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issues in oncology

Cost vs Our Values in Cancer Care

An 80-year-old patient with metastatic prostate cancer asked me to discontinue his treatments, which were costing him more than $1,000 every 3 months. Although he had Medicare, he did not have secondary insurance. I told him that I would seek compassionate-care payment from the pharmaceutical...

leukemia

A Lasting Legacy

When Emil J Freireich, MD, retires from the University of Texas MD Anderson Cancer Center on September 1, he will have spent 50 years at the institution and a total of 60 years in the pursuit of curing childhood leukemia as well as other cancers and in the educational development of young...

Community Oncologist Stephen Grubbs, MD, to Lead ASCO’s New Clinical Affairs Department

Stephen S. Grubbs, MD, a community oncologist and managing partner at Medical Oncology Hematology Consultants, PA, in Newark, Delaware, has been named the Senior Director of ASCO’s new Clinical Affairs department. Dr. Grubbs is a longtime ASCO member and volunteer and the Principal Investigator of...

2015–2016 ASCO President Julie M. Vose, MD, MBA, FASCO: Leading During a Year of Historic Changes

Julie M. Vose, MD, MBA, FASCO, began her term as the 2015–2016 President of ASCO at the 2015 Annual Meeting on June 1, 2015. Dr. Vose, a leading expert in the treatment of patients with lymphoma, is the current Neumann M. and Mildred E. Harris Professorial Chair and Chief of the Oncology/Hematology ...

Collective Wisdom: Patient-Centered Care and Research

In 1964, when the first seven physicians who founded ASCO met, I doubt they imagined what a successful Society they were forming. At that time, cancer treatments were just beginning to have some early successes with a few cytotoxic therapies, new radiation modalities, and improved surgical...

An Oncologist’s Memoir

BOOKMARK Title: Megalies: A Memoir Author: Lodovico Balducci, MD Publisher: Resource Publications Publication date: February 28, 2014 Price: $33.00; hardcover, 304 pages Reading a good book produces various sensory responses; a skilled author exerts his or her narrative power on each page,...

lung cancer

ODAC Discussion ‘Constructive’ About Necitumumab for Squamous NSCLC

The U.S. Food and Drug Administration’s (FDA) Oncologic Drugs Advisory Committee (ODAC) favored the approval of necitumumab in combination with gemcitabine and cisplatin for use in first-line treatment of patients with locally advanced or metastatic squamous non–small cell lung cancer (NSCLC). In...

geriatric oncology

Geriatric Oncology: A Geriatrician’s Perspective

“The management of older individuals, including older cancer patients, involves a wisdom developed over a lifetime, thanks to time-consuming listening and painstaking collection and interpretation of clinical details.” —Lodovico Balducci, MD It is not simple to be a geriatrician in a world of...

cost of care

Calculating the Value of Cancer Drugs

For nearly a decade, Peter B. Bach, MD, MAPP, Director of the Center for Health Policy and Outcomes at Memorial Sloan Kettering Cancer Center in New York, has been a leading voice in sounding the alarm over the escalating cost of cancer drugs and in seeking a solution to the problem. In 2012, Dr....

supportive care
pain management
palliative care
symptom management

Managing Cancer Pain at the End of Life

Cancer-related pain does not exist in a vacuum. To effectively treat it, clinicians should understand the contributing factors. Proper assessment and management of cancer pain at the end of life can significantly alleviate patient suffering, according to Eduardo Bruera, MD, FAAHPM, Department Chair ...

lung cancer

Immune Checkpoint Inhibitors: The Dawn of a New Era for Lung Cancer Therapy

The therapeutic paradigm for lung cancer has changed rapidly over the past few years toward individualized therapy. For certain subsets of patients, molecularly targeted agents have resulted in robust gains in overall survival and quality of life. However, for the majority of patients with...

breast cancer

Studies Explore New Avenues to Pursue in Metastatic Triple-Negative Breast Cancer

Two agents targeting novel pathways show promise in metastatic triple-negative breast cancer, according to separate studies presented at the 2015 ASCO Annual Meeting and reviewed at the Best of ASCO® meeting by Steven J. Isakoff, MD, PhD, of Massachusetts General Hospital, Boston. The first study...

