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Expect Questions From Patients

Results from the Scandinavian Prostate Cancer Group Study Number 4 (SPCG-4), showing that men with early-stage prostate cancer, particularly men under 65 years old, treated with radical prostatectomy had increased survival compared to those assigned to watchful waiting, has raised concerns among...

prostate cancer

Prostate Cancer Study Showing Increased Survival for Younger Men Undergoing Prostatectomy Not Expected to Increase Surgeries

Extended follow-up in the Scandinavian Prostate Cancer Group Study Number 4 (SPCG4), reported recently in The New England Journal of Medicine,1 found that men with early-stage prostate cancer, particularly those under 65 years old, who were treated with radical prostatectomy had increased survival...

integrative oncology

Reishi Mushroom

Scientific name: Ganoderma lucidum Common names: Ling zhi, lin zi, mushroom of immortality Overview A fungus, reishi mushroom is an important component of the traditional medical systems of China, Japan, Korea, and other Asian countries. It is used to increase energy, stimulate the immune system,...

prostate cancer

Does ‘Specialist Bias’ Contribute to Overtreatment of Prostate Cancer?

Specialist bias, in which specialists recommend the therapy that they are capable of delivering, is thought to influence the treatment of patients with localized prostate cancer and to contribute to overtreatment of men with limited life expectancy,” Ayal A. Aizer, MD, MPH, and colleagues, from the ...

Recent Study Finds Tripling in Thyroid Cancer

According to a recent report by Davies and Welch,1 the incidence of thyroid cancer in the United States has nearly tripled since 1975, from 4.9 to 14.3 per 100,000 persons, with most of the increase due to papillary thyroid cancer, which has increased from 3.4 to 12.5 per 100,000 persons. The...

survivorship

Detecting Accelerated Aging in Adult Survivors of Childhood Cancer

Last fall, Kirsten K. Ness, PhD, published her study1 on the prevalence of frailty as a sign of accelerated aging in adult survivors of childhood cancer, and the results are startling. Among the 1,922 participants in the study, the prevalence of prefrailty was 31.5% among women and 12.9% among men; ...

prostate cancer

Prostatectomy vs Radiotherapy: A Study for Cautious Interpretation

Men with newly diagnosed localized prostate cancer face a decision between prostatectomy and radiotherapy, treatments deemed similarly effective but with well-established trade-offs in terms of treatment-related morbidity. Numerous clinical trials and other prospective studies, from both academic...

prostate cancer

Complications Other Than Incontinence or Erectile Dysfunction After Prostatectomy or Radiotherapy for Prostate Cancer

Studies of complications of surgery or radiotherapy for prostate cancer generally focus on incontinence and erectile dysfunction. In a population-based cohort study reported in The Lancet Oncology, Robert Nam, MD, MSc, FRCS(C), Professor of Surgery, Sunnybrook Health Sciences Centre, University of...

prostate cancer

Georgetown Researchers Study Nonsurgical, Minimally Invasive Approach to Benign Prostatic Hyperplasia

Physicians at MedStar Georgetown University Hospital and Georgetown University Medical Center, Washington, DC, are studying the safety and effectiveness of prostate artery embolization in men with enlarged prostate glands and urinary obstruction. According to the National Institutes of Health,...

Conquering Colorectal Cancer With Sanjay Goel, MD, the 2010 Advanced Clinical Research Award in Colorectal Cancer Recipient

Colorectal cancer is the third most common cancer diagnosed in both men and women in the United States, and about 1 in 20 individuals will develop colorectal cancer in their lifetime. The good news is that improvements in screening, earlier detection, and treatments are all leading to improved...

prostate cancer

Tadalafil Did Not Prevent Erectile Dysfunction Among Men Receiving Radiotherapy

Daily use of tadalafil (Cialis) did not improve erectile function compared to placebo or prevent erectile dysfunction among men undergoing radiotherapy for prostate cancer, according to results of a stratified, placebo-controlled, double-blind, parallel-group study with 1:1 randomization at 76...

ASCO Cofounder Jane Cooke Wright, MD, Defied Racial/Gender Barriers and Helped Usher in the Modern Age of Chemotherapy

When Jane Cooke Wright, MD, met with six other oncologists at the Edgewater Beach Hotel in Chicago on April 9, 1964, to discuss the creation of American Society of Clinical Oncology, the first medical society dedicated to bringing patient-oriented issues to clinical oncology, the Civil Rights Act...

gastroesophageal cancer

Ramucirumab for Advanced or Metastatic Gastric or Gastroesophageal Junction Adenocarcinoma

On April 21, 2014, ramucirumab (Cyramza) was approved for use as a single agent in the treatment of patients with advanced or metastatic gastric or gastroesophageal junction adenocarcinoma with disease progression on or after prior treatment with fluoropyrimidine- or platinum-containing...

thyroid cancer

Increased Incidence of Thyroid Cancer: An Epidemic of Diagnosis?

