; Elects Charles L. Sawyers, MD, as President-elect, 2012-2013

Leadership of the American Association for Cancer Research (AACR) inducted Frank McCormick, PhD, FRS, DSc (hon), as President of the society during the AACR Annual Meeting held earlier this month Dr. McCormick is the Director of the University of California, San Francisco (UCSF) Helen Diller Family ...

issues in oncology

2012 Annual Meeting to Highlight NCI’s ‘Provocative Questions’ and Offer First-ever Pre–Annual Meeting Seminars

As this year’s ASCO Annual Meeting was being planned, the NCI was developing and releasing its “Provocative Questions” project—an effort to stimulate the cancer community to ask itself 24 key questions in order to advance the treatment of cancer and provide better care. It quickly became clear to...

Expert Point of View: Controlled Study Links ‘Chemobrain’ to Longitudinal Changes in Brain

Commenting on the study by Deprez et al, Patricia Ganz, MD, noted the importance of the finding for clinicians. “This study tells us that self-reported complaints mapped onto the neuropsychologic tasks; this has not been shown very often,” said Dr. Ganz, who is Director of the Division of Cancer...

SIDEBAR: Women Who Received HPV Vaccine Still Need Cervical Cancer Screening

The updated cervical cancer screening guidelines from the the U.S. Preventive Services Task Force (USPSTF) note that women who receive the HPV vaccine still need to be screened for cervical cancer because the vaccine does not protect against all strains of HPV that can cause cervical cancer. “The...

gynecologic cancers
issues in oncology

New Guidelines Recommend Less Frequent Screening for Cervical Cancer, but That Doesn’t Mean Screening Is Less Important

In the News focuses on media reports that your patients may have questions about at their next visit. This continuing column will provide summaries of articles in the popular press that may prompt such questions, as well as comments from colleagues in the field. In March 2012, the U.S. Preventive...

multiple myeloma

Novel Agents and Genomic Sequencing Show Promise in Improving Multiple Myeloma Management

For over 30 years, Kenneth C. Anderson, MD, Kraft Family Professor of Medicine at Harvard Medical School and Director of the Jerome Lipper Multiple Myeloma Center and LeBow Institute for Myeloma Therapeutics at Dana-Farber Cancer Institute in Boston, has focused his translational research on B-cell ...

breast cancer
kidney cancer
lung cancer
skin cancer
leukemia
lymphoma
issues in oncology

NCCN Clinical Practice Guidelines: Important Updates for 2012

The National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology have become the most widely used guidelines in oncology practice. The Guidelines cover 97% of all patients with cancer and are continually updated by expert panels. The 2012 Guidelines include some completely...

health-care policy

Letter to the Editor: Patient Protection and Affordable Care Act Reconsidered

I read with interest the front-page interview of Dr. Ezekiel Emanuel by Jo Cavallo in the December 15, 2011, issue of The ASCO Post. Dr. Emanuel may have had some of the most prestigious positions in all of medicine, but his opinion of the Affordable Care Act is completely misguided. This...

head and neck cancer

I Refuse to Let Cancer Win

My battle with cancer started with a simple sore throat in June 2005. Despite two rounds of an antibiotic to clear up the problem, within 2 months my throat hurt so much I couldn’t swallow, and a mysterious lump had suddenly appeared on my tongue. By the end of August, I was diagnosed with stage...

SIDEBAR: Expect Questions from Your Patients

While the process of finding permanent solutions to the shortage of oncology drugs continues, physicians and patients may still face difficult situations when certain drugs, possibly part of curative regimens, are not available. “The key thing is that we urge patients to have discussions with...

issues in oncology

Novel Initiative to Address Oncology Drug Crisis

Much has been written about the oncology drug shortage crisis in the United States. In the spirit of being part of the solution to that problem, a group of oncologists has formed the Citizen’s Oncology Foundation (COF). The goal of the start-up not-for-profit association is two-pronged: to find...

issues in oncology

Before Accepting a ‘Friend’ Request on Social Media, Carefully Consider the Potential Pitfalls and Perils

To friend or not to friend? That is the question many social networkers ponder daily. Oncologists and other health professionals considering “friend” requests from patients would be wise to first consider the potential pitfalls and perils of accepting such requests, according to an article written...

Conquer Cancer Foundation Board Member Tom Roberts Cites Need to Grow Research Capacity as Opportunity for Discovery Accelerates

Thomas G. Roberts, MD, dedicates a shelf in his home to memories of patients—photographs, notes, expressions of gratitude, traces of lives linked with his through cancer treatment. He looks at it every day, he says, and the memories inform his mission. “In oncology, you become part of people’s...

global cancer care
pain management
palliative care

Untreated Cancer Pain Remains a Significant Global Problem

“Physicians are afraid of morphine … Doctors [in Kenya] are so used to patients dying in pain … they think that this is how you must die. They are suspicious if you don’t die this way — [and feel] that you died prematurely.” —Human Rights Watch interview with Dr. John Weru of Nairobi Hospice,...

leukemia

Progress in Treating Chronic Lymphocytic Leukemia Has Led to Across-the-board Improvements in Survival

Four decades ago, Kanti R. Rai, MD, was determined to figure out why some of his patients with chronic lymphocytic leukemia (CLL) died within 2 years after their diagnosis, while others lived for 20 or even 30 years. At the time, Dr. Rai was a young scientist doing research in leukemia at...