lymphoma

Increased Lifetime Risk of Cardiovascular Disease for Patients Treated for Hodgkin Lymphoma

Survivors of Hodgkin lymphoma treated as adolescents or adults are at increased risk of cardiovascular diseases throughout their lives, according to results of a retrospective cohort study of 2,524 Dutch patients followed for a median of 20 years. “Treating physicians and patients should be aware...

gynecologic cancers

How Carolyn D. Runowicz, MD, FASCO, Is Shaping the Future of Gynecologic Cancers

Carolyn D. Runowicz, MD, ­FASCO, has worn just about every hat in the field of oncology—clinician, professor, researcher, administrator, and even cancer survivor.  Currently the Executive Associate Dean for Academic Affairs and Professor in the Department of Obstetrics and Gynecology at the Herbert ...

The Flipped Classroom: Swapping the Traditional Lecture Hall for an Online Version

Despite enormous advances in modern medicine and the explosion of biomedical information over the past century, the way medical education is taught in the United States is stuck in a format that does not optimize learning, according to Charles Prober, MD, Senior Associate Dean for Medical Education ...

ASCO Guidelines: A Collaborative Effort

The ASCO Guidelines Program has worked with other professional societies and guideline development organizations in an effort to expand the ASCO guideline portfolio and harmonize recommended care options across prominent guideline development groups. For ASCO, this effort began with a systematic...

solid tumors

State-of-the-Art Management of Germ Cell Tumors Produces High Cure Rates

Pasquale W. Benedetto, MD, the Leonard M. Miller Professor of Medicine at the University of Miami/Sylvester Comprehensive Cancer Center, recently spoke at the 2015 New Orleans Summer Cancer Meeting about his approach to diagnosing and treating germ cell tumors in men.1 The ASCO Post was there to...

issues in oncology

New Techniques in Oncologic Surgery and Radiology: Some Worth the Expense, Some Not So Much

In recent years, patients with cancer have had the benefit of much high technology: proton-beam radiotherapy, intensity-modulated radiation therapy, various minimally invasive surgery techniques, and robots in the operating room. They all receive hype in the professional and public press, and...

supportive care

Suicide After Cancer: Understanding the Challenges Across the Treatment Trajectory

Suicidal thoughts and impulses are among the most challenging symptoms in patients with cancer, and they may occur both during and after treatment. It has long been known that a cancer diagnosis carries an increased risk for suicide, but the problem is not widely addressed. Suicide is one of the...

International Psycho-Oncology Society and American Psychosocial Oncology Society Meet to Foster Psychosocial Oncology Worldwide

The International Psycho-Oncology Society (IPOS) has partnered with the American Psychosocial Oncology Society (APOS) for the 17th World Congress of Psycho-Oncology, held in late July 2015 in Washington, DC. Its theme, “From National to Global: Implementing the Standard of Psychosocial Care in...

head and neck cancer

HPV16 DNA in Post-Treatment Oral Rinses Signals Poor Prognosis in Oropharyngeal Cancer

Detectable oral HPV16 DNA in oral rinses post treatment for oropharyngeal cancer appears to be a harbinger of poor prognosis and can predict recurrence. Oral HPV16 DNA rinses are a potential tool for long-term tumor surveillance, according to a study selected for the Best of ASCO® 2015.1 “The goal ...

issues in oncology

Our Patients Are the True Heroes of Cancer Research

A few weeks ago, I read an op-ed1 in The New York Times written by Stan Collender, a patient with Merkel cell carcinoma, a rare and aggressive type of skin cancer. In his article, he described his participation in a clinical trial for a new drug he is hoping will stem progression of his cancer and...

multiple myeloma

Elotuzumab Ushers in a New Era in Myeloma Therapy

The long wait for monoclonal antibodies for the treatment of multiple myeloma is over. In the landmark ELOQUENT-2 study, reviewed in this issue of The ASCO Post, Lonial and colleagues convincingly demonstrate the effectiveness of elotuzumab, a monoclonal antibody directed against SLAMF7, in the...

Let It Be Hard

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

geriatric oncology

ASCO 2015: Geriatric Oncology Highlights

The theme of the 2015 ASCO Annual Meeting, Illumination and Innovation, is especially appropriate as we consider the field of geriatric oncology. For too long, the elderly cancer patient has remained in the dark regarding treatment planning, clinical trial enrollment, and shared decision-making....