In a study reported in JAMA Otolaryngology Head & Neck Surgery,1 Davies and Welch found that the incidence of thyroid cancer has nearly tripled since 1975. However, the increase appears to represent an “epidemic of diagnosis” and to almost exclusively represent increased diagnosis of papillary...

supportive care
survivorship

Maximizing the Benefits of Exercise in Patients With Cancer

Many nonpharmacologic therapies increase both physical and emotional strength during cancer treatment as well as throughout survivorship. These therapies include the mind-body practices of meditation, self-hypnosis, guided imagery, and breath awareness, touch therapies including massage and...

ASCO Launches New Resources for Providers and Patients to Address Link Between Obesity and Cancer

As the obesity epidemic takes its toll on the nation’s health, ASCO is making strides to address this growing concern as it relates to cancer. ASCO has developed a suite of educational resources designed to help oncology providers educate their patients about the negative effects of obesity on...

prostate cancer

Beyond the Cystoscope: Thinkers and Technicians

I have spent my career working with urologists. Over a long period of time, I have concluded that they are fine and interesting people who work hard, live well, support interesting hobbies, generally take good care of their families, and are very enjoyable company at parties. The recent discussion...

prostate cancer

Continued Survival Benefits Seen With Radical Prostatectomy vs Watchful Waiting in Long-Term Follow-up of the SPCG-4 Trial

The long-term benefits of radical prostatectomy vs watchful waiting in men with localized prostate cancer has remained a debated issue. As reported in The New England Journal of Medicine by Anna Bill-Axelson, MD, of Uppsala University Hospital, and colleagues, additional long-term follow-up in the...

prostate cancer

Blood Test Can Identify Prostate Cancer Patients Who Are Not Likely to Respond to Enzalutamide

A simple blood test may be able to identify men with castration-resistant prostate cancer who will not respond to enzalutamide (Xtandi). The presence of the splice variant androgen receptor (AR) V7 in circulating tumor cells identified men who were unlikely to respond to enzalutamide and whose...

issues in oncology

Water Pipe Smoking May Increase Risk for Cancer

Young adults who smoked water pipes in hookah bars had elevated levels of nicotine, cotinine, tobacco-related cancer-causing agents, and volatile organic compounds in their urine, and this may increase their risk for cancer and other chronic diseases, according to a study published in Cancer...

colorectal cancer

FDA Approves Panitumumab Plus FOLFOX for  Wild-Type KRAS Metastatic Colorectal Cancer

The U.S. Food and Drug Administration (FDA) has approved panitumumab (Vectibix) for use in combination with FOLFOX (fluorouracil, leucovorin, oxaliplatin) as first-line treatment in patients with wild-type KRAS (exon 2) metastatic colorectal cancer. This approval converts the accelerated...

prostate cancer

17-Gene Assay Is a Significant Predictor of Prostate Cancer Aggressiveness

Results from three studies published recently in European Urology indicate that the 17-gene Oncotype DX Genomic Prostate Score is a significant predictor of disease aggressiveness at the time of diagnosis before intervention with radiation or surgery.1 The test provides precise and individualized...

ASCO Takes Aim at the Link Between Obesity and Cancer

ASCO is stepping up its efforts to address the link between obesity and cancer—both as a leading cause of cancer and as a complicating factor for treatment. In recent years, research has demonstrated that a growing number of cancers are linked to obesity, and public health researchers predict that...

Expert Point of View: Peter P. Yu, MD

Discussing the study on immediate vs deferred androgen deprivation therapy in the setting of prostate cancer with prostate-specific antigen (PSA)-only relapse, ASCO President Peter P. Yu, MD, noted that more than 60,000 men each year will face the dilemma of when to start androgen deprivation...

prostate cancer

Delaying Androgen Deprivation Therapy May Not Compromise Survival in Men With Prostate Cancer and PSA-Only Relapse

In men with prostate cancer and a prostate-specific antigen (PSA)-only recurrence after curative surgery or radiation, delaying androgen deprivation therapy for at least 2 years or until clinical progression (ie, new symptoms, metastasis by imaging techniques or short PSA doubling time) did not...

