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global cancer care

Addressing the Global Cancer Burden

Since 1990, the annual global death toll from cancer has risen about 40%, and that number is projected to increase from the current level of approximately 8 million cancer deaths per year to more than 13 million by 2030. The poorer, resource-challenged regions of the world will suffer a...

prostate cancer

Active Surveillance in Intermediate-Risk Prostate Cancer Called Into Question

A study presented at the 2015 Genitourinary Cancers Symposium calls into question the use of active surveillance in patients with intermediate-risk prostate cancer. Patients with intermediate-risk prostate cancer managed with active surveillance had almost a four times higher risk of prostate...

pain management

Key Evidence Gaps and Research Priorities Should Be Addressed So Physicians Can Identify Patients Most Likely to Benefit From Opioids

Key evidence gaps and research priorities must be addressed “so that physicians can recognize patients for whom opioids are most appropriate and use optimal regimens for these patients,” according to the National Institutes of Health (NIH) Pathways to Prevention Workshop final report on the role of ...

breast cancer

Nearly Half of Women Taking Tamoxifen for Primary Prevention Discontinue Its Use Before 5 Years

After 4.5 years of taking tamoxifen for primary prevention of breast cancer, 46% of women discontinued its use, according to research conducted within the Sister Study, a prospective cohort of women who had a sister diagnosed with breast cancer but did not have breast cancer themselves. Eligible...

prostate cancer

Selenium Supplements After Diagnosis of Nonmetastatic Prostate Cancer May Raise Prostate Cancer Mortality Risk

“Selenium supplementation of 140 or more μg/d after diagnosis of nonmetastatic prostate cancer may increase risk of prostate cancer mortality,” according to a prospective study following 4,459 men initially diagnosed with nonmetastatic prostate cancer in the Health Professionals Follow-up Study...

palliative care

Recognizing Physical Signs Associated With Impending Death Can Assist Clinicians, Patients, and Caregivers With Complex Decisions

In a recently published study of patients with advanced cancer whose status was systematically documented twice a day, from the time of admission to a palliative care unit until death or discharge, investigators identified eight physical signs associated with death within 3 days. Taken together...

cns cancers

Having Cancer So Early in Life Gave Me Purpose

I had every classic brain tumor symptom in the book—severe headaches, dizziness, morning nausea—which plagued me for 16 years, starting when I was 8. In college, if I allowed myself to sleep more than 4 hours a night, the morning headaches, which were centered on the top of my head, were so severe, ...

head and neck cancer

The Center of Who We Are

The following essay by Eric M. Genden, MD, is adapted from The Big Casino: America’s Best Cancer Doctors Share Their Most Powerful Stories, which was coedited by Stan Winokur, MD, and Vincent Coppola and published in May 2014. The book is available on Amazon.com and thebigcasino.org.   There’s...

ASCO Commends Dr. Varmus for Outstanding Leadership

Following news of Dr. ­Varmus’ planned departure from the National Cancer Institute (NCI), ASCO issued the following ­statement: ASCO is enormously grateful for the service and leadership of Harold Varmus, MD, as Director of the National Cancer Institute [NCI]. During Dr. Varmus’ tenure, the...

Harold Varmus, MD, Steps Down as NCI Director, Douglas Lowy, MD, Named Acting Director

Harold Varmus, MD, who has led the National Cancer Institute (NCI) at the National Institutes of Health (NIH) for nearly 5 years, has announced that he will step down from his post, effective March 31, 2015. “It has been our great fortune to have Dr. Varmus at the helm of the NCI,” said NIH...

breast cancer

Dr. Halsted’s Breast Amputation Specimens, Johns Hopkins Hospital, 1894

A Century of Progress The text and photographs on these pages represent the establishment of oncology as a viable medical specialty during the late 1800s and showcase the early medical advances and treatments in cancer. The images and captions are excerpted from a four-volume series of books titled ...

survivorship
breast cancer

Mobile Patient-Centered App Tracks Breast Cancer Survivors’ Experiences

Patricia Ganz, MD, Director of Cancer Prevention and Control Research at the Jonsson Cancer Center of UCLA, and collaborators Apple and Sage Bionetworks, recently announced the launch of “Share the Journey: Mind, Body and Wellness after Breast Cancer,” a patient-centered mobile application (app)...

issues in oncology

Study Finds Websites That Market Personalized Cancer Care Services Overemphasize Benefits

