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colorectal cancer
issues in oncology

Many Patients Do Not Receive Surveillance Colonoscopies Following a Diagnosis of High-Risk Adenomas

A population-based study examining patient receipt of a surveillance colonoscopy 3 years after the removal of high-risk adeonomatous polyps has found that the procedure was underutilized and varied by health-care system, patient age, and number of adenomas found. Strategies to improve adherence to...

geriatric oncology

Leader in Geriatric Oncology, Arti Hurria, MD, FASCO, Dies at Age 48

ARTI HURRIA, MD, FASCO, died tragically on November 7, 2018, from injuries sustained in a traffic accident. Dr. Hurria was a national leader in geriatric oncology, embracing the age-associated nuances of the elderly, and leading initiatives and research that advanced this specialty field. “The...

leukemia

A Single CAR T Cell Cured My Chronic Lymphocytic Leukemia

The combination of symptoms I began experiencing in the spring of 2007, including night sweats so severe they woke me from a sound sleep and midline chest wall swelling so extreme I needed a larger shirt size, drove me to seek immediate medical attention. A series of imaging and blood tests...

issues in oncology
breast cancer
genomics/genetics

Obligation to Evaluate Racial/Ethnic Features That May Affect Outcomes for Patients With Breast Cancer

"WE ABSOLUTELY have an obligation to evaluate all of the features describing our patients with cancer when we are trying to figure out why some patients do better than others,” Lisa A. Newman, MD, MPH, reminded the nearly 700 participants at the 2018 Lynn Sage Breast Cancer Symposium, hosted by...

A Pediatric Oncologist Recounts 7 Years at a Hospital in Jerusalem

Elisha Waldman, MD, is a pediatric oncologist and Associate Chief in the Division of Palliative Care at the Ann and Robert H. Lurie Children’s Hospital in Chicago. He grew up in a Connecticut suburb, the son of a conservative rabbi. Early on, Dr. Waldman majored in religious studies and felt...

issues in oncology

Focus on the Rocky Mountain Oncology Society

Formed in 1991, the Rocky Mountain Oncology Society (RMOS), a Chapter Member of the Association of Community Cancer Centers (ACCC) and State Affiliate of ASCO, serves as the voice for Colorado’s multidisciplinary cancer care teams and the patients they serve. Representing the common interests of...

At Sea

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,...

How to Tell Patients They Have Cancer

The following essay by Stan Winokur, MD, is adapted, with permission, 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...

lung cancer

Lung Cancer Researcher Melissa Johnson, MD, Benefits From Father’s Perspective as Career Military Officer

Lung cancer researcher Melissa Johnson, MD, is a self-described “military brat,” whose father was a career officer in the Marine Corps, serving for more than 35 years. She was born in Oklahoma City and moved nine times during her childhood. When Dr. Johnson was in high school, her father was...

When Illness and Culture Collide

“‘Sickness’ is what is happening to the patient. Listen to him. Disease is what is happening to science and to populations.” —Lawrence Weed, MD, 1978 America’s massive health-care system is highly complex, with its own unique language, methods, technologies, and scientific approaches, developed and ...

issues in oncology

Electronic ‘Datarrhea’ and Wellness

THE INTRODUCTION of the electronic health record (EHR) was supposed to lead us to a utopian world for health-care delivery in America. The Patient Protection and Affordable Care Act, signed into law on March 23, 2010, promoted its implementation by providing financial incentives.1 The Centers for...

A Career Path Shaped by Unlimited Possibilities for Clifford A. Hudis, MD, FACP, FASCO

In this installment of the Living a Full Life series, guest editor Jame Abraham, MD, interviewed Clifford A. Hudis, MD, FACP, FASCO, ASCO’s Chief Executive Officer. Prior to his current position, Dr. Hudis served in a variety of roles at ASCO, including President during ASCO’s 50th anniversary...

issues in oncology
immunotherapy

The Abscopal Effect: A Reemerging Field of Interest

For the past 50 years or more, oncologists have designed their treatment plans around the three pillars: surgery, chemotherapy, and radiation. Now, with a series of recent successes, immunotherapy is rapidly reemerging as the fourth pillar in the oncologic armamentarium. Despite major advancements...

