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breast cancer

Insightful Advice From a College Advisor Leads to an Unexpected Career in Oncology

For this installment of the Living a Full Life series, guest editor Jame Abraham, MD, FACP, spoke with Tatiana M. Prowell, MD, who currently serves as Associate Professor of Oncology in the Breast Cancer Program at the Johns Hopkins Kimmel Comprehensive Cancer Center and as a Medical Officer and...

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...

issues in oncology
health-care policy

Karen M. Winkfield, MD, PhD, on Policy and Business Solutions to Address Disparities in Cancer Care

Karen M. Winkfield, MD, PhD, of the Wake Forest Baptist Medical Center, discusses cultural factors that contribute to cancer care disparities, the role of national policy in addressing inequities in access to care, and what local institutions can do to improve the situation.

issues in oncology

Hey Siri, Should I Get a Medical Degree?

I received a coffee mug from a physician colleague some years ago with the tag line: “Please do not confuse your Google search with my Medical Degree.” Physicians of all stripes and colors can relate to the agony of debunking a “Dr. Google” diagnosis. However, in a fast-evolving health-care...

issues in oncology

How Patient Advocacy Is Integral to High-Quality Oncology Care

Karen M. Winkfield, MD, PhD, has made patient advocacy—with a specific emphasis on health equity and access to high-quality care—front and center of her oncology practice since she completed her residency at the Harvard Radiation Oncology Program in Boston, where she noticed that most of the...

skin cancer

Stage IV Melanoma: What Current Role Should Surgery Play?

Advanced melanoma has become a different entity in the era of immunotherapy and targeted agents. Considering the potential for good outcomes from systemic therapy in advanced disease, has the role of surgery changed? Should it be offered up front or limited to patients with oligometastatic ...

breast cancer
survivorship

Pregnancy Appears Safe After Treatment for Breast Cancer in Patients With BRCA Mutations

Pregnancy after breast cancer appears to be safe in patients with germline BRCA mutations—and particularly among those with BRCA1 mutations—according to new research. Limited data are available on the safety of pregnancy and reproductive outcomes in patients with breast cancer and BRCA mutations,...

supportive care

ASCO Expands Therapeutic Options for Venous Thromboembolism Prophylaxis in Patients With Cancer

ASCO has updated its recommendations for the prevention and treatment of venous thromboembolism (VTE) in patients with cancer. “The recommendations were last updated in 2015, but since then, new, significant publications have emerged, which prompted this update,” said Nigel S. Key, MBChB, of the...

multiple myeloma

Is It Time to Intervene in Smoldering Myeloma?

Early intervention in smoldering multiple myeloma prevents progression to symptomatic disease and should be strongly considered for patients meeting new criteria for high risk, according to Sagar Lonial, MD, Professor and Chair of Hematology and Medical Oncology and the Anne and Bernard Gray...

issues in oncology
cost of care

2019 Quality Care: Cost of Treatment, Prior Authorization of Treatment Plans May Cause Barriers to Care

Drug costs and requirements for prior authorization of treatment plans pose barriers to cancer treatment and can potentially affect outcomes for many patients, according to two studies that will be presented at the ASCO Quality Care Symposium. The studies respectively examine how the high...

prostate cancer

TITAN Trial: Apalutamide Adds to Options for Men With Metastatic Hormone-Sensitive Prostate Cancer

Androgen-deprivation therapy has been, and remains, the standard of care for patients with metastatic prostate cancer. Patients are often surprised to know that was all we would do to control their disease and sometimes asked why they would not get chemotherapy, as for other cancers. I would take...

issues in oncology
survivorship

What Role Do Physicians Play in Health Promotion Among Patients With Cancer?

A recent study published by Stump et al in Cancer indicated that certain physicians who care for patients with cancer do not often promote healthy lifestyle changes to cancer survivors, and they may fear that providing such advice would distress or overwhelm patients. The findings are noteworthy...

prostate cancer

Many Choices Now for Men With Metastatic Hormone-Sensitive Prostate Cancer: How to Decide?