A recent analysis of 55 Internet websites marketing a broad range of tests and services that promise the ability to personalize cancer treatment has found that the websites often overemphasize their purported benefits and downplay their limitations. In addition, the study results show that the...

integrative oncology

Herbal Supplements: Increasing Problems

In Don Quixote, the 1605 Spanish literary masterpiece by Miguel Cervantes, “Balsam of Fierabras” is mentioned often as a therapeutic panacea. It calls for mixing rosemary, wine, oil, and salt. As the story goes, the knight relied heavily on this herbal preparation to relieve him of pain from the...

breast cancer

Wrestling With the Challenges of Breast Cancer

Bookmark Title: Then Came Life: Living With Courage, Spirit, and Gratitude After Breast CancerAuthor: Geralyn LucasPublisher: Gotham BooksPublication date: October 2, 2014Price: $19.89; hardcover, 240 pages Over the past decade or so, the oncology community has increased its understanding and...

health-care policy
cost of care

Medicine Turned Upside Down

BookmarkTitle: The Patient Will See You Now: The Future of Medicine Is in Your HandsAuthor: Eric Topol, MDPublisher: Basic BooksPublication date: January 2015Price: $28.99; hardcover, 384 pagesMost books about health care center on fixing broken parts of the massive $3 trillion system, as seen with ...

lymphoma

New Partnership Launches to Empower People Diagnosed With Lymphoma

The Leukemia & Lymphoma Society (LLS), together with the Lymphoma Research Foundation (LRF), CancerCare, the Association of Community Cancer Centers (ACCC), and Genentech announced the launch of a new partnership, the Alliance for Resource Collaboration in Hematology (ARCH). ARCH was developed...

Seattle Children’s Names Jeff Sperring, MD, New Chief Executive Officer

Seattle Children’s Hospital announced that the Board of Trustees has named Jeff Sperring, MD, Chief Executive Officer, effective early in May. Dr. Sperring, who currently serves as President and Chief Executive Officer of Riley Hospital for Children at Indiana University Health, will continue to...

multiple myeloma

Five Questions Can Guide the Treatment of Relapsed Myeloma

Joseph Mikhael, MD, MEd, myeloma expert at the Mayo Clinic in Arizona, Scottsdale, and Associate Dean of the Mayo School of Graduate Medical Education, considers five questions when selecting treatment for patients with multiple myeloma who relapse. “With prolonged survival, which approaches 10...

health-care policy

New Oncology Care Model: Encouraging Better Coordination for Cancer Care

On February 12, 2015, the U.S. Department of Health and Human Services (HHS) announced its new Oncology Care Model, a multipayer payment and care delivery model intended to support better coordination for cancer care. The initiative will include 24-hour access to practitioners for beneficiaries...

Beating the Odds in The Big Casino

More than 35 ASCO members contributed personal essays to a recently published collection of stories about humanism in medicine, including ASCO Past Presidents Paul A. Bunn, Jr, MD, FASCO, and Emil J. Freireich, MD, FASCO, and current President-Elect Julie M. Vose, MD, MBA, FASCO. The Big Casino:...

FDA Takes Steps to Simplify Compassionate Use Process, Invites Comment

The U.S. Food and Drug Administration (FDA) introduced a more streamlined form for requesting permission for patient access to investigational drugs outside of clinical trials. The new form is available for comment in a draft guidance for industry entitled “Individual Patient Expanded Access...

multiple myeloma

Panobinostat in Combination With Bortezomib‑Dexamethasone in Previously Treated Multiple Myeloma

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.   On February 23, 2015, panobinostat (Farydak) was granted...

FDA Names Geoffrey Kim, MD, Director of the Division of Oncology Products

The U.S. Food and Drug Administration (FDA) recently announced the appointment of Geoffrey Kim, MD, as Director of the Division of Oncology Products 1 (DOP1) in the Office of Hematology Oncology Products. Dr. Kim assumed this position effective March 22, 2015. Dr. Kim previously served as the...

issues in oncology

Development and Approval of Biosimilar Products

INSIDE THE BLACK BOX is an occasional column providing insight into the U.S. Food and Drug Administration (FDA) and its policies and procedures. In this installment, Leah Christl, PhD, and Albert Deisseroth, MD, PhD, answer questions about biosimilar products. Dr. Christl is the Associate Director...

multiple myeloma

Lenalidomide in Combination With Dexamethasone in Newly Diagnosed Multiple Myeloma