2018 San Antonio Breast Cancer Symposium Award Winners Announced

THE SAN ANTONIO Breast Cancer Symposium (SABCS) and the American Association for Cancer Research (AACR) will honor three researchers for their work in breast cancer at the upcoming 2018 SABCS in December. They are Ian Smith, MD, FRCP, FRCPE, who will receive the SABCS William L. McGuire Memorial...

issues in oncology

Patients With Cancer in Rural America Remain Underserved

Despite growing national awareness of health-care inequities, the plight of rural Americans diagnosed with cancer has persistently remained inadequate. Speaking with The ASCO Post, Jan Probst, PhD, Professor at the Arnold School of Public Health, University of South Carolina, Columbia, noted, “We...

pain management
supportive care

Parenteral Opioid Shortage Threatens Appropriate Pain Care for Patients With Cancer

In response to the opioid-overdose epidemic, several measures have been put in place, such as the reclassification of hydrocodone as a Schedule II opioid and new requirements for physician review of prescription drug–monitoring program databases in most states. Moreover, the Surgeon General and...

issues in oncology

Inflammation, DNA Damage, and Cancer

The link between inflammation and cancer is a field of growing interest in the oncology community. Biologists have theorized that simultaneous DNA damage and cell division during inflammation could lead to cancer. To shed light on this important issue, The ASCO Post recently spoke with Jennifer...

Steven A. Rosenberg, MD, PhD, Works to Unmask Cancer’s Achilles Heel

Steven A. Rosenberg, MD, PhD, knew from the start of his medical career that if treatments for cancer were to become curative, research in new therapies would have to move away from the mainstay one-size-fits-all approach of systemic chemotherapy to an innovative, personalized strategy that...

Atlantic Health System Announces Collaboration to Further Patient Access to Innovative Cancer Therapies

The Atlantic Health System, an integrated health-care delivery system, recently announced a partnership with the Translational Genomics Research Institute, an affiliate of City of Hope, and Origin Commercial Ventures to create a new platform to deliver economically viable immunotherapies and other...

issues in oncology

Modern Clinical Trials: Engaging Stakeholders at the Front Lines of Care

Randomized clinical trials have been providing high-quality evidence for decades, but there are limitations to the traditional design. At the 2018 ASCO Quality Care Symposium, George J. Chang, MD, MS, FACS, FASCRS, discussed the need to modernize clinical trials, so they continue to provide...

cost of care

Mary K. Buss, MD, MPH, and Candice A. Johnstone, MD, MPH, on Financial Toxicity During Treatment and Beyond

Mary K. Buss, MD, MPH, of Beth Israel Deaconess Medical Center, and Candice A. Johnstone, MD, MPH, of the Medical College of Wisconsin, discuss a session they co-chaired on the perspective of stakeholders on the cost of cancer care, what drives patients’ preferences when faced with mounting medical ...

palliative care
survivorship
myelodysplastic syndromes
leukemia

Suleika Jaouad on Making the Most of a Life Interrupted: A Young Adult Perspective on Cancer

Suleika Jaouad, an Emmy Award–winning writer, advocate, and cancer survivor who was diagnosed at age 22 with myelodysplastic syndrome and acute myeloid leukemia, discusses what she has learned about coping with cancer, learning from it, and growing beyond it.

Expert Point of View: Julien Taieb, MD, PhD

The invited discussant for the CheckMate-142 findings was Julien Taieb, MD, PhD, Professor of Medicine at Paris Descartes University in France. Dr. Taieb called the findings “impressive” but said longer follow-up is needed, especially since median outcomes have not yet been reached. After a...

gastrointestinal cancer

Neoadjuvant Immunotherapy Yields Major Response in Colon Cancer Subset

In a small study of patients with early-stage colon cancer, neoadjuvant ipilimumab (Yervoy) plus nivolumab (Opdivo) produced major pathologic responses in 100% of patients with mismatch repair (MMR)-deficient tumors but in none of the patients with MMR-proficient tumors, researchers reported at the ...

Expert Point of View: Richard K. Valicenti, MD, MA, FASTRO

Discussant of the SPPORT trial abstract at the ASTRO Annual Meeting, Richard K. Valicenti, MD, MA, FASTRO, Chair and Professor of Radiation Oncology at the University of California Davis Comprehensive Cancer Center, commented that the interim results of this study along with data from other...

lung cancer

Lung Cancer Screening: Proven Effective but Still Fighting for Acceptance

In 2010, the long-awaited findings from the National Lung Screening Trial (NLST) revealed that participants who received low-dose helical computed tomography (CT) scans had a 15% to 20% lower risk of dying of lung cancer than participants who received standard chest x-rays. In response, the U.S....

prostate cancer
symptom management

NCRI 2018: COMPARE Study: Side Effects and Quality of Life Associated With Prostate Cancer Care

Men who have been newly diagnosed with prostate cancer say they would trade some improvement in their odds of survival for improvements in side effects and quality of life, according to research presented by Ahmed et al at the 2018 National Cancer Research Institute (NCRI) Cancer Conference...

