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issues in oncology

Infertility in Women and Low Absolute Risk of Cancer

A study of over 64,000 women of childbearing age in the United States has found that infertility is associated with a higher risk of developing cancer compared to a group of over 3 million women without fertility problems—although the absolute risk is very low, at just 2%. These findings ...

Use Technology and Appreciate the Importance of Partners

Most oncologists are comfortable treating lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) patients with cancer, according to a survey of 149 oncologists from 45 National Cancer Institute–designated Comprehensive Cancer Centers, but not as confident in their knowledge of the...

issues in oncology

Knowing Gender Identity and Sexual Orientation of Patients Is a Vital Aspect of Medical Care

A survey of oncologists from National Cancer Institute (NCI)-designated Comprehensive Cancer Centers found that 95.3% of oncologists who responded are comfortable with treating lesbian, gay, and bisexual patients with cancer, and 82.5% are comfortable treating transgender patients with cancer.1...

Obesity, Examined and Explained

BOOKMARK Title: The Obesity Code: Unlocking the Secrets of Weight LossAuthor: Jason Fung, MDPublisher: Greystone BooksDate: March 2016Price: $18.95, paperback; 296 pages According to data from the National Cancer Institute (NCI), obesity plays a significant role in developing at least 12 different ...

palliative care
supportive care

Sweet Surrender

The ASCO Post is pleased to reproduce installments of the Art of Oncology as published previously in the Journal of Clinical Oncology. These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer, and they include narratives, topical essays,...

WebMD Recognizes Seven Cancer Innovators With Its Health Heroes Award

On January 15, 2019, WebMD, an online and print health-care resource for consumers, presented its 2018 Health Heroes Award in New York City to 7 people who are making a difference in oncology care. The honorees include Karen M. Winkfield, MD, PhD, Associate Professor of Radiation Oncology at Wake...

issues in oncology

The Risks of Drug Approval Based on Shaky Evidence

Two recent publications in The New England Journal of Medicine (NEJM), and the resulting drug approval applications that have already been filed, lead to concern that the basis of medical practice on valid evidence may be corrupted. Each involves statistically shaky analysis leading to a striking...

ASCO President-Elect Howard A. Burris III, MD, FACP, FASCO, Gained Leadership Skills From His Experience at West Point

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. In this installment of Living a Full Life, guest editor Jame Abraham, MD, spoke with Howard A. “Skip” Burris III, MD, FACP,...

hematologic malignancies
lymphoma

CAR T-Cell Therapy for DLBCL: At the Crossroads of Hype and Reality

In the 20-plus years I have spent in hematologic oncology, I have been fortunate to have a ringside seat to watch “game-changing” advances come into our field—all-trans retinoic acid for acute promyelocytic leukemia, tyrosine kinase inhibitors starting with imatinib for chronic myeloid leukemia,...

prostate cancer

EAU 2019: Testosterone Replacement Therapy May Slow Recurrence in Low-Risk Prostate Cancer

Researchers have shown that testosterone replacement may slow the recurrence of prostate cancer in low-risk patients. Findings from the study were presented by Towe et al at the European Association of Urology (EAU) 2019 Congress (Abstract 646). Practitioners have long regarded testosterone as a...

issues in oncology

Assessing the Clinical Utility of ASCO’s and ESMO’s Value Frameworks

In 2015, ASCO and the European Society for Medical Oncology (ESMO) introduced value frameworks that utilize algorithmic scales to evaluate the clinical benefit of cancer therapies and provide an objective assessment of outcomes and treatment toxicities experienced by patients.1,2 Although the two...

issues in oncology
global cancer care

Global Incidence of Undiagnosed Pediatric Cancers

Nearly half of all childhood cancers are not being diagnosed globally, according to a new modeling study published by Ward et al in The Lancet Oncology. “Our model suggests that nearly one in two children with cancer are never diagnosed and may die untreated,” said lead...