Based on the recently published ENZAMET, ARCHES, and TITAN trials,1-3 we now have several choices of systemic combination therapies for men with metastatic hormone-sensitive prostate cancer; the ENZAMET trial is reviewed in this issue of The ASCO Post. In 2019, men are now faced with decisions of...

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...

pancreatic cancer

Role of the YAP Regulatory Network in Pancreatic Ductal Adenocarcinoma

Researchers have decoded a chain of molecules that are critical for the growth and survival of pancreatic ductal adenocarcinoma. They say their findings, published by Murakami et al in Developmental Cell, suggest that inhibiting the YAP biologic network may effectively regress early-stage...

New From ASCO eLearning: Platform Offers Enhanced, Personalized Online Learning Experience

PERSONALIZATION AND STREAMLINED navigation were two priorities of the recent rebranding of ASCO University. Now known as ASCO eLearning (elearning.asco.org), the rebrand more accurately reflects what the program offers and who it is intended for. “The priority I see for ASCO eLearning is to make...

Some Practices May Not Be Subject to USP and Standards

ASCO recently received clarification from the United States Pharmacopeia (USP) around the newly revised USP General Chapter <797> Pharmaceutical Compounding Standards–Sterile Preparations and USP General Chapter <800> Hazardous Drugs–Handling in Health-Care Settings, which become...

Register for ASCO’s Research Community Forum 2019 Annual Meeting

Registration is open for the ASCO Research Community Forum (RCF) 2019 Annual Meeting. The ASCO RCF Annual Meeting brings together physician-investigators and research staff from across the country for 2 days of learning and collaboration. The meeting offers colleagues from a variety of research...

prostate cancer

Looking at Prostate Cancer–Specific Mortality by Gleason Score and Race

Black men suffer disproportionately from prostate cancer, both in terms of incidence and mortality, compared with their white counterparts. However, a newer study conducted by investigators at the University of California, San Francisco, and Dana-Farber Cancer Institute, Boston, found that black...

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...

supportive care
symptom management

Virtual Reality May Improve Pain, Vision, Functioning in Patients With Cancer

Virtual reality can be used to improve functioning in patients with cancer, according to David Rhew, MD, Chief Medical Officer, Vice President and General Manager of Enterprise Healthcare, Samsung Electronics America. Research has shown that this technology can decrease pain and improve vision, as...

issues in oncology
pain management

Opioids for Cancer Pain: A Review of the Evidence and Current Challenges

In the wake of the opioid crisis in the United States, patients with cancer pain are often undeservedly confronted with rigid barriers to receiving the opioids they need. To compound this problem, the research around opioids in cancer pain has been limited—placebo-controlled trials are lacking,...

lung cancer
immunotherapy

Optimal First-Line Therapy for Stage IV Non–Small Cell Lung Cancer: Immunotherapy Alone or With Chemotherapy?

Recent studies in non–small cell lung cancer (NSCLC) have shown benefit for combining checkpoint inhibitors with chemotherapy. Should combinations, therefore, be the first choice for treating patients with newly diagnosed stage IV disease? Two lung cancer experts debated this point at the 2019...

solid tumors

Expert Point of View: Thomas Paul Slavin, Jr, MD

Thomas Paul Slavin, Jr, MD, of City of Hope National Medical Center, where he is Assistant Clinical Professor in the Department of Medical Oncology, Division of Clinical Cancer Genomics, and a Program Member of Cancer Control and Population Sciences, commented on these substudy findings. The...

solid tumors

Exploratory Analysis Shows DNA Methylation Assay Highly Specific for Cancer Detection

A cell-free DNA test based on the presence of DNA methylation has proven highly specific as a multicancer detection test and appears especially good at detecting high-risk malignancies. In most cases, it can also accurately pinpoint the tumor’s tissue of origin, researchers reported at the 2019...

immunotherapy

What Causes Liver Injury During Treatment With Pembrolizumab

Immunotherapy as a treatment for advanced solid cancers has rapidly evolved over the past decade—often yielding remarkable results. However, its use has also given way to new adverse effects, including drug-induced gastrointestinal and liver toxicities. “Checkpoint inhibitors are a game changer...

hematologic malignancies
lymphoma

A Clinical Trial Was the Right Choice for Me

I found my cancer quite accidentally. In March 2018, as I was taking a shower, my hand casually brushed against my right mastoid bone, and I noticed the area sounded hollow. Around the same time, I realized I had developed a sense of fullness in that ear as well. I had been feeling tired, but that...