Conquer Cancer Foundation Donor Spotlight: Fibrolamellar Cancer Foundation

When Tucker Davis was diagnosed with fibrolamellar hepatocellular carcinoma (FL-HCC) in 2008, there was very little information about this very rare cancer and, as Tucker would soon discover, even fewer treatment options available. An annoying cough and sharp pain radiating down his back leg...

issues in oncology

Radiation Oncology Looks to Collaboration for Big Data Systems

Radiation oncologists dream of a day when, faced with a new patient sitting in their office, they can quickly consult a computer database offering specific treatment recommendations based on accurate, freshly updated data from millions of previously treated patients with cancer. To hasten that day, ...

head and neck cancer

HPV-Positive Head and Neck Cancer: When Can Chemotherapy Be Omitted?

Are there patients with locally advanced squamous cell carcinoma of the head and neck associated with human papillomavirus (HPV) for whom chemotherapy can be omitted? Experts debated this question at the 2015 Debates and Didactics in Hematology and Oncology Conference in Sea Island, Georgia,...

About the Summit

The research summit was part of the ASCO Obesity Initiative, which sought to increase awareness of the links between obesity and cancer and to foster research in this area that evaluated the impact of weight loss and increased activity on cancer outcomes. There have been hundreds of observational...

cost of care

Making Their Voices Heard: 118 Oncologists Speak Out About Stemming the High Cost of Cancer Drugs

In a bold move to shed light on the ramifications of the ever-increasing cost of cancer drugs for patients with cancer and for the health-care system, 118 prominent oncologists came together to write a commentary in Mayo Clinic Proceedings detailing their concerns.1 To learn more about these...

issues in oncology

Our Children’s Future Is Our Responsibility

Cancer prevention is a child-care issue. With many of cancer’s instigators planting their seeds during childhood, we—as a profession and as a nation—must seize this important window of opportunity to protect the health and well-being of future generations. Current estimates suggest that up to...

lung cancer

First-Line Nivolumab/Ipilimumab Combination in Non–Small Cell Lung Cancer Shown to Be Tolerable

For advanced non–small cell lung cancer (NSCLC), first-line treatment with combined immune checkpoint blockade—in novel doses and schedules—was associated with deep and durable responses, encouraging progression-free survival, and much better tolerability than has been previously observed with...

issues in oncology
global cancer care

Over Three-Quarters of People With Cancer Worldwide Have No Access to Safe Surgery

Over 80% of the 15 million people diagnosed with cancer worldwide in 2015 will need surgery, but less than one-quarter of them will have access to proper, safe, affordable surgical care when they need it, according to a major new Commission examining the state of global cancer surgery. The...

Scotty’s Gift

The following essay by Emil J. Freireich, 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. I learned...

global cancer care

Measuring Global Health Issues, Seven Billion Times

BOOKMARK Title: Epic Measures: One Doctor. Seven Billion PatientsAuthor: Jeremy N. SmithPublisher: Harper WavePublication date: April 7, 2015Price: $26.99; hardcover, 352 pages Health measures are essential tools in assessing public health and safety. Collecting large amounts of data is a laborious ...

breast cancer

Varied Reactions to Study Finding That Preventing Ipsilateral Recurrence Did Not Prevent Death From Breast Cancer

Women diagnosed with ductal carcinoma in situ have a low risk of dying of breast cancer, according to an observational study looking at data from 108,196 women diagnosed with ductal carcinoma in situ between 1988 and 2011.1 The breast cancer–specific mortality rate for these women was 1.1% at 10...