Humanitarian, Cancer Specialist Advocates for Universal Access to Care as a Basic Human Right

There is a plethora of educational books for patients with cancer and their families; advocates and patients themselves write most. Books in this genre often have a difficult time distilling the hard science of oncology into a lay-friendly narrative that keeps the reader engaged from cover to...

breast cancer

We Need Better Screening Methods for Detecting Breast Cancer

MY BREAST CANCER was probably a decade in the making, although I only became aware that there might be a problem in 2014, when I noticed some slight pain in my left breast. A routine mammogram and ultrasound found benign cysts in my dense breasts, which most likely explained the pain, I was told,...

breast cancer
issues in oncology
cost of care

Patients With Breast Cancer Provide Recommendations to Ease Financial Toxicity

A qualitative study yielded nine patient-driven recommendations across circumstances that include changes to insurance, supportive services, and financial assistance to reduce long-term, breast cancer–related economic burden. The study was published by Dean et al in Cancer. Unique...

solid tumors
issues in oncology

Effect of Adjuvant Treatment for Early Testicular Cancer on Reproductive Potential

Men with early-stage testicular cancer can safely receive one course of adjuvant chemotherapy or radiotherapy without it having a long-term effect on their reproductive potential, according to a study published by Weibring et al in Annals of Oncology. Although it is known already that several...

FDA Commissioner Scott Gottlieb, MD, Resigns

On March 5, 2019, Scott Gottlieb, MD, announced his resignation as Commissioner of the U.S. Food and Drug Administration (FDA), a post he began in 2017. Dr. Gottlieb’s resignation will be effective next month. In a resignation letter to Alex M. Azar II, Secretary of Health and Human Services ...

skin cancer
issues in oncology

2019 AAD: Disadvantages and Potential Improvements of Artificial Intelligence in Skin Cancer Detection

While artificial intelligence (AI) systems for skin cancer detection have shown promise in research settings, there is still a lot of work to be done before the technology is appropriate for real-world use. This was the topic of a scientific session at the 2019 American Academy of Dermatology (AAD) ...

issues in oncology

Eliminating the Taboo of Cancer

All homes and all families have or have had their own cancer experiences. Speaking about it dissolves the taboo and allows for earlier diagnosis, less discrimination, increased awareness, and higher commitment by authorities. It also helps those struggling with the disease feel like part of a...

hematologic malignancies

Advances in Haploidentical Transplantation and Cellular Therapies

With advances in the field, the number of haploidentical stem cell transplants being performed (ie, using human leukocyte antigen [HLA] half-matched donor stem cells) has been increasing. In recognition of evolving strategies to improve outcomes, a group of transplant physicians started the...

breast cancer

Long-Term Study Finds Axillary Radiotherapy Safe and Effective After Positive Sentinel Node Biopsy

Following identification of a positive sentinel lymph node, surgical axillary lymph node dissection and axillary radiation therapy provide comparable locoregional control and survival, according to a 10-year follow-up of the large European Organisation for Research and Treatment of Cancer AMAROS...

issues in oncology

10 Patient-Centered Principles for More Conservative Cancer Diagnosis

Although diagnostic errors date back to antiquity, in recent years, they have begun to receive attention as an important patient safety issue. This culminated in the National Academy of Medicine’s 2015 landmark report, which concluded that most people in the United States would experience at...

Expert Point of View: Lori Wood, MD

Formal discussant of KEYNOTE-426, Lori Wood, MD, of Dalhousie University, Halifax, Nova Scotia, Canada, called both KEYNOTE-426 and JAVELIN-101 “practice-changing.” “In 2019, we have a new standard of care,” Dr. Wood declared. “The majority of patients with clear cell advanced renal cell carcinoma ...

skin cancer
immunotherapy

AACR 2019: Diet May Influence Gut Microbiome and Response to Immunotherapy

Among patients with melanoma treated with anti–programmed cell death protein 1 (PD-1) immunotherapy, consumption of a high-fiber diet was associated with higher gut microbiome diversity and better response to treatment, according to data presented by Spencer et al at a presscast in advance of ...

First-Line Ibrutinib/Rituximab Combination Shows Benefit for Younger Patients With CLL

FIRST-LINE therapy with the combination of ibrutinib and rituximab reduced disease progression by two-thirds compared with standard chemotherapy using fludarabine, cyclophosphamide, and rituximab (FCR) in younger patients with chronic lymphocytic leukemia (CLL), according to the late-breaking...

Large Single-Arm Trial of Hydroxyurea for Sickle Cell Anemia in Sub-Saharan Africa

THE LARGEST PROSPECTIVE trial of hydroxyurea for sickle cell anemia has shown that this treatment is feasible, accepted, well tolerated, and safe for children living in sub-Saharan Africa. Hydroxyurea has long been the standard of care for treating children with sickle cell anemia in developed...