V. Craig Jordan, CMG, OBE, PhD, DSc, Honored for Accomplishments in Women’s Health

The Companion of the Most Distinguished order of St. Michael and St. George (CMG) is generally reserved for ambassadors and leaders of the United Kingdom’s defense and security services. Only 1, 750 appointees are permitted. This year, the Head of M16, the Secret Intelligence Service, was in the...

immunotherapy

What Causes Liver Injury During Treatment With Pembrolizumab

Immunotherapy as a treatment for advanced solid cancers has rapidly evolved over the past decade—often yielding remarkable results. However, its use has also given way to new adverse effects, including drug-induced gastrointestinal and liver toxicities. “Checkpoint inhibitors are a game changer...

An Early Decision to Become an Oncologist

GUEST EDITOR Dr. Abraham is the Director of the Breast Oncology Program at Taussig Cancer Institute, and Professor of Medicine, Lerner College of Medicine, Cleveland Clinic.   For this installment of the Living a Full Life series, Guest Editor Jame Abraham, MD, FACP, spoke with Gilberto de Lima...

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...

breast cancer

Total Cumulative Chemotherapy Dose and Survival in Breast Cancer

Physicians should attempt to maintain full doses of chemotherapy, especially early in the course of treatment, for patients with intermediate- or high-risk breast cancer, according to research published by Veitch et al in JNCCN—Journal of the National Comprehensive Cancer Network. The...

issues in oncology

Relationship Between Sleep Apnea and Cancer Risk in Women

Women with severe sleep apnea appear to also have an elevated risk of developing cancer, according to findings from a study by Pataka et al in the European Respiratory Journal. No causal relationship was demonstrated, but a link between nocturnal hypoxia in women and higher cancer risk was...

prostate cancer

Mortality Risk for Patients With Preexisting Cardiovascular Conditions Treated With Abiraterone Acetate or Enzalutamide

A new population-based study showed that novel oral androgen signaling–inhibitor therapies may be associated with an increased risk of death in patients with preexisting cardiovascular conditions. The research was published by Lu-Yao et al in European Urology. “Data from published ...

colorectal cancer

Does Exercise Improve Outcomes in Patients With Metastatic Colorectal Cancer?

Patients with metastatic colorectal cancer who engaged in moderate exercise while undergoing chemotherapy tended to have delayed progression of their disease and fewer severe side effects from treatment, according to the results of a new study published by Guercio et al in the Journal of Clinical...

solid tumors
head and neck cancer

Remembering Michael D. Becker

The staff of The ASCO Post were sad to learn of the passing of Michael D. Becker on July 9, 2019. When Michael was diagnosed with human papillomavirus (HPV)-related oropharyngeal cancer in 2015, he made the decision to go public with his diagnosis to raise awareness of the importance of having...

The Opioid Overdose Crisis: Victims, Villains, and the Gray Area in Between

According to politicians and the media, such as award-winning journalist Beth Macy, we are in the midst of the worst drug crisis in American history. Sparked first by oxycodone and broadening into heroin and fentanyl, opioid addiction is indeed ravaging communities across the nation, largely in...

The Obesity Epidemic From a Neuroscience Perspective

Since the 1970s, there has been an alarming increase in obesity. According to the latest data from the Centers for Disease Control and Prevention (CDC), about 70% of Americans are either overweight or obese. Excess body weight is linked to numerous diseases, including more than 14 types of cancers. ...