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.   On February 18, 2015, the indication for lenalidomide (Revlimid)...

issues in oncology
health-care policy

Ongoing Controversies in Allocating Our Health‑Care Resources

Disparities of care that result in poorer outcomes among certain populations have long been an issue addressed by the cancer community and its major organizations such as ASCO. While ethnicity and race play key roles in this ongoing debate over equitable allocation of our precious health-care...

breast cancer
gastrointestinal cancer

Gastric, Breast Cancer Risk in Carriers of CDH1 Gene Mutations

In a new study,1 more precise estimates of age-associated risks of gastric and breast cancer were derived for carriers of the CDH1 gene mutation, a cancer-predisposing gene that is abnormal in families meeting criteria for clinically defined hereditary diffuse gastric cancer (HDGC). David G....

issues in oncology

Physician-Controlled Decisions in Cancer Care Linked to Lower Quality Rating

Patients who described physician-controlled decisions about their cancer care vs shared decision-making were less likely to report receiving excellent quality of care, according to a study published by JAMA Oncology.1 The Institute of Medicine has called for shared decision-making and accommodation ...

breast cancer

SOFT Trial Results Inconclusive: Further Study Needed

The results of the SOFT trial—presented at the 2014 San Antonio Breast Cancer Symposium, reported recently by Francis et al in The New England Journal of Medicine,1 and reviewed in this issue of The ASCO Post—were not as conclusive as we had hoped. In essence, the study enrolled women with resected ...

breast cancer

Adjuvant Ovarian Suppression May Benefit Women With Premenopausal Breast Cancer Who Received Prior Chemotherapy

In a phase III trial (SOFT) reported in The New England Journal of Medicine, Prudence A. Francis, MD, of Peter MacCallum Cancer Centre, Melbourne, Australia, Meredith M. Regan, ScD, of IBCSG Statistical Centre at Dana-Farber Cancer Institute, Boston, and colleagues found that the addition of...

breast cancer
survivorship
thyroid cancer

New Analysis Reports Increased Risk of Thyroid Cancer After Breast Cancer Diagnosis

Breast cancer survivors are at increased risk of developing thyroid cancer, especially within 5 years of their breast cancer diagnosis, according to a new analysis of a large national database. The study results were presented at the Endocrine Society’s 97th Annual Meeting.1 “Recognition of this...

breast cancer

Increasing the Use of Hypofractionated Radiation in Early-Stage Breast Cancer: The Way Forward

Bekelman and colleagues are to be congratulated on the publication of an important paper—reviewed in this issue of The ASCO Post—alerting us all to the underutilization of hypofractionated whole-breast irradiation in the treatment of early-stage breast cancer.1 As background, recent randomized...

breast cancer

Hypofractionated Whole-Breast Irradiation After Breast-Conserving Surgery Used in Up to One-Third of Eligible Patients

In a study reported in JAMA, Justin E. Bekelman, MD, of the University of Pennsylvania Perelman School of Medicine, and colleagues found that approximately two-thirds of patients with early-stage breast cancer for whom hypofractionated whole-breast irradiation (for 3–5 weeks) was endorsed received...

colorectal cancer

Optimal Timing of Rectal Surgery: 60 Days or Less Post Chemoradiation Therapy

For the treatment of locally advanced rectal cancer, the optimal timing between the end of neoadjuvant chemoradiation therapy and surgical resection appears to be 60 days, according to an analysis of the National Cancer Database presented at the 2015 Gastrointestinal Cancers Symposium.1 An interval ...

supportive care

Many Cancer Patients at Risk for Hepatitis B Virus Reactivation

In 2015, no cancer patients should be cured of their malignancy only to die of reactivation of hepatitis B virus (HBV),” according to Anna S. Lok, MD, the Alice Lohrman Andrews Research Professor in Hepatology and Director of Clinical Hepatology at the University of Michigan, Ann Arbor. “I...

sarcoma

Priority Review Granted for Trabectedin in Advanced Soft-Tissue Sarcoma

The U.S. Food and Drug Administration (FDA) has granted Priority Review for the New Drug Application (NDA) for trabectedin to treat patients with advanced soft-tissue sarcoma, including liposarcoma and leiomyosarcoma subtypes, who have received prior chemotherapy including an anthracycline. The NDA ...