Expert Point of View: Mrinal Patnaik, MBBS, and David P. Steensma, MD

Mrinal S. Patnaik, MBBS, Associate Professor of Internal Medicine and Oncology and a consultant in hematology at the Mayo Clinic, Rochester, commented on the MEDALIST trial for The ASCO Post. “Given its unique mode of action, relative ease of administration, and excellent tolerability,...

Front-Line Ibrutinib Improves Progression-Free Survival in Older Patients With Chronic Lymphocytic Leukemia

IN A PHASE III TRIAL reported during the Plenary Session at the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition and published in The New England Journal of Medicine, single-agent ibrutinib and ibrutinib/rituximab were associated with superior progression-free survival vs...

head and neck cancer
immunotherapy

In Era of Immunotherapy, Radiation Therapy May Become Essential Component of Systemic Treatments of Cancer

“IN THIS era of immunotherapy, it is highly possible, and potentially probable, that radiation therapy may become not just a form of locoregional and palliative treatment, but an essential component of our systemic treatments of cancer,” according to Zachary S. Morris, MD, PhD, Vice-Chair,...

head and neck cancer
immunotherapy
symptom management

Immunotherapy for Head and Neck Cancer Expands, but Concerns Persist About Patient Selection and Toxicities

SOME PATIENTS with advanced head and neck cancer may achieve durable responses with immunotherapy, and recent trial results suggest first-line immunotherapy may increase survival among patients with recurrent or metastatic disease. However, concerns remain about selecting patients most likely to...

hematologic malignancies

FDA Approves Caplacizumab-yhdp for Acquired Thrombotic Thrombocytopenic Purpura

ON FEBRUARY 6, 2019, the U.S. Food and Drug AdministrationFDA approved caplacizumab-yhdp (Cablivi) injection, in combination with plasma exchange and immunosuppressive therapy, for the treatment of adult patients with acquired thrombotic thrombocytopenic purpura (aTTP). “Patients with aTTP endure...

issues in oncology
survivorship

How to Improve Care for Young Sexual and Gender Minority Cancer Survivors

IN 2017, ASCO issued its recommendations for addressing the oncology care needs of sexual and gender minority cancer survivors and the unique challenges they face.1 There are myriad reasons for cancer disparities in this population compared to heterosexual cisgender cancer survivors, including...

issues in oncology
health-care policy

‘Curve 2’ and Oncology: What Those in Charge Don’t Understand … or Ignore

THERE IS little doubt that the U.S. health-care system is under assault from many directions.1 It is clear that the costs of health management are no longer sustainable, and the United States has one of the highest per capita health costs among the 36 member nations of the Organisation for...

issues in oncology

Former JAMA Editor Offers Perspective on Challenges Past and Present in American Health Care

BOOKMARK Title: Severed Trust: Why American Medicine Hasn’t Been FixedAuthor: George D. Lundberg, MD, With James StaceyPublisher: Basic BooksPublication date: March 2001Price: $28.00, hardcover, 336 pages Pathologist George D. Lundberg, MD, served as Editor-in-Chief of The Journal of the American...

Northwestern Medicine Receives $10 Million Gift to Create Urologic Cancer Institute

Northwestern Medicine has received a $10 million gift to fund the creation of a new multidisciplinary institute dedicated to urologic cancers. The Polsky Urologic Cancer Institute of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University at Northwestern Memorial Hospital (Polsky ...

$30 Million Gift to Huntsman Cancer Institute Doubles the Size of Planned Expansion

Peter Huntsman, Chief Executive Officer of the Huntsman Foundation and Chairman and Chief Executive Officer of the Huntsman Cancer Foundation (HCF), recently announced a $30 million gift from the family’s foundation. This donation allows Huntsman Cancer Institute at the University of Utah to...

issues in oncology

Physician Wellness: Time to Heal the Healer

Physician wellness is emblazoned upfront in the news with attention-seeking headlines on a daily basis. The fact that one or two physicians commit suicide every day in this country sometimes elicits more of a sympathetic acknowledgment than a committed call to address it. Moreover, these sobering...

issues in oncology

Artificial Intelligence and the Brave New World of Cancer Diagnostics

A study published in Nature Medicine found that an artificial intelligence program could distinguish between the histologic diagnosis of adenocarcinoma and squamous cell carcinoma.1 Experienced pathologists often struggle to differentiate these tumor types without confirmatory tests. The artificial ...