Expert Point of View: Michael J. Morris, MD

Formal discussant of the E3805 study, Michael J. Morris, MD, Associate Member at Memorial Sloan Kettering Cancer Center in New York, said that these results confirm the role of upfront chemotherapy along with androgen-deprivation therapy in men with newly diagnosed metastatic hormone-sensitive...

prostate cancer

‘Unprecedented’ Survival Benefit in Prostate Cancer With Addition of Docetaxel to Hormone Therapy

Adding docetaxel to standard androgen ablation therapy (ie, testosterone suppression) extended survival by more than 1 year in men with newly diagnosed metastatic hormone-sensitive prostate cancer in the phase III E3805 trial, funded by the National Institutes of Health. As reported at the ASCO...

colorectal cancer

Colonoscopy Adenoma Detection Rate Inversely Proportional to Risk of Interval Colorectal Cancer and Colorectal Cancer Mortality

In a study of health-care organization data reported in The New England Journal of Medicine, Douglas A. Corley, MD, PhD, of Kaiser Permanente, and colleagues assessed the relationship between proportion of colonoscopies performed by a gastroenterologist that detect an adenoma and risk of subsequent ...

hematologic malignancies

FDA Approval of Siltuximab for Multicentric Castleman’s Disease

INSIDE THE BLACK BOX is an occasional column providing insight into the FDA and its policies and procedures. In this installment, FDA hematologist/oncologist Albert Deisseroth, MD, PhD, discusses the recent approval of siltuximab for patients with multicentric Castleman’s disease who are human...

colorectal cancer

Colorectal Cancer Screening Poised for Change

New screening modalities and the customization of the screening population could soon change the way that screening for colorectal cancer is done. At Digestive Disease Week 2014, the largest gathering of gastrointestinal disease specialists in the world, researchers presented data suggesting that...

Expert Point of View: Gregory A. Masters, MD, FASCO

This combination shows good activity in the difficult-to-treat second-line setting of NSCLC,” said Gregory A. Masters, MD, FASCO, about the results of the REVEL study reported at the ASCO Annual Meeting. Dr. Masters, who is Attending Physician at the Helen F. Graham Cancer Center and Research...

Expert Point of View: Cora N. Sternberg, MD, FACP

Despite the availability of hormonal therapy for the treatment of metastatic prostate cancer and the high response rates for these agents, most patients eventually experience progression to castration-resistant disease. “Multidisciplinary team approaches have contributed to the enormous progress...

Expert Point of View: Scott T. Tagawa, MD

Formal discussant Scott T. Tagawa, MD, Associate Professor of Clinical Medicine and Urology at Weill Cornell Medical College, New York, had the task of putting the three prostate cancer trials—PREVAIL, ELM-PC 4, and SWOG S0925—into context. “Since the approval of docetaxel, we have learned much...

prostate cancer

Updated Information on Prostate Cancer Drugs: Enzalutamide, Orteronel, and Cixutumumab

Three separate studies of treatments for prostate cancer reported at the 2014 ASCO Annual Meeting in Chicago showed excellent, intermediate, and disappointing results. An update of the previously reported PREVAIL trial (see March 1 issue of The ASCO Post, page 1) was overwhelmingly positive for the ...

head and neck cancer
issues in oncology

Limited Public Awareness of Head and Neck Cancers Raises Concerns About Prevention and Detection

Public awareness of head and neck cancer is limited, with the lack of awareness including the term head and neck cancer and common symptoms and risk factors, such as tobacco use and human papillomavirus (HPV), according to results of a cross-sectional online survey reported in JAMA...

ASTRO Names Three Radiation Oncologists as Recipients of Society’s 2014 Gold Medal

The American Society for Radiation Oncology (ASTRO) has announced the names of three recipients of the Society’s highest honor, the ASTRO Gold Medal. Mary K. Gospodarowicz, MD, FASTRO, Leonard L. ­Gunderson, MD, MS, FASTRO, and Nancy J. ­Tarbell, MD, FASTRO, will receive the ­ASTRO Gold Medal...

issues in oncology

ASCO Convenes Think Tank to Tackle Disparities in Cancer Care

Despite advances in cancer screening and in more effective therapies to treat the disease, which have led to improved outcomes and increased survival rates for millions of people with cancer, not every American is reaping the benefits of these advances. Disparities in health-care access, quality of ...

lung cancer

Importance of Using Multiplex Testing for Oncogenic Drivers to Select Targeted Drugs in Lung Cancer

Lung cancer is the leading cause of cancer death in the world as well as in the United States, where it is the leading cancer killer in both men and women. The majority of lung cancer patients present with metastatic (stage IV) disease that cannot be cured with current therapies. Standard cytotoxic ...