ASCO in the Community: Listening and Learning From Our Patients in Appalachia

2018–2019 ASCO President Monica M. Bertagnolli, MD, FACS, FASCO, is putting the words of her presidential theme— “caring for every patient, learning from every patient” —into action. During her term, she and other ASCO leaders will be traveling to local communities around the United States to...

issues in oncology

Novel Physician-Driven Practice Model Offers Alternative to Community Oncologists

Three leading oncology practices have united with partners in technology and finance to launch OneOncology, a physician-driven company that aims to unite more than 225 community oncology providers from 60-plus locations. Altogether, OneOncology will treat nearly 158,000 cancer patients a year. The...

palliative care

Developing Patient-Centered Palliative Care From Diagnosis to End of Life

In December, The University of Texas at Austin Dell Medical School will launch an innovative cancer care model called the CaLM (cancer life re-imagined) Clinic as part of its new cancer center, the Livestrong Cancer Institutes. The goal of the Livestrong Cancer Institutes and the CaLM Clinic is to...

issues in oncology

Do Incident Learning Systems Prevent Medical Errors?

ACCORDING TO a study by Johns Hopkins, medical errors are the third leading cause of death in the United States.1 Lakshmi Santanam, PhD, tackled such sobering data at the 2018 ASCO Quality Care Symposium. “Incident learning systems are not just about medical errors or data; it’s kind of a first...

issues in oncology

Challenges and Successes of Adopting an Oncology Care Model

IN ORDER TO rein in the untenable rise in costs while delivering high-value cancer care, the Centers for Medicare & Medicaid Innovation developed a new payment system—the Oncology Care Model. At the 2018 ASCO Quality Care Symposium, Cardinale B. Smith, MD, PhD, shed light on the system’s...

issues in oncology
palliative care

End-of-Life Dashboard Drives Transformation With Actionable Personalized Data

A NUMBER OF STUDIES from the palliative care literature have shown that nonbeneficial health-care interventions actually may harm patients’ quality of life, increase patient and caregiver distress, and drive costs. Yet, according to the National Cancer Institute, about 30% of all cancer spending...

lung cancer
immunotherapy

Atezolizumab Plus Chemotherapy Improves Outcomes in Small Cell Lung Cancer

ATEZOLIZUMAB (TECENTRIQ), an anti–program cell death ligand 1 (PD-L1) antibody, combined with carboplatin/ etoposide as first-line treatment for extensive-stage small-cell lung cancer (SCLC) improved overall and progression-free survival and may represent a new standard of care, according to...

issues in oncology

Cancer Taught Me to Help Patients Find Healing Hope

AS AN INTERNIST, I strived to give patients hope by prescribing therapies that increased their chance—their hope—of the best outcome and by encouraging them with hopeful words. My own hope was to care for patients until I was old. Just weeks after celebrating my 36th birthday, I was diagnosed with ...

lung cancer

Expert Point of View: Fiona Blackhall, MD, PhD

FORMAL STUDY discussant, Fiona Blackhall, MD, PhD, of the University of Manchester, UK, welcomed brigatinib (Alunbrig) as a new first-line option for ALK-positive patients but said, “In the absence of comparisons of next-generation ALK inhibitors, it will take some time to determine if there is...

symptom management

Can Patients Use Topical Skin Creams During Radiation Therapy?

Contrary to the advice most patients with cancer receive when they go through radiation treatment, topical skin treatments, unless applied very heavily, may not increase the radiation dose to the skin and can be used in moderation before daily radiation treatments, according to findings from a new...

hematologic malignancies
leukemia
genomics/genetics

Without Genomic Sequencing, I Would Not Be Alive Today

The extreme fatigue I experienced during the winter of my fourth year in medical school, in 2003, was easily attributable to the rigors of my medical training and the lack of sleep that comes from trying to keep up with an intensely busy schedule. I was looking forward to resting and recuperating...