SIDEBAR: Obese Children with Cancer May Be at Greater Risk for Cancer Recurrence

A study published in the Journal of Clinical Oncologyin 2008 found that obesity is an important contributing factor to chemotherapy resistance and rising relapse rates in children with leukemia.1 According to the study, obese children diagnosed with leukemia have a 50% higher chance of relapsing...

health-care policy

ASCO Reexamines the Oncology Workforce Shortage

A study commissioned by ASCO in 2006 predicted a significant shortage of medical and gynecologic oncologists in the United States by 2020. As a result, the organization created the Workforce Implementation Group to develop recommendations to stem the projected workforce shortfall and ensure ongoing ...

prostate cancer

Denosumab Delays Time to First Bone Metastasis in Men with Castration-resistant Prostate Cancer

Denosumab (Xgeva) significantly delayed time to first bone metastases among men with nonmetastatic castration-resistant prostate cancer enrolled in a phase III randomized, placebo-controlled trial. The time to first bone metastasis was 33.2 months among the 716 patients randomly assigned to receive ...

Markers in Cancer 2012, to be Held October 11–13, Will Seek to Move the Field of Biomarkers to the Next Phase

There are hundreds and hundreds of papers published on biomarkers in cancer each year, but very few make it over the hurdles necessary to be used in actual patient care, said James L. Abbruzzese, MD, Chair of the Department of Gastrointestinal Medical Oncology at the University of Texas MD Anderson ...

Patient-friendly News from the ASCO Annual Meeting

Go to Cancer.Net to find the latest news for patients from the 2012 ASCO Annual Meeting. At www.cancer.net/ascoannualmeeting, patients can listen to expert-led podcasts, watch disease-specific videos, read research summaries, and get recaps of each day’s highlights. The information here was updated ...

Full Membership: What It Means, What It Offers, and Why It’s Essential

As part of our series explaining the benefits of ASCO’s various membership categories, in this issue we focus on the Full Membership Category Involvement in ASCO—the largest and most inclusive professional organization in oncology—allows those involved in cancer care to chart the very course of the ...

issues in oncology

Can Whole-genome Sequencing Predict Cancer Risk and Improve Public Health?

If, as expected, the cost of whole-genome sequencing continues to drop, perhaps down to the $1,000 vicinity, it may become an alluring option for consumers who want to know about their risks for cancer and other diseases. But can genome sequencing really provide practical information about...

At More than a Century Old, American Association for Cancer Research Continues to Evolve

Margaret Foti, PhD, MD (hc), has been Chief Executive Officer of the American Association for Cancer Research (AACR) since 1982, and has been instrumental in launching some of the most seminal efforts of the cancer research organization. Over the past 4 years, she has helped spearhead the AACR’s...

survivorship

Better Information Needed for Primary Care Providers Who Treat Cancer Survivors

Many primary care providers are unaware of the late effects of chemotherapy, according to survey results presented at the ASCO Annual Meeting.1 For three out of four commonly used chemotherapy agents, medical oncologists performed well on the survey, but 29% to 38% of medical oncologists were...

When It Comes to Scientific Exploration, Renowned Clinical Investigator Lets the Work Guide His Path

Internationally renowned clinical investigator Daniel D. Von Hoff, MD, FACP, attended grade school in a one-room schoolhouse on the rural outskirts of Oshkosh, Wisconsin. Polio was a scourge at the time, and Dr. Von Hoff recalled lining up with his skittish classmates to get the newly developed...

Dana-Farber Researcher’s Work with Partners in Health Brings Quality Cancer Care to Rwanda

Lawrence N. Shulman, MD, Chief Medical Officer at Dana-Farber Cancer Institute, grew up in New York City. A product of the public school system, Dr. Shulman entered Syracuse University as a history major, only to realize that studying the past, although important, wasn’t for him. “I wanted a field...

Trailblazing Oncologist Had Instrumental Role in France’s War on Cancer

David Khayat, MD, PhD, Chair of the Department of Medical Oncology at the Pitié-Salpêtrière Hospital in Paris, was inspired to become an oncologist by an episode that could have been ripped from the pages of one of his best-selling novels. At the age of 18, Dr. Khayat was the witness at his best...

After 3 Decades at MD Anderson, Leukemia Researcher Shows No Sign of Slowing Down

Hagop M. Kantarjian, MD, Chair of the Department of Leukemia at The University of Texas MD Anderson Cancer Center, was born in Lebanon. The only member of his family to have pursued a career in medicine, he received his medical degree from the American University of Beirut (AUB), which was founded...

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