Expert Point of View: Eleni Efstathiou, MD, PhD

The magic of this research is that it requires a liquid biopsy [circulating tumor cells in the blood]—a simple blood collection,” said Eleni Efstathiou, MD, PhD, Associate Professor at The University of Texas MD Anderson Cancer Center, Houston, commenting on the study presented by Antonarakis and...

prostate cancer

AR-V7 Predicts Resistance to Enzalutamide and Abiraterone in Men With Castration-Resistant Prostate Cancer

Androgen receptor (AR) splice variant 7 (V7) appears to be a new biomarker for response and disease progression in patients treated with enzalutamide (Xtandi) or abiraterone (Zytiga). The presence of AR-V7 in circulating tumor cells predicted resistance to both drugs in men with metastatic...

prostate cancer

Prostate Cancer Biomarkers: Improvement in Predicting Clinically Significant Disease

Prostate cancer will be diagnosed in 233,000 American men in 2014. It is one of the leading causes of death by a cancer (killing ~29,500 men annually).1 Hundreds of thousands of men undergo prostate biopsies each year, most for either benign disease or for a cancer that will never lead to their...

Expect Questions From Patients

An updated study reporting a 20% increased risk of advanced prostate cancer and a 19% increased risk of lethal prostate cancer among men who have had vasectomies generated coverage by the medical and major media, including CBS News and The New York Times, and can be expected to prompt questions...

prostate cancer

‘Reasonable’ to Advise Men Who Have Had Vasectomies That They Have a Small Increased Risk for Lethal Prostate Cancers

Long-term results from the Health Professionals Follow-up Health Study have shown a 20% increased risk of advanced prostate cancer and a 19% increased risk of lethal prostate cancer among men who had vasectomies.1 According to the study’s lead author, Mohummad Minhaj Siddiqui, MD, it is...

head and neck cancer

Michael Douglas Shares His Experience With Stage IV Oropharyngeal Cancer

Academy Award winning actor and producer Michael Douglas was the guest of honor at the opening day of the International Federation of Head and Neck Oncologic Societies (IFHNOS) 5th World Congress on July 27 in New York (see page 22 for more on the World Congress). He came not to plug the release of ...

prostate cancer

Low-Risk Prostate Cancer and Principles of Active Surveillance

For specific diseases, many physicians tend to recommend interventions and therapies with which they are most comfortable and familiar. It is not surprising that urologists and radiation oncologists did so in the study reported by Hoffman and colleagues in JAMA Internal Medicine and reviewed in...

prostate cancer

Active Surveillance in Low-Risk Prostate Cancer: When Will We Pay It More Than Just Lip Service?

Active surveillance is well established as an appropriate management option for men with low-risk prostate cancer and particularly for those over 65 years of age. Its legitimacy is now enshrined within National Comprehensive Cancer Network guidelines, in the American Society for Radiation Oncology...

prostate cancer

Minority of Older Patients With Low-Risk Prostate Cancer Managed by Observation, Rates Vary Widely Among Urologists and Radiation Oncologists

Most older men with low-risk prostate cancer receive upfront treatment, despite the absence of a clear survival benefit and potential for morbidity. In a retrospective cohort study reported in JAMA Internal Medicine, Karen E. Hoffman, MD, MHSc, MPH, of The University of Texas MD Anderson Cancer...

prostate cancer

College of American Pathologists Publishes Recommendations for Prostate Cancer Active Surveillance

Recommendations from the United States Preventive Services Task Force and randomized trials have drawn attention to overtreatment of localized, low-risk prostate cancer. PSA screening and changing consensus on PSA testing practices are among the many factors that contribute to the overdiagnosis and ...

prostate cancer

Enzalutamide and the Landscape of Castration-Resistant Prostate Cancer: Integrating New Indications With Existing Agents

The androgen receptor axis is a validated target for the treatment of castration-resistant prostate cancer. Several perturbations in this pathway are postulated to lead to androgen-independent growth, including androgen receptor mutation and amplification as well as the autocrine production of...

prostate cancer

PREVAIL Trial: Enzalutamide Before Chemotherapy Prolongs Survival in Metastatic Prostate Cancer

The androgen-receptor inhibitor enzalutamide (Xtandi) has been shown to prolong survival in men with metastatic castration-resistant prostate cancer with progressive disease after chemotherapy. In the phase III PREVAIL trial reported in The New England Journal of Medicine, Tomasz M. Beer, MD, of...

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