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...

issues in oncology
genomics/genetics

How Technology Is Transforming the Assessment of Inherited Cancer Risk

ASCO published its first statement on genetic testing and its impact on oncology practice over 2 decades ago. Since then, ASCO has revised the statement three times, the most recent in 2015, in response to advances propelled by the sequencing and mapping of the human genome and the identification...

issues in oncology

Eighth Edition of the AJCC Staging Manual Offers a More Personalized Approach to Patient Classification

This year marks the 60th anniversary of the creation of the American Joint Committee on Cancer (AJCC), whose founding mission was to standardize the anatomic staging of cancer based on the size of a tumor and any spread to nearby tissue (T); the spread of the cancer to nearby lymph nodes (N); and...

survivorship

The Role of Primary Care Physicians in Pediatric Cancer Survivorship

The symptoms related to childhood cancers that first prompt parents to seek medical care may be as nonspecific as those of the flu or a number of other common ailments. Therefore, a suspicion of cancer sometimes emerges during a visit to the child’s primary care physician. Although primary care...

skin cancer

Can Genetic Counseling and Test Reporting in Patients Susceptible to Melanoma Development Change Behavior?

A new study published by Stump et al in Genetics in Medicine investigated whether genetic testing would motivate people at risk of developing melanoma to alter their behavior in order to reduce their risk. “We are trying to understand whether a genetic test result adds value over and above...

Sylvester Comprehensive Cancer Center Earns NCI Designation

Sylvester Comprehensive Cancer Center, part of the University of Miami Leonard M. Miller School of Medicine, has been named a National Cancer Institute (NCI)-designated cancer center. The NCI designation recognizes Sylvester as among the top cancer centers in the United States. Sylvester joins a...

issues in oncology
health-care policy

Looking at the Impact of State Policies on Access to High-Quality Care

The state of Washington is adding a public option to its health insurance marketplace; Massachusetts, Connecticut, and others have passed laws requiring that payers cover fertility preservation procedures for patients with cancer. Many states are seeking to expand Medicaid eligibility, and some, in ...

hematologic malignancies
lymphoma

Treatment Update on Selected Non-Hodgkin Lymphomas

As part of The ASCO Post’s coverage of the 2019 ASCO Annual Meeting, featured here are four abstracts from different clinical trials evaluating newer treatments for Waldenström’s macroglobulinemia and T-cell lymphomas. Waldenström’s Macroglobulinemia ABSTRACT 7509: Outcomes with bendamustine plus ...

survivorship

Preserving Sexuality and Restoring Sexual Function in Male and Female Cancer Survivors

Intimacy changes after a cancer diagnosis. Both male and female survivors can experience significant sexual dysfunction, pain with sex, loss of desire, and a slew of other clinical and psychological sequelae. To make matter worse, sexual function is often not discussed by patients and their...

lymphoma

FDA Requests Manufacturer Recall of Some Textured Breast Implants

On July 24, the U.S. Food and Drug Administration (FDA) requested that Allergan, the manufacturer of a specific type of textured breast implant, recall specific models of its textured implants from the U.S. market due to the risk of breast implant–associated anaplastic large cell lymphoma (ALCL)....

symptom management
supportive care

Novel Therapeutics on the Horizon for Treating Chemotherapy-Induced Peripheral Neuropathy

Chemotherapy-induced peripheral neuropathy is a major clinical problem, and better therapies are needed for both its treatment and prevention. According to Charles Loprinzi, MD, a medical oncologist at the Mayo Clinic in Rochester, Minnesota, to devise better preventive and treatment approaches,...

lung cancer

Studies Find Trilaciclib May Improve Chemotherapy Experience for Patients With Small Cell Lung Cancer

In patients with extensive-stage small cell lung cancer (SCLC), adding trilaciclib to standard-of-care chemotherapy demonstrated meaningful delays in deterioration of myelosuppression-related symptoms, according to Jared Weiss, MD, of the UNC Lineberger Comprehensive Cancer Center, Chapel Hill,...

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