Expert Point of View: Matthew I. Milowsky, MD

Commenting on the study presented by Galsky et al at the Genitourinary Cancers Symposium, Matthew I. Milowsky, MD, Section Chief, Genitourinary Cancer, at the Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, agreed with Dr. Galsky that it is unlikely that we will...

bladder cancer

Adjuvant Chemotherapy Favored in Locally Advanced Bladder Cancer Not Treated With Neoadjuvant Therapy

A large observational study presented at the 2015 Genitourinary Cancers Symposium in Orlando, Florida, found that adjuvant chemotherapy extended the likelihood of survival in locally advanced bladder cancer compared with observation alone.1 Using three different approaches to propensity scores...

Expert Point of View: Jonathan Rosenberg, MD

Formal discussant of both trials, Jonathan Rosenberg, MD, of the Genitourinary Division at Memorial Sloan Kettering Cancer Center in New York, agreed that both studies move the field of antiangiogenesis in advanced bladder cancer forward. “The very high overall response rates in the pazopanib plus...

bladder cancer

Antiangiogenesis Plus Chemotherapy Pursued in Advanced Bladder Cancer

Two separate phase II studies lend support to the concept of antiangiogenesis in advanced bladder cancer. The combination of an antiangiogenic agent and chemotherapy may fulfill an unmet need in this disease, the studies suggest. Both studies were presented at the 2015 Genitourinary Cancers...

Expert Point of View: Andrew Loblaw, MD

Commenting on this study, formal discussant D. Andrew Loblaw, MD, a radiation oncologist at the Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Canada, said: “The trial showed that after a median follow-up of 7.0 years, there were no differences in overall survival between the two ...

prostate cancer

High-Dose Radiotherapy Provides Meaningful Improvements in Localized Prostate Cancer—But Not Increased Survival Yet

High-dose radiotherapy failed to improve overall survival at 7 years compared with standard-dose radiotherapy in men with stage II localized prostate cancer. However, the high-dose schedule had several advantages, including improved rates of local tumor control and distant metastasis, according to...

Expert Point of View: Eric J. Small, MD

GETUG-AFU 15 sought to improve outcomes in metastatic hormone-naive prostate cancer, but the study failed its primary objective,” noted formal discussant Eric J. Small, MD, of the University of California, San Francisco. In the overall analysis of this previously published trial, with no...

prostate cancer

No Survival Benefit Reported With Docetaxel Added to Hormone Therapy in Metastatic Prostate Cancer

Docetaxel added to androgen-deprivation therapy did not improve overall survival over androgen-deprivation therapy alone in hormone-naive metastatic prostate cancer, according to an updated analysis of the GETUG-AFU 15 trial presented at the 2015 Genitourinary Cancers Symposium.1 In a retrospective ...

issues in oncology
health-care policy

Health-Care Fraud and Abuse: Implications for Oncology

Health-care fraud is a long-standing problem in the United States, accounting for $75 billion in government expenses per year,1 while total spending on government health-care programs is over $1 trillion. Two decades ago, the Department of Justice increased its efforts to combat health-care fraud....

Expert Point of View: Charles Ryan, MD

ASCO Expert and GU News Planning Team Member, Charles Ryan, MD, of the University of California, San Franciso, Helen Diller Family Comprehensive Cancer Center, said the results presented by Singh et al at the 2015 Genitourinary Cancers Symposium were “encouraging” and that it makes sense to exploit ...

prostate cancer

Intensified Immunotherapy Encouraging in Chemotherapy-Naive Metastatic Prostate Cancer

Emerging evidence suggests that immunotherapy may play an important role in treating prostate cancer. In particular, preliminary results have shown that combining a new vaccine with ipilimumab ­(Yervoy) boosts overall survival in men with castration-resistant prostate cancer.1 A study comparing...

Remembering Neurosurgeon and Writer Paul Kalanithi, MD

What initially drew me to read the eloquent essay by Paul Kalanithi, MD, in The New York Times—“How Long Have I Got Left?”—was its provocative title.1 What kept me there was the moving description of his quick transition from healthy physician with a brilliant career in neurosurgery to terminally...

lymphoma

Radiotherapy in Good-Prognosis DLBCL

I was disturbed by the article on “Radiotherapy in Good-Prognosis ­DLBCL” published recently in The ASCO Post.1 As a practicing radiation oncologist for 30 years, I have seen the evolution of radiation techniques (and philosophy) for non-Hodgkin lymphoma progress from regional—or even...

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