Norman E. Sharpless, MD: From Director of a Comprehensive Cancer Center to Director of the NCI

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. In this installment of the Living a Full Life series of articles, guest editor Jame Abraham, MD, FACP, interviewed Norman E. ...

lung cancer
issues in oncology

System-Based Intervention to Reduce Racial Disparities in Early-Stage Lung Cancer Treatment

Results from a study published by Cykert et al in Cancer Medicine showed that a pragmatic system-based intervention within cancer treatment centers may eliminate existing disparities in treatment and outcomes for black patients with early-stage lung cancer. “These results show ...

skin cancer

Updated German Guidelines for Basal Cell Carcinoma

The German S2k guidelines for cutaneous basal cell carcinoma were recently updated to include new developments regarding the epidemiology, diagnosis, and histology of the disease. Commissioned by the Dermatologic Cooperative Oncology Group of the German Cancer Society and the German Society of...

kidney cancer
immunotherapy

2019 GU Cancers Symposium: KEYNOTE-426: Pembrolizumab Plus Axitinib vs Sunitinib in Advanced Renal Cell Carcinoma

Results from the randomized, phase III KEYNOTE-426 clinical trial show that first-line therapy with a combination of pembrolizumab and axitinib extended both overall survival (OS) and progression-free survival (PFS) for patients with clear cell metastatic renal cell carcinoma compared with the...

integrative oncology

Advancing the Science and Art of Integrative Oncology

In 2019, we will mark the 20th year of the establishment of the Integrative Medicine Service at Memorial Sloan Kettering Cancer Center (MSK), which helped lay the foundation for the emerging field of integrative oncology. Over the past 2 decades, academic cancer institutions, including The...

lymphoma

Living My Best Life

Five years ago, I was living my dream life. I was under contract as a commentator on Fox News, which necessitated commuting weekly from my home in Los Angeles to New York, and was building a new home in Palm Springs with my partner, Matt Lashey. Not only was my career and personal life going well,...

lung cancer

Encourage Lung Cancer Screening to Prevent Early Deaths

Discussions of benefits and harms from screening of high-risk populations for lung cancer have missed the point. The National Lung Screening Trial (NLST) showed an early and statistically significant major benefit in all-cause mortality from computed tomography (CT) screening.1 Those referred for...

immunotherapy

How Turning ‘Cold’ Tumors Into ‘Hot’ Ones May Improve Response to Immunotherapy

The proliferation of immunotherapeutics in the treatment of cancer over the past decade has revolutionized the way many cancers are treated, especially lung cancer and melanoma, as well as some blood cancers, including leukemia and lymphoma, drastically improving outcomes for many patients with...

myelodysplastic syndromes

Novel Treatments of Myelodysplastic Syndromes

AS PART of The ASCO Post’s continued coverage of the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition, here is an update on seven different studies on new therapeutics in myelodysplastic syndromes (MDS). Among the treatments highlighted here are the erythroid maturation...

immunotherapy

Machine Learning Identifies Multiple Underlying Factors Predicting Response to Immunotherapy

A research team is using a branch of artificial intelligence known as machine learning to better target immunotherapy to those who will benefit. In a recent study published by Leiserson et al in PLOS One, the team used data from a clinical trial of patients with bladder cancer to...

supportive care
symptom management

FDA Approves Caplacizumab-yhdp for Acquired Thrombotic Thrombocytopenic Purpura

Today, the U.S. Food and Drug Administration approved caplacizumab-yhdp (Cablivi) injection, the first therapy specifically indicated, in combination with plasma exchange and immunosuppressive therapy, for the treatment of adult patients with acquired thrombotic thrombocytopenic purpura (aTTP), a...

Taking a Stand: How ASCO Develops Policy Guidance and Position Statements

As a global thought leader in the spheres of cancer care and research, ASCO recognizes the importance of taking a position on certain key issues affecting its members and the patients they serve. As a result, ASCO will, on occasion, release policy guidance and position statements when existing...

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