Children’s Hospital of Philadelphia Is a Founding Member of the New Pediatric Preclinical Testing Consortium

Addressing the relatively small number of new cancer drugs for children, a selective group of leading research centers is joining a new federally funded research consortium aimed at bringing scientific rigor and a concentrated effort to identifying new drug candidates for pediatric clinical trials. ...

issues in oncology

A Cancer Care Model for Rural Areas

Rural cancer patients have long had to adjust to difficult geographic and financial barriers to access high-quality cancer care. These problems are exacerbated by today’s fiscal challenges, which have disrupted many of the small community practices that once served rural communities. In 2006, the...

global cancer care

Cancer: Increasing Awareness and Addressing This Lethal Disease on the Global Stage

The ASCO Post is pleased to introduce this special focus on the worldwide cancer burden, beginning in this issue with a close look at the cancer incidence and mortality rates in the United States. The aim of this special feature is to highlight the global cancer burden for various countries of the...

skin cancer

Anti–PD-1 Superior to Chemotherapy in the KEYNOTE-002 Trial

Immunotherapy, once considered a niche treatment for a few specific cancers, has rapidly emerged as an additional pillar of cancer therapeutics. With the proliferation of promising results, clinical trials, and new drug approvals, one cannot help but be amazed that only 3 years have elapsed since...

cost of care
health-care policy

ASCO Asks CMS to Revisit Its Payment Policy to Support Optimal Cancer Care

ASCO has called on the Centers for Medicare & Medicaid Services (CMS) to reconsider revisions to payment policies that could be administratively burdensome to oncology practices and result in reimbursement that inadequately supports optimal cancer patient care. In a comment letter to CMS on...

issues in oncology

Focus on Geriatric Oncology: ASCO Prepares for an Aging Nation

The United States—and much of the world—is experiencing unprecedented demographic shifts in the population of older people, defined as people age 65 and over. In 2012, the population of older people in the United States reached a never-before seen height of 43.1 million, a number that will more...

supportive care
survivorship

Patient and Survivor Care Studies Yield Useful Results to Improve Quality of Life

Recent studies have yielded useful results that clinicians can put into practice, some right now, to help improve the quality of life for patients with cancer. Concerns addressed included cachexia, pain, “chemobrain,” and fertility preservation. At the Best of ASCO®/Chicago meeting, Arif ­Kamal,...

lung cancer

Nivolumab in Lung Cancer Supported by Updated Trial Data

For the treatment of advanced squamous non–small cell lung cancer (NSCLC), the programmed cell death protein 1 (PD-1) antibody nivolumab (Opdivo) continues to show results in key trials that now report 18-month data. The updates were reported at the 16th World Conference on Lung Cancer in Denver,...

lung cancer

AZD9291 Updates Encouraging for Treatment-Resistant NSCLC

At the 16th World Conference on Lung Cancer, several studies showed consistent activity with the investigational third-generation inhibitor AZD9291 in patients with advanced non–small cell lung cancer (NSCLC) that is resistant to epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors....

lung cancer

Patients Whose Treatment Included Bevacizumab Were More Likely to Experience Toxicity but Less Likely to Be Hospitalized

A study among patients with advanced non–small cell lung cancer (NSCLC) treated with carboplatin-paclitaxel or carboplatin-paclitaxel-bevacizumab (Avastin) found that those receiving the triplet were more likely to experience a toxicity event but less likely to be hospitalized within 180 days after ...

breast cancer

The Race of My Life

I've lived my adult life by three guiding principles I learned as an adventure racer: to set goals, to determine how to achieve them, and to persevere in the face of adversity. Those standards helped me complete more than 70 marathons and 7 Ironman competitions, and they helped me conquer breast...

solid tumors

A Snapshot of Early Immunotherapy

Over the past several years, immunotherapy has had a renaissance of sorts, emerging as one of the most active areas in cancer research. For instance, we have seen the therapeutic promise of disrupting the programmed cell death protein 1 (PD-1) and its ligand (PD-L1) immune checkpoints in cancer,...

hematologic malignancies

Early Research of David G. Nathan, MD, Ushered in the Field of Pediatric Hematology

When David G. Nathan, MD, was admitted to Harvard University in 1947, he had every intention of becoming an English professor. It was only his lack of writing talent that dissuaded him from a life in the classroom and propelled him into a medical career that has spanned more than 5 decades and has...

Confessions of a Neurosurgeon

BookmarkTitle: Do No Harm: Stories of Life, Death, and Brain SurgeryAuthor:  Henry Marsh, CBE, FRCSPublisher: Thomas Dunne BooksPublication date: May 26, 2015Price: $25.99, hardcover; 288 pages “I often have to cut into the brain and it is something I hate doing. With a pair of diathermy forceps I ...

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