Living a Full Life After a Diagnosis of Cancer

BOOKMARK Title: Here We Grow: Mindfulness Through Cancer and BeyondAuthor: Paige DavisPublisher: She Writes PressDate: May 2018Price: $22.95, paperback, 154 pages Since the publication of Dr. Paul Kalanithi’s best-selling book, When Breath Becomes Air, about his diagnosis of cancer and untimely...

Family Archivist Holds Joyful Memories Amid Grief of Losing Loved Ones

BOOKMARK Title: The Trail to Tincup: Love Stories at Life’s EndEditors: Joyce Lynnette HockerPublisher: She Writes PressPublication date: May 2018Price: $23.95, hardcover, 288 pages Human mortality is embedded in the day-to-day challenges of clinical oncology; a cancer diagnosis is a reality...

supportive care
integrative oncology

Acupuncture for Joint Symptoms Caused by Aromatase Inhibitors

Arthralgia is a common and debilitating adverse effect experienced by patients with breast cancer who are being treated with aromatase inhibitors, often resulting in poor adherence. And premature treatment discontinuation can negatively impact disease-free and overall breast cancer survival....

Never a Doubt About a Career in Medicine for Anne S. Tsao, MD

There was no epiphany or family influences, as long as she can remember; Anne S. Tsao, MD, always wanted to be a doctor or, because of her love for caring for sick animals, a veterinarian. Dr. Tsao was born in Fountain Creek, Pennsylvania, but her parents moved to a suburb just outside of Chicago...

issues in oncology

Cancer Care in the U.S. Prison System

A health-care system is evaluated by various metrics: one is how it cares for its most vulnerable patients. The United States spends far more on health care than any nation in the world, yet access to high-quality oncology services remains elusive to certain minority populations—none more so than...

solid tumors
breast cancer

The Persephone Trial Reconsidered

Persephone is a 4,088-patient trial that Helena Margaret Earl, MBBS, PhD, reported at the 2018 ASCO Annual Meeting as establishing that 6 months of trastuzumab (Herceptin) is not inferior to 12 months in 4-year survival without invasive or local regional recurrence or distant metastases. Dr. Earl...

solid tumors
breast cancer

The Persephone Trial Reconsidered

The Persephone presentation by Helena Margaret Earl, MBBS, PhD, got a lot of publicity after a pre–ASCO Annual Meeting press release, suggesting that 6 months of adjuvant trastuzumab (Herceptin) is enough. The advice of experts has been that the evidence is inconclusive, but I have not heard a...

issues in oncology
health-care policy

Health-Policy Forum Focuses on New Care-Delivery Paradigms

What was an MBA doing at the podium of a clinical oncology meeting? Ten years ago or so, that might have been surprising. But in an era of rapid change—in therapies, costs, payment models, and practice—it only makes sense. Amy Porter-Tacoronte, MBA, Health System Chief Administrative Officer at the ...

Expect Patient Concerns and Some Fear About Radiation Therapy for Early-Stage Follicular Lymphoma

Radiation therapy to the limited disease in patients with early-stage follicular lymphoma “achieves local control in over 90% of lesions, and almost 50% of patients remain free of any lymphoma event (cured) for decades,” Joanna C. Yang, MD, MPH, and Joachim Yahalom, MD, wrote in a recent editorial...

solid tumors

2018 ASTRO: SABR-COMET: Stereotactic Ablative Radiation Therapy for Oligometastatic Tumors

In the first randomized, phase II clinical trial of its kind, researchers have shown that an aggressive form of high-precision radiation therapy can increase survival in patients with oligometastatic tumors. These findings were presented by Palma et al in the plenary session at the 60th Annual ...

breast cancer

2018 ASTRO: Radiation After Breast-Conserving Surgery in 'Good-Risk' DCIS

A subset of patients with low-risk breast cancer is highly unlikely to see cancer return following breast conservation surgery, but can lower that risk even further with radiation therapy, finds a new long-term clinical trial report. These 12-year follow-up data from the only prospective,...

prostate cancer
issues in oncology

2018 ASTRO: Radiation Therapy Outcomes in African American Patients With Prostate Cancer

A new analysis of genetic data from a large prospective registry and clinical data from several randomized trials indicates that African American patients may have comparatively higher cure rates when treated with radiation therapy than Caucasian patients. The study, which is